Patients often wonder whether popping knuckles causes arthritis later in life. There is no evidence to show this to be true. However, repeated joint popping can lead to hyper-mobility which means the ligaments supporting the joint have become stretched out. Without the support of the ligaments, the joint becomes more vulnerable to injury.

This can also be true in the neck and back. Frequent popping and aggressive stretching of the spinal joints can lead to excessive joint motion. In some cases this is a good thing, such as for gymnasts and dancers who require greater flexibility and range of motion in their muscles and joints. These individuals usually have strong core muscles to support their spine in place of the ligaments. However, later in life these individuals’ core muscles may weaken but the spinal joints still remain hyper-mobile. As the back then sustains significant forces from lifting with poor mechanics, pregnancy, or poor sustained postural habits, etc, pain may develop.  It may still feel good to pop a joint that is hyper-mobile due to the endorphin release that occurs with it, but the relief will be temporary and it will ultimately perpetuate the problem. Any person with an excessively flexible spine at one or more spinal segments is susceptible to this type of back pain. Low back hyper-mobility is particularly common because the lumbar spine is not supported by the adjacent rib joints of the mid/upper back.  For an individual with spine hyper-mobility, it is important to maintain extremely strong core muscles, especially if the individual’s lifestyle or vocation requires repeated stress to the low back.

Many people have joints (such as the ankle or knee) which frequently give off a popping sound or sensation with movement. Generally, if no pain accompanies the popping it is not of concern.  If the popping becomes excessive and the joint does not feel stable during activity, it may need to be strengthened or temporarily braced.

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What are heat and cold used for?

Heat Therapy

-Decrease joint stiffness

-Relieve muscle spasm

-Provide pain relief

-Increase blood flow

-Increase extensibility of connective tissue

Cold Therapy:

-Decreases muscle spasm

-Decreases pain and nerve conduction velocity

-Relieves swelling and edema through vasoconstriction

-Prevents excessive tissue damage

When should I use heat or cold?

The choice to use heat or cold depends on the injury you sustain.  If you are recovering from a sudden, traumatic injury such as a ligament sprain or surgery, this would be considered “acute”. Conversely, a slow developing injury that hasn’t healed within the first six months would be considered chronic.

Acute:  Use cold

Chronic:  Use heat

(If in doubt, use ice for pain relief without aggravation)

How long should I apply heat or cold?

Cold pack:  Wrap a cold pack in a thin towel or pillow case and apply for twenty minutes.  For a new injury, elevate the injury above your heart and apply ice every 2-3 hours.

Hot Pack:  Apply for up to 30 minutes.  If using an electric heating pad, be sure to follow the instructions recommended by the manufacturer.

Cautions:

Individuals with nerve damage need to be extra careful wthen applying heat or cold

Remember that heat and ice are more intense if you lie on top of them

Always set a timer to avoid falling asleep and sustaining a burn or cold injury

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