Cracking knuckles is fine – and bad weather doesn’t make arthritis worse: nine myths about your joints debunked

Cracking your knuckles is bad…

It may get on the nerves of others, but clicking your knuckles is unlikely to worsen joint problems or increase the risk of arthritis. The joints are lubricated by synovial fluid, which contains dissolved nitrogen gas.

When you stretch a joint, the cavity containing this fluid expands, causing a pressure drop. This causes the dissolved gas to come out of solution and form a bubble – and the rapid release of the gas creates a popping sound.

The same knuckle cannot be broken again immediately, because it takes about 20 minutes for the bubbles to dissolve back into the liquid. Several studies suggest the habit is harmless, including one from a California doctor who regularly cracked the knuckles of just one hand for decades: an x-ray showed no difference in the arthritis between his two hands. Another study of a group of 300 patients found no link between a history of joint tears and arthritis.

Gas bubbles around the joints can also cause joints to make clicking sounds during exercise, although repetitive popping or clicking sounds can also be caused by tendons or ligaments moving over bony protrusions under the joint.

Rheumatoid arthritis and osteoarthritis are the same thing…

Arthritis means ‘inflammation of the joint’, but the inflammation can be caused by various causes. Osteoarthritis is caused by wear and tear and normally affects only one joint, usually the knee or hip, and is most common in people over 50. People whose work involves heavy manual labor, such as bricklaying, or involves a lot of kneeling, such as carpentry, are at greater risk. Obesity, which also puts more strain on the joints, is another major risk factor. But there is also a genetic component research that puts the heritability at 40%-70%.

Rheumatoid arthritis is an autoimmune disease in which the immune system tricks and attacks the synovial membrane that covers and protects the joints. It is less common than osteoarthritis, usually begins in middle age and causes pain in joints throughout the body. Women are two to three times more likely to get it than men. There are certain genes that increase the risk of rheumatoid arthritis and make the symptoms more severe, but smoking and obesity also increase the risk.

There is nothing you can do to prevent arthritis…

For osteoarthritis, being overweight is a major risk factor because it puts more strain on the joints, so maintaining a healthy weight helps limit the risk. For rheumatoid arthritis, smoking is one of the biggest risk factors – and regular smoking has been shown to make symptoms worse. So quitting smoking helps reduce the risk.

Joint pain during menopause is inevitable…

Estrogen helps maintain cartilage and other joint tissues, meaning joints are sensitive to the levels of the hormone in the body. Because estrogen drops during menopause, many women experience joint pain. Hormone replacement therapy (HRT) is widely accepted as the most effective treatment for menopausal symptoms, including joint pain, and works by restoring estrogen levels; but HRT is not always suitable and some women may prefer other ways to control symptoms. An important way to improve joint pain is through exercise. Exercise that strengthens the musculoskeletal system is especially good for relieving joint pain. This can include walking or running, for the lower body, or doing weights at the gym, for the upper body.

Collagen supplements can help rebuild joints…

Collagen is the most abundant protein in the body and plays a crucial role in the formation of connective tissue. Without enough collagen, our skin, bones, muscles, tendons and cartilage lose elasticity and strength. The body produces less collagen as we age, so there is some logic in taking supplements to make up for the deficiency, but there is a lack of hard evidence that this makes a meaningful difference. Some studies have found encouraging results, but most were small and funded by companies that make the supplements, increasing the potential for bias.

Supplements are not necessary to maintain healthy joints…

It should be possible for most people to get most of the vitamins and minerals needed for healthy bones from a healthy diet. But vitamin D is the exception. Vitamin D helps the body absorb calcium, which is essential for building bone mass. It is produced in the skin during exposure to sunlight and during the summer months this source is normally sufficient. However, in winter it is not possible to produce enough vitamin D from sun exposure alone, and it can be difficult to replenish the deficiency through dietary sources such as oily fish, meat and eggs alone. In Britain, the NHS says adults should consider taking supplements during the winter months. Vitamin D deficiency has been linked to joint pain and is also a common cause of rickets, which causes bones to soften and deform.

Your diet doesn’t affect your joints…

Inflammation is often a cause of joint pain and stiffness, so following a diet that reduces inflammation can help. There’s no one magic ingredient, but avoiding too much red meat, processed foods and sugar and making sure your diet includes omega-3 fatty acids and vitamins is a good start.

Gout is no longer a health problem…

Gout is associated with portly, ruddy, middle-aged men who indulge in rich food and alcohol – Henry VIII suffered from it. But gout is increasingly affecting younger people and women, research shows a global increase in the number of people aged 15 to 39 being diagnosed, from 39 cases per 100,000 people in 1990 to 46 per 100,000 in 2019. This trend is believed to be driven by the sharp rise in obesity and diabetes, which are risk factors.

Gout is a form of arthritis that causes sudden, severe joint pain and inflammation, often in the big toe. It is caused by a high concentration of uric acid in the blood, which can lead to needle-shaped crystals around the joints. Uric acid is a byproduct of purines, which are found in higher concentrations in red meat, shellfish and alcoholic beverages. Premenopausal women are at a much lower risk of gout because estrogen increases the removal of uric acid by the kidneys. Being overweight, type 2 diabetes, high cholesterol or high blood pressure are all risk factors, and are thought to be behind the increase in the number of younger people with gout.

Rain and thunderstorms worsen arthritis…

You may know someone who claims they can predict bad weather from a flare-up of arthritis pain. And some have suggested that the alleged link could be due to the drop in atmospheric pressure that often precedes bad weather, causing joints to expand. However, there is little conclusive evidence to support this idea. A studybased on data from more than 11 million medical visits by US patients, found no pattern linking rainy days to more aches and pains – in fact, people were slightly more likely to seek treatment on dry days.