Crepitus- The ‘Noisy’ Joint
What is crepitus
Crepitus refers to audible sounds (for example grating, cracking, crunching, or popping) in and/or around a joint during joint movement. Although commonly seen in the knee joint, crepitus can occur in all joints.
What causes crepitus
Crepitus can be due to numerous factors:
- Outside the joint:
- Ligaments and tendons may stretch as they pass over a small bony lump, then snap back into place, causing noise
- Inside the joint:
- Movement of joint fluid causes changes in joint pressure can cause gas bubbles to form quickly and create a popping sound.
- Shock-absorbing cartilage (menisci) can be thickened leading to popping or clicking
- Joint capsule (synovium) surrounding the joint can be elongated with excess portions catching and creating popping sounds
- Joint fluid moving from one area of the joint to another
It was previously believed that crepitus is a sign of degeneration and premature ageing of joints, however this is not the case. Yes it often affects more people as they get older, but it can also affect people of all ages.
Is crepitus bad and should I have it treated
Generally crepitus alone should not cause any worry or need treatment. Importantly, there is NO research demonstrating a definitive link between a ‘noisy’ joint and joint pathology.
Studies have shown that knee crepitus is prevalent in 30-40% of people WITHOUT knee pain. Additionally, people with knee pain and noisy knees have demonstrated similar levels of strength, function and pain compared to those with knee pain and NO crepitus.
However, if you do experience crepitus associated with pain and/or swelling in the joint, then it is advisable to seek medical assessment. In this situation there is likely some underlying pathology, which a skilled professional like a physiotherapist can help diagnose and manage.
In summary, crepitus or a noisy joint is not a sign a pathology or injury. It is possible to have crepitus without any pain or other symptoms, and it is important to continue to stay active and moving to maintain the overall health in your joints.
Kelly Laing
McKenzie Credentialed Physiotherapist
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References
de Oliveira Silva, D., Barton, C., Crossley, K., Waiteman, M., Taborda, B., Ferreira, A. S., & de
Azevedo, F. M. (2018). Implications of knee crepitus to the overall clinical presentation of women with and without patellofemoral pain. Physical Therapy in Sport, 33, 89-95.
de Oliveira Silva, D., Pazzinatto, M. F., Del Priore, L. B., Ferreira, A. S., Briani, R. V., Ferrari, D., … & de Azevedo, F. M. (2018). Knee crepitus is prevalent in women with patellofemoral pain, but is not related with function, physical activity and pain. Physical Therapy in Sport.
Robertson, C. J., Hurley, M., & Jones, F. (2017). People’s beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: a qualitative study. Musculoskeletal Science and Practice, 28, 59-64.
Song, S. J., Park, C. H., Liang, H., & Kim, S. J. (2018). Noise around the Knee. Clinics in orthopedic surgery, 10(1), 1-8.
