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Insider Arthritis Tips, October 2008 Does knuckle-cracking cause arthritis?
October 15, 2008

"Life is like a 10-speed bike. Most of us have gears we never use."-- Charles Schulz, Cartoonist

Hope your fall is going well...

My birthday was August 10th. I turned 59. Seems hard to believe. It’s only recently I’ve started to look in the mirror and ask myself the question, “Where have the years gone?”

When you’re growing up, time seems to drag on forever. The night before Christmas is the longest night of the year. The school year, from September to June seems like an eternity.

But why does summer seem so short?

And all of a sudden things change. Time seems to move faster and faster and faster.

I use my driving time to listen to educational programs. The other day, the program I was listening to, talked about the “dash.”

Let me explain...

On a headstone, you see the person’s name and the year they were born, then a dash, and then the year they died.

So... you’re born... then you die. But it’s the in between, the “dash” that truly makes the difference.

What did you do during the dash? Did you help bring children into the world? Did you bring them up well? What kind of work did you do? Did it make a difference in the lives of others? Is the world a better place or not because of you?

I think about the dash all the time now. Not that I didn’t before but now the dash really makes all the difference in the world.

So when a patient tells me, “Dr. Wei... you really helped me...,.” it tells me that my dash will be worth while.

And when my children or my wife tell me they really love me, it helps me know my dash is worthwhile.

Table of contents


Does knuckle-cracking cause arthritis?

Tips of the month


This month I'll discuss a common question I get...

And quite frankly, I didn't know the answer to this until I researched it. So you get the benefit of that research and if somebody asks you this question, you'll be prepared!

Does knuckle-cracking cause arthritis?

Does knuckle-cracking cause arthritis? The answer: Probably not.

The largest study to explore a link to arthritis was published in 1990 in the Annals of the Rheumatic Diseases. It looked at 300 healthy people older than 45. Of these, 74 were habitual knuckle crackers. In their abstract, the authors stated,

“The relation of habitual knuckle cracking to osteoarthrosis with functional impairment of the hand has long been considered an old wives' tale without experimental support.

The mechanical sequelae (results)of knuckle cracking have been shown to produce the rapid release of energy in the form of sudden vibratory energy, much like the forces responsible for the destruction of hydraulic blades and ship propellers.

To investigate the relation of habitual knuckle cracking to hand function 300 consecutive patients aged 45 years or above and without evidence of neuromuscular, inflammatory, or malignant disease were evaluated for the presence of habitual knuckle cracking and hand arthritis/dysfunction.

The age and sex distribution of the patients (74 habitual knuckle crackers, 226 non-knuckle crackers) was similar. There was no increased preponderance of arthritis of the hand in either group; however, habitual knuckle crackers were more likely to have hand swelling and lower grip strength. Habitual knuckle cracking was associated with manual labour, biting of the nails, smoking, and drinking alcohol. It is concluded that habitual knuckle cracking results in functional hand impairment.”

(Castellanos J. Axelrod D. Effect of habitual knuckle cracking on hand function. Annals of the Rheumatic Diseases. 49(5):308-9, 1990)

The loud pop of a cracked knuckle is caused by synovial fluid, the thick lubricant that is contained within all joints. When the fingers are stretched or bent backward, the bones of the joint pull apart. This creates bubbles of air in the fluid, which subsequently burst. This process is called “cavitation.” There is some relief and increased mobility when the bubbles “pop”, which helps explain why people like doing it.

( Brodeur R. The audible release associated with joint manipulation. Journal of Manipulative & Physiological Therapeutics. 18(3):155-64, 1995)

One final study used a patient population consisting of 28 persons, with an average age of 78.5 years, of whom 23 were women and 5 were men. Eleven women and 4 men were habitual knuckle-crackers. The data fail to support evidence that knuckle cracking leads to degenerative changes in the metacarpophalangeal joints (knuckles)in old age. The conclusion by the authors..."The chief morbid consequences of knuckle cracking would appear to be its annoying effect on the observer.

"(Swezey RL. Swezey SE. The consequences of habitual knuckle cracking. Western Journal of Medicine. 122(5):377-9, 1975)

Hear Hear!!!

Tips of the month

Arthritis tips of the month:

These are kitchen tips...

If you boil food, consider using a frying basket inside the pot to help you lift the food out and drain the water. Or consider using a ladle with a build up handle to scoop the food out instead.

There are many jar openers available that are either electric or work using friction. These may be fastened underneath the cabinet to allow easy access.

Try using some of the new lightweight types of cookware instead of cast iron.

Appliances that work with levers or by pushing buttons will make your life easier. Knobs that you need to twist place a lot of stress on the hands.

Store your canned goods with the labels facing forward. Line similar cans up behind one another so you can tell what’s in the back part of the shelf.

Store the most commonly used items between waist and eye level.

Plan your meals. If you can cook large batches and freeze them for the days ahead, it will help save you some labor. Slow cookers allow you to do this very easily.

Simple is better. Look for recipe books that will allow you to prepare meals in minutes.

Serve food in the containers they were cooked in. Consider storing them in the refrigerator in the same containers as well.

Use disposable dishes (paper) if possible. Use wet wash clothes or suction cups to stabilize mixing bowls.

Store pots and pans efficiently. It’s hard to reach underneath and pull out pots and pans. It’s much easier to hang them on hooks within easy reach.

Use sharp knives. These require less stress and strain on the hands.

Put your sugar and flour inside containers instead of leaving them in large bags that need to be lifted.

Use a coat hanger or other utensil to pull oven racks out to check a meal.

That’s it for this month. Hope it’s been helpful.

I'll be back next month with more news.

Nathan Wei, MD, FACP, FACR

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Insider Arthritis Tips A monthly ezine on arthritis written by a board-certified rheumatologist with tons of excellent and useful information for anyone interested in arthritis

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