The child's joints are cracking. From cause to solution

The causes of this crunch have been the subject of controversy in the medical literature since at least the 1930s, but agreement among scientists has never been reached.

Crunching in joints

- This is a “crackling” sound that occurs during passive or active movements. Most often, a crunch occurs when the fingers are deliberately bent (stretched) to an extreme position. Crunching can occur in many joints, such as the spine, hip, wrist, elbow, shoulder, fingers, knees, jaw and others. The crunch occurs due to the formation of small gas cavities in the joint, which can sharply increase the volume of intra-articular space (occurs when we stretch the finger).

Using magnetic resonance imaging, Canadian researchers were able to answer the question of why a crunching sound is heard when you pull a finger. This time, scientists led by Professor Gregory N. Kawchuk from the University of Alberta in Edmonton resorted to the achievements of 21st century technology. They built a device that made it possible to pull a finger while the hand was in the tomograph. The tomograph recorded the process at a speed of 3.2 frames per second.

As a result, it was possible to establish that the cause of the sound is a phenomenon that physicists call tribonucleation. When two solid surfaces are immersed in a liquid containing dissolved gas, their joining and separation can cause small gas bubbles to appear. In technology, tribonucleation is observed, for example, in bearings. In the case of finger crunching, bones act as hard surfaces, surrounded by synovial fluid, which fills the joint cavity.

In each case, the crunching and "splitting" of the joint was associated with the rapid appearance of a gas-filled cavity, a bubble in the synovial fluid - an extremely slippery substance that moistens the joints. When the surface of the joint suddenly “spreads”, there is not enough fluid to fill the volume of the joint, so a cavity is created, and this leads to the production of sound.

Gregory Kovchuk compares the behavior of the joint to two wet glass plates placed next to each other. They are very difficult to separate, since the water film between them creates resistance that must be overcome. That is, the sound that the tape makes, if you tear the ego off the wall, then it causes this sound.

And its cause is a cavity that quickly forms inside the joint. The working title of the study (“Pull My Finger”) reflected its essence - this is exactly how the observation took place, which was recorded using MRI and showed what was happening inside the joints. To find answers, the research team needed someone who could crack knuckles to order, since most people who are able to “crack” cannot always get all their fingers to crack and, after a standard break, do it again. The subject's fingers were alternately placed in a tube connected to a cable, which was slightly stretched until the joint cracked. The crunch was recorded on the MRI in real time and occurred every 310 milliseconds.

Conclusion

Causes of crunching in joints

Causes of “crunching in the bones” - the so-called. crepitus - can be as follows:

• Congenital features of connective tissue. The elasticity of the ligaments and joint capsule is determined genetically. Some people have joint hypermobility - they say that they bend in all directions. If you can, for example, extend your arm at the elbow more than 180°, an anatomical feature may cause clicks in the joint. Another “hereditary” reason is insufficient production of joint lubrication.
• Gas bubbles. The viscous synovial fluid that lubricates the joint can form dioxide bubbles when pressure on the joint surfaces is suddenly released. You suddenly unloaded a limb, and when you took the next step you heard a pop in your knee? Don't worry, it's harmless.
• Tendon movement. When the joint flexes and extends, the tendon also shifts. It sometimes clicks into place when it clicks into place. Most often observed at the age of 10-19 years.
• Teenagers grow too fast. During adolescence, children grow in leaps and bounds, which is why the proportions of their body may be disrupted and their joints may not have time to “adjust.” In the absence of other pathologies, teenage cracking in the joints will go away on its own by the age of 16-24.
• Developmental anomalies. The articular surfaces may not coincide - the edges of the bones protruding from the articular capsule provoke a characteristic sound. Most abnormalities of the musculoskeletal system, which can cause crunching in the joints of the legs, are diagnosed by doctors in the first 7 years of a child’s life. For example, crunching when rotating the foot can cause flat feet.
• Hormonal and metabolic disorders. Age-related hormonal changes (male and female menopause), thyroid diseases and other factors of hormonal imbalance affect the elasticity of the joint. Also, crunching in the joints can be caused by uric acid deposits due to gout, arthropathy due to diabetes mellitus and other metabolic pathologies.
• Taking hormonal drugs. Oral contraceptives and drugs based on glucocorticosteroids can cause joint cracking. It disappears after completing the course or changing the drug.
• Injuries. If crunching and pain in the joints occurs after an injury or strenuous physical activity, you should consult a doctor. Sometimes the joint simply “dries out” due to a lack of synovial fluid, in which case it needs rest and supportive care for 2-3 weeks. And sometimes an already worn-out joint crunches - you need to rush to a rheumatologist to save it.
• Long immobility. For normal production of joint lubrication, the joint must experience moderate physical stress. With a sedentary lifestyle, the joint glides poorly and begins to crunch, and weakness of the ligamentous apparatus is observed. If the cause of joint immobility was an injury, you should consult a rehabilitation doctor who will help restore its functionality without consequences.
• Age-related changes and diseases. Among patients over 60 years of age, inflammatory or degenerative diseases in the joints and adjacent muscles are common. They are less commonly diagnosed in young people.

