Many people have noises that come from their knees. Creaking, crunching, and popping knee joints are common. Often, those noises don’t mean too much, but sometimes they do. Should you be worried about the noises that come from your knee? I’ve heard many people say that these noises don’t matter, or sometimes that they do, but what does the evidence really show about noisy knees?
The Knee Joint
The knee joint is the location where three bones come together: The shin bone (the tibia), the thigh bone (the femur), and the kneecap (the patella).
Another bone, the fibula, is located near the joint but doesn’t have the cartilage attachments that are important in the development of arthritis. The surface of all three of these bones is covered with a smooth layer of cushioning tissue called articular cartilage. In addition, another type of cartilage, called the meniscus, sits between the thigh and shin bone and acts as a shock absorber. The cartilage of the joint, both articular and meniscus, is the critical structure in the development of osteoarthritis.
When people develop osteoarthritis, they sustain damage of both the articular and meniscus cartilage. Often called wear-and-tear arthritis, osteoarthritis causes wearing away of the articular cartilage and tears in the meniscus cartilage. As this degenerative process progresses, the cartilage surfaces become rough and uneven, and bone under the cartilage is exposed. As the knee joint bends back and forth, these rough surfaces can cause noises to occur.
The most common noise experienced in the knee joint is called crepitus. Crepitus is the rough, grinding that can be felt and heard in the knee. Often detected by placing the palm over the kneecap and bending the knee back and forth, crepitus sounds and feels like sandpaper grinding in the knee joint.
Crepitus can be the result of rough cartilage surfaces grinding over each other, or it can be the result of inflammation in the knee joint causing the motions of the joint to grind. Sometimes during the development of osteoarthritis, bone spurs, small projections of abnormally formed bone, will cause the grinding to worsen.
Other sounds include popping and snapping. These sounds are typically much more audible than crepitus. A pop or a snap typically occurs more infrequently, and may be elicited by certain positions or movements of the joint, but not by all motion. Pops and snaps can be normal noises that occur when tendons suddenly snap over the bone surrounding the joint, or they may be a sign of cartilage damage inside the joint. Physicians typically worry when the snap or pop is associated with significant pain, swelling, