Foot Health

Cracking toes

There are some people who can crack their toes the same way some people crack their knuckles. It is often a frightening sound that makes you wonder if it is healthy to crack your toes or is it causing damage to your joints. The cracking sound that toes sometimes make may be harmless, or it could be a sign of arthritis or other conditions in need of medical treatment.

The grating, cracking, or popping noises made by joints – referred to as crepitus – is rarely serious, but there are times when it may be a sign of fracture or other problems in need of immediate care.

No one exactly knows why crepitus, the cracking or popping sounds made by the bending joint, occurs. With that said, it is a common condition thought to be caused by:

Cavitation: This is a harmless phenomenon in which a vacuum develops in the lubricating fluid surrounding a joint, called synovial fluid. When a joint quickly bends, the rapid release of pressure can cause a cracking sound.

Escaping gas: If a joint is expanded or flexed, air bubbles can gradually build up in the synovial fluid in the joint space. When the joint is bent, the rapid escape of gas can cause a popping or cracking sound.


Rapid stretching of ligaments: 
Ligaments are fibrous tissues that connect bone to bone. If a joint is rapidly bent, the ligament can sometimes make a snapping sound, particularly if it is displaced.


Joint erosion: 
When the smooth white tissues between joints, called cartilage are worn away, they can cause bone to rub against bone. This can cause grating or crunching sounds with movement.


Broken adhesions: 
An adhesion is the sticking together of tissues. This can occur after an injury when scar tissues effectively “glue together” adjacent membranes or tissue. When this occurs between the joints, the rapid bending of the joint can cause the adhesion to break, creating a snapping or popping noise.

Underlying causes of toe popping

While crepitus is generally harmless, there can be times when the sound indicates a bigger problem in need of treatment. It can be caused by the rapid release of gas or pressure between joints. It may also be caused by the rapid stretching of joint ligaments, the erosion of joints, and the breaking of scar tissues between joints. As a general rule, if the popping or cracking is accompanied by pain or other symptoms, you should see your healthcare provider.


Prior toe injuries

Sometimes a cracking toe is caused by an old injury that has either disrupted the normal position of a joint or caused scar tissues to develop in the joint space. The uneven alignment of the joint or uneven joint surfaces can cause grating, crunching, or popping sounds.

One such example is the development of bone spurs, also known as osteophytes. Bone spurs are tiny projections of bone that can develop after an injury when the body tries to rapidly repair bone. A popping sound can often be heard when smooth cartilage meets the rough surface of the bone spur.


Stress fracture

A stress fracture of the foot is a tiny crack in the bone that often occurs due to repetitive low-impact force. It is a common occurrence among athletes, including long-distance runners, but can also be caused by a traumatic injury. The symptoms of a stress fracture may not be overt and may only cause pain when pressure is placed on the joint. When crepitus develops alongside toe pain, it is often a sign that the stress fracture is progressing to a complete fracture. Immediate medical care should be sought if toe pain with movement is suddenly accompanied by cracking, popping, or grating sounds.


Arthritis

A popping toe joint is common with arthritis. There are two main types of arthritis, both of which can cause the progressive loss of joint cartilage and the development of osteophytes.

Osteoarthritis: Also known as wear-and-tear arthritis increases with age.

Rheumatoid arthritis: An autoimmune form of arthritis in the body’s immune system targets and attacks joints of the body.


Gout

Gout is another autoimmune disease that primarily targets the toes (especially the big toe). Also known as gouty arthritis, the condition is caused by the build-up of uric acid crystals in the joint space. The resulting inflammation causes toe pain and swelling which has sudden onset and is very painful especially at night. Over time, gout can cause joint damage that increases the odds of crepitus. It can also cause the formation of lumpy deposits, called tophi, that erode bone and cartilage and further increase the risk of crepitus and other arthritis symptoms.

When the bending of the toes causes clicking, popping, or grating sounds this is referred to as crepitus, the cause is most likely harmless. It may be due to increased pressure or trapped gas in the joint space or “snapping” of a ligament with quick joint movement. The sound may also be caused by something more serious, like bone spurs or the loss of cartilage in a joint space.

Crepitus of the toes may also be a sign of an underlying conditions that may need treatment. This includes a stress fracture or a prior toe injury. It may also be due to osteoarthritis or long-term complications of autoimmune arthritis (including rheumatoid arthritis and gout). Crepitus typically doesn’t require treatment if it is not accompanied by pain and does not interfere with joint movement. However, if there are other symptoms like pain or the loss of mobility, treatment may be needed and can vary by the cause.


• For more information, email us at foothealth242@gmail.com or visit www.apma.org. To see a podiatrist, telephone 325-2996 for an appointment, visit Bahamas Foot Centre on Rosetta Street, or call 394-5824 for an appointment; or visit Bahamas Surgical Associates Centre on Hilltop Medical Centre off 4th Terrace Collins Avenue. In Grand Bahama, call Lucayan Medical Centre at 373-7400 for an appointment.

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