Excess weight, uncomfortable shoes, and an uncomfortable workplace can also cause crunching and pain in the joints due to improper load distribution.

Causes of finger arthritis and risk groups

At its core, arthritis is an inflammatory process. It develops in the joints of the limbs, and, more precisely, in the phalanges of the fingers. This disease rarely occurs on its own. Almost always it appears against the background of previous infections, rheumatic or metabolic problems.

Medicine names different causes of arthritis of the fingers:

• Most often this disease appears in older people;
• minor injuries, damage or cracks to bones;
• improper functioning of the endocrine glands;
• past infectious diseases, including colds or flu;
• hereditary predisposition;
• surgeries can also cause arthritis in the fingers;
• unhealthy and sedentary lifestyle;
• alcohol abuse and smoking;
• poor blood circulation, due to which the joints do not receive enough nutrients;
• constant stress that negatively affects the composition of joint lubrication.

The cause of arthritis in the fingers may depend on the type of disease. The doctor can explain it in more detail after making a diagnosis.

How do you know when it's time to see a doctor?

In itself, crunching in the joints is not a pathology and is even reassuring - with advanced joint diseases it is physiologically impossible.

You need to be concerned about a cracking sound in a joint if it is accompanied by:

• a feeling of friction - as if sand had gotten between the heads of the bones;
• pain that intensifies with movement;
• unusual tension, twitching in the muscles even at rest;
• swelling of the joint and increase in its volume, engorged soft tissues;
• limitation of mobility in the joint;
• a feeling that the joint is “jammed” - possibly a foreign body in the joint capsule;
• redness of the skin over the joint, local increase in temperature;
• a feeling of numbness in the muscles, their weakness, up to impairment of gait or fine motor skills.

Healthy crackling occurs periodically. A simple example: if a gas bubble collapses in a joint, when you move again, there will be no more crunching noise, no matter how much you bend the limb. But the pathological one is heard constantly and only intensifies over time. The specificity of the sound also differs. A loud, dry crunch is quite normal. But if you hear something rough, “with a grinding sound,” check with your doctor for the causes and treatment of crunching in the joints.

Why do joints start to crack?

To understand the mechanism of crunching in joints, you need to remember the basics of anatomy. The structure of joints in the human body resembles hinges: in them, one bone slides over the surface of another. The heads of the bones are smooth and adjusted in shape to each other: this is necessary for good gliding. Between them there is joint fluid, which plays the role of a kind of “machine oil” for the joints. To prevent it from leaking out, the bones are covered with articular cartilage. They also ensure the external integrity of the joints. The same joint fluid circulates inside the capsule formed by cartilage. Ligaments are also woven into the capsule, which increase the strength of the entire joint mechanism. And between some bones, the heads of which do not fit perfectly against each other, there are special spacers - menisci. The joint fluid is saturated with gases - oxygen, nitrogen and carbon dioxide. Therefore, strong stretching of the joint capsule and sudden movements lead to the collection of bubbles. Each of them bursts, which is why a characteristic sound occurs - a crunch in the joints.

In the vast majority of cases, this is a completely natural process that does not require medical intervention or treatment
. A child’s joints are just forming, the connective tissue in them is less dense and more elastic than in adults, while the muscular system is less developed. These factors cause crunching in children and adolescents. As a rule, with age, all symptoms go away on their own.

But in some cases, the cause of the crunch may be associated with pathological mechanisms. Dysplasia. The main causes of this pathology are changes in the structure of collagen caused by genetic reasons and a lack of components from which connective tissue is built. The disease is manifested by frequent dislocations, curvature of the spine, mitral valve prolapse, myopia, and flat feet. Crunching in the joints can also be one of the symptoms.

Lack of intra-articular fluid. Another pathology that is caused by hereditary factors. In addition to clicking, the child may be bothered by decreased joint mobility and pain when moving. Arthritis. The inflammatory process in the joint leads to delamination, thinning and cracks of cartilage tissue. If the disease is not treated, changes over time affect the bone: growths, compactions and spines appear on it. Next, the bone becomes deformed, causing swelling and severe pain even at rest.

Unlike physiological cracking of joints, pathological changes require consultation with an orthopedist and timely treatment.

