What’s All the Noise About? Joint Sounds and RA
When battling rheumatoid arthritis, staying in one position for long is not feasible as joints become stiff and uncomfortable. After a few minutes the urge to stretch hits. When doing this, it’s not uncommon for some non-normal sound to emit from a joint. My right knee is the worst offender and it regularly makes a loud pop upon flexing.
It’s embarrassing when this happens at a meeting at work – especially during a quiet lull. A smile and acting like it’s no big deal usually deflects attention. My knee isn’t the only one that snaps, crackles, and pops. My finger joints regularly crunch as I move them, my ankles pop constantly, my jaw clicks, and my shoulder catches and locks up.
Why do my joints make sounds?
Joints are normally lubricated with fluids and contain cartilage allowing for smooth movement.1There are many reasons for joints to make noises. Some are serious and some are completely harmless.
Sometimes soft tissues like tendons and ligaments glide across bones. This is common in the neck.2 My neck, both before and after vertebral fusion surgery, cracks and crunches every time it moves. My physical therapist said that many people’s necks make these innocuous sounds.
Trapped air bubbles
Sometimes sounds come from harmless trapped air bubbles. Many people may have a habit of popping finger knuckles. I started doing this in elementary school and it became a bad habit. The popping sound comes from bubbles of gas trapped in the joint capsule called the synovial capsule. There is no proven evidence that popping knuckles cause any damage to the joints.3 But it’s probably a good idea not to purposefully manipulate joints that are impacted by RA as it may precipitate more damage.
Damaged tissue due to RA
Other joint sounds actually come from damaged tissue that gets caught in a joint.4 My shoulder joints crunch and lock when I attempt to raise them above my head. My left shoulder locks and pops at three different spots. This snapping sound is known as crepitus5 which is Latin for crackling.6 There are multiple forms but articular crepitus, which occurs at the tips of bones, is a common symptom of RA. As the joint is attacked by inflammation, tissues are degenerated resulting in soft tissue destruction and bone damage.
I know that my knees have permanent damage because an MRI confirmed that the articular cartilage was eroded to the point where pieces of the soft tissue were frayed and floating around in the joint. There are places where rough surfaces of the bone are in contact with one another. My doctor said that the loud popping sounds in my knee are likely from a piece of frayed cartilage catching on something during the flexing motion.
This also explains the nearly constant pain that racks my right knee. But I’ve lived with this for over six years and perhaps the progressive aspects of the disease have been slowed down by treatments.
Clicking sounds in the jaw
A prominent joint that can be damaged by RA and make sounds is the temporomandibular joint (TMJ). Every jaw opening I make results in a painful catching and clicking. This is fairly common as in one study it was shown that in a sample of RA patients, clicking was observed in 12.7 percent and crepitus in 35.9 percent of the group. Almost twice the number of RA patients displayed TMJ problems when compared to non-RA comparison groups.7
Joint sounds due to inflammation
One cannot blame every joint sound on rheumatoid arthritis as some joint deterioration is expected from normal aging. But for me, the sounds come and go depending on the level of inflammation. This symptom reminds me that joints may be activity impacted by the disease. The snap, crackle, and pop of joints serve as an audible reminder of RA.
When was your last flare?