Knuckle Cracking & OA: Surprising Findings

  • Cracking knuckles does not cause OA
  • Studies show no increased risk, even in lifelong crackers
  • 34% of 11-year-olds crack their knuckles. This increases in incidence to 54% of seniors older than 78
  • Cracking may lower OA incidence in the thumb joint
  • Leads to momentary reduction in tension, stretches tendons, and improves joint motion.
  • Often involves an audible “pop” (with the release of carbon dioxide and other gases, similar to when the spine is manipulated).
  • May develop as learned or conditioned behaviour, continues as a habit, but may also provide relief due to tendons and their associated muscles being lengthened

Are There Risks to Cracking Knuckles?

Rare, but excessive force or frequency may cause:

  • Joint cartilage damage
  • Ligament/tendon strain, tears or dislocation
  • Localized swelling
  • Pain

If cracking causes pain, it’s time for a professional assessment.

Chiropractic Care & Hand OA

OA is a disabling this disease and little research has been done to provide clear evidence-based treatment guidelines, including the lack of curative or disease-modifying treatments.

Dr. Horowitz believes that conservative hand treatments including joint mobilization and manipulation should be considered if you have mild to moderate finger/hand arthritis. Other helpful treatments include:

  • Ultrasound therapy
  • Cross friction tendon therapy
  • Gentle muscle/tendon stretching

Since cracking the knuckles begins in childhood, increases with age, and begins well before osteoarthritis affects the hand and fingers rathe than due to OA, this suggests that cracking may provide relief for overused joints, tendons and deep finger and wrist ligaments.

Learning how to stretch your forearm and hand muscles and tendons is something that children should be taught at a young age and adults would continue to benefit from this as well.

If you have a joint that has completely lost it’s motion and is fused, joint manipulation and mobilization should not be attempted.

Just as when you stretch your neck or low back when twisting it is best to stretch slowly and gently, without the goal of haring a crack.