What to do if your child has cracking joints If the crunching occurs only from time to time and does not cause any inconvenience to the child, there is no need to worry. Most likely, it has a physiological cause and will pass as you mature and grow. However, everything may not be so smooth if the crunching is heard constantly for a long time and is accompanied by other symptoms:

• loud clicks during flexion and extension movements in the joint;
• asymmetry of skin folds on the legs and difficulty in spreading the hips; • restlessness, crying or complaints of pain during active or passive movements in the joint; • swelling and redness of the skin in the joint area. • In addition, the presence of pathology may be indicated by the fact that crunching occurs regularly in only one joint.
In the situations described above, you should not put off visiting an orthopedist. The specialist will conduct an examination and, if necessary, prescribe additional examinations:

• general blood and urine tests to identify the inflammatory process;
• biochemical blood test for differential diagnosis of rheumatoid arthritis and other joint diseases; • Ultrasound of joints to assess the condition of cartilage, ligaments, muscles and the amount of joint fluid; • radiography of joints to assess the condition of bones.

In diagnostically difficult cases, the doctor may also prescribe a computer or magnetic resonance imaging scan. If studies reveal pathology, treatment must be started immediately. In most cases, it includes conservative methods: medication, physical therapy, physiotherapy, and only in rare situations may surgical intervention be required. The most important thing is not to let the disease progress and strictly adhere to the recommendations of your doctor.

In which joints is the crunch heard?

Almost all joints can crackle - from the temporomandibular joints to the interphalangeal joints and even the intervertebral joints. For some joints, dry crunching is a physiological norm due to their active load and specific axis of rotation. Therefore, you should not worry about how to get rid of crunching in the joints if “healthy” crackling is heard in the ankles, knees, fingers and spine.

Crunching in the hip joint

Crunching in the hip joint is common among athletes, dancers, and people involved in physical labor. It is often caused by the so-called. snapping hip syndrome - a sound that occurs when tendons roll over bones as the joint flexes and extends.

The hip joint can crunch when there is excess protein in the diet or dehydration. Increasing crunching and pain in the joints may indicate the development of arthritis or arthrosis of the hip joints, or other inflammatory diseases in the muscles and ligaments.

Crunching in the knee joint

Crunching in the knees usually occurs as a result of stress, changes in the periarticular tissues (muscles, ligaments, tendons). Frequent squats, sitting too low or too high, and the habit of tucking your legs can interfere with blood circulation and cause congestion, which is accompanied by a crunch in the knee joint. They are not a pathology, although they can contribute to cartilage degeneration.

Actually, the destruction of the knee joint is accompanied by swelling, discomfort when moving, pain when squatting and other loads.

Crunch in the shoulder joint

Clicking and crunching sounds in the shoulder joint are rarely observed when the joint capsule and soft tissues are healthy. In patients under 35 years of age, they usually occur due to injury—usually while attempting to bench press at the gym. With proper treatment, crunching and other symptoms disappear within 2-4 months. Arthritis of the shoulder joint is more common among people over 60 years of age.

Crunching in fingers

The joints of the fingers are the “crispiest” in the human body. The articular surfaces of the fingers move away from each other more often than others, forming gas bubbles, and ligaments and tendons (there are especially many of them in the hands) more often rub against the protrusions of the bones. How to remove crunching in hand joints? No way. This is an absolutely normal phenomenon - a tribute to developed fine motor skills.

But if your fingers bend worse and become swollen, it’s time to see a doctor.

How to treat cracking joints

The choice of treatment begins with a diagnosis by a rheumatologist. To do this, you need to undergo an initial examination, functional tests, and possibly x-ray and laboratory tests. If crunching in the joints appears after an injury, it is better to consult a traumatologist.

The first step to treating cracking joints is making a diagnosis.

Treatment for cracking joints is aimed at:

• stopping the inflammatory process in the joint or soft tissues,
• elimination of primary diseases or other causes that caused a problem with the joint (damage to ligaments, cartilage, menisci, labrum, etc.),
• maintaining the elasticity of cartilage,
• prevention of further joint destruction.

Preparations for cracking joints

If the patient is concerned about pain and symptoms of inflammation, non-steroidal anti-inflammatory drugs for cracking joints - such as diclofenac, meloxicam, nimesulide, ibuprofen, naproxen, indomethacin, ketoprofen - become the standard choice. In severe cases, steroids (glucocorticoids) are used - prednisolone, methotrexate and others. The dosage and procedure for using hormonal tablets for cracking joints should be determined by a doctor!

Preparations for cracking joints based on chondroitin and glucosamine (the main structural components of cartilage) are recommended in all cases without exception - as prevention and maintenance therapy of degenerative processes. These include chondroprotectors artracam, artradol, dona, structum (they are available in the form of tablets for cracking joints, which need to be taken for 3-6 months).

If drug treatment for cracking joints is ineffective, the question of partial or complete joint replacement may arise.

