Variety of causes triggers joint noises – south platte sentinel gas in back and chest

Let’s discuss the topic of joint crepitus, or joint noise, something that is often the source of questions and concerns for patients coming into the clinic. Joint crepitus can be something very benign or something quite serious and patients should know the warning signs and bring these to their physician’s attention when appropriate.

The first cause of joint crepitus is arthritis. Arthritis causes a grinding and popping sound that is similar to the sound of two sheets of sandpaper rubbing together or perhaps a grinding stone grinding corn. This type of sound is usually heard in a joint that has progressively gotten worse over time and patients usually know by this point that they have some form of arthritis which is the source of their crepitus.

When joint crepitus is sudden, often there is cause for concern as this could be a symptom of some other type of injury. Generally, gradually progressing joint grinding and crepitus is not cause for significant concern. However, patients who experience a sudden onset of joint noise should certainly bring it up with their physician.

Clunking—another source of joint crepitus – is the “clunk.” Clunks happen for a number of reasons, usually occurring around joints with internal cartilage providing stability such as the knee, shoulder and hips. A clunk in the shoulder is significant when the patient either has not had a history of clunking or has had a history of trauma following which the clunking began.

In both cases there is a question as to whether or not the integrity of the stabilizing cartilage has been torn and the clunk being the sound of the joint falling in and out of proper physiologic position. This type of clunk can begin occurring in the shoulder following a dislocation. After the joint has been reduced into its normal position, the patient presents to the clinic complaining of recurring joint clunking which occurs with specific motion.

In other cases, however, joint clunking, particularly in the shoulder, has been present for years and the patient simply does not know why it is occurring. This is usually not cause for significant concern as there is no traumatic history and no emergency to discover the source. Investigation of such joint noise is ultimately important, however, the urgency of this is much less.

Soft tissue crepitus: This type of crepitus is something that I have heard many times under the scapula or shoulder blade. Patients who have suffered a trauma to the rib cage often develop problems with the ribs or intercostals muscles and adjacent musculature around the scapula as well as the bursal sacs along the scapula. These types of injuries can result in a soft tissue type of crepitus around the shoulder blade that sounds quite alarming. However, generally speaking, the treatment for this type of soft tissue noise is minimal.

Spinal crepitus: Spinal crepitus occurs with traumatic or chronic history of damage to the spine and the facet joints of the spine begin making noise either due to the instability and excess movement or due to the repetitive subluxation or excess physiologic travel of the facet joints. This type of joint noise in the spine is cause for concern when it is painful and suddenly painful and/or is not usual for the patient. Many patients have joint crepitus in the spine that is painless and as such, is generally regarded as harmless. However, sudden onset pain or noise that is painful should be evaluated.

For more information on joint crepitus and the many causes and treatments, stop by the clinic for a free spinal consultation at one of our offices in Fort Morgan, Sterling or Haxtun. Also, feel free to visit our Facebook page at McDonald and Keil Physical Therapy.

(Dr. Mark McDonald, PT, DPT, OCS is a lifelong Sterling native and board certified orthopedic physical therapist with 21 years practice in Sterling. He is a clinical partner with AB Fitness/Alma Blagg, Devonshire Acres, and Northeast Plains Home Health Care in Sterling.)