Physiotherapy

Physiotherapy is used both in the acute phase of the disease and during remission. It allows you to relieve inflammation, deliver medications to tissues, reduce pain and improve mobility in the joints. Physiotherapeutic methods for treating crunching joints improve blood supply to the muscles and connective tissue around the joint (which means the cartilage receives more nutrients) and restore healthy metabolism. Particularly effective for cracking joints has been demonstrated by:

• kinesiotherapy;
• physiotherapy;
• massage;
• magnetic wave therapy;
• medicinal electrophoresis;
• UHF;
• amplipulse

Other treatments

To treat cracking joints, it is important to include a special diet that helps balance the water-salt balance, nourish cartilage tissue and reduce body weight if you are overweight. The specifics of the diet depend on the causes of the crunch: for diabetes, the consumption of carbohydrates is minimized, for gout - meat.

You should not ignore a rehabilitation doctor - he will help you choose the optimal level and type of physical activity (therapeutic exercises, walking, swimming, cycling, modeling), comfortable orthoses and other ergonomic devices.

Doctors' advice: how to get rid of crunching in joints?

To prevent and treat crunching in the joints, doctors recommend alternating physical activity with rest, not allowing the joint fluid to stagnate. Also get rid of bad habits - alcohol, smoking and excess coffee consumption accelerate the destruction of joints and reduce the effectiveness of treatment for cracking joints.

Physical activity

Avoid both inactivity and heavy loads on the joint. Any sports exercise should begin with a warm-up, which will “warm up” the muscles and prevent starvation of the cartilage. Aggressive sports, running, and strength training with cracking joints are contraindicated, especially if you have been diagnosed with inflammatory, degenerative changes, or joint hypermobility.

If the crunch in the joints is not associated with the individual anatomical characteristics of the patient, doctors recommend walking more (at least 40-60 minutes or 10 thousand steps a day, or 5-8 km) or cycling, swimming (2-3 times a week ), do Nordic walking or yoga. To track your activity, install a pedometer on your phone. Exercise should be done daily and systematically - do not try to catch up in a few hours 2 times a week. This can worsen the condition of the joint, because synovial fluid does not have time to be produced during intense exercise.

For arthritis and arthrosis, it is better to do not standard exercises, but a set of general strengthening exercises that help maintain the tone of muscles and ligaments.

Labor activity

Increased joint mobility, although not a pathology, can cause varicose veins or injuries due to high load on the joints. Taking this feature into account, it is better not to choose standing work. If you still have to stand, shift your weight from foot to foot more often, equip the place with a low bench on which you can place your foot from time to time. To prevent crunching in the joints, try to dilute the work in the same position with 10-15 minute warm-ups (3-4 during the day) - so-called. industrial gymnastics exercises. These include rotation of the head and torso, clenching and unclenching of fists, circular movements of the feet, hands, knees, and the “mill” exercise with the hands.

If necessary, use elastic bandages and restraints while working.

Weight

Regardless of the causes and treatment of cracking in the joints prescribed by the doctor, the patient needs to lose excess weight - it disrupts the healthy distribution of load between the joints, which is why the intervertebral discs of the lumbar region, hip, knee, and ankle joints begin to suffer. For example, 1 extra kilogram of weight is felt by the knee cartilage as 5.

How to prevent joint problems in a child

If the pathology is hereditary, it is impossible to get rid of it completely, but the influence of provoking factors can be significantly reduced. By the way, the same preventive measures will also help a healthy child: they will allow the musculoskeletal system to develop harmoniously and in a timely manner. Moderate physical activity. Every child needs physical activity. We're not talking about exhausting workouts, but regular exercise certainly won't hurt. Loads must be selected taking into account the desires of the child and his state of health. If there are pathologies of the joints, therapeutic exercises will help. Swimming lessons won't hurt either. This sport, by the way, is also useful for healthy children. Cycling, dancing, badminton or tennis will bring a lot of benefits. If there is even a suspicion of joint problems, you should avoid sports that involve long walking, running, heavy lifting, and also involve injuries. In addition, before any physical activity you need to warm up with stretching exercises.

Balanced diet. To maintain joint health, a child's diet should contain enough protein, calcium, phosphorus and vitamins. Also useful are dishes that contain a lot of collagen: for example, jellied meat, aspic, jelly. Proper drinking regime. A deficiency of intraarticular fluid may be associated with general dehydration of the body. To avoid such a problem, the child should drink enough clean water. The individual norm is determined based on the fact that for every kilo of weight there is 30 ml of water. It must be remembered that only clean water is taken into account, and not tea, coffee, soups and other liquids. Body weight control. Excess weight always means additional stress on the joints. Of course, a couple of extra kilos will not have a significant impact on the functioning of the musculoskeletal system, but obesity of any degree is guaranteed to lead to problems with the joints. Therefore, be sure to objectively assess your child’s body weight and, if necessary, select a diet with your doctor. Crunching in the joints is not a reason to go crazy with excitement and take your child to the clinic every day, but it is a reminder that your child’s health needs to be closely monitored at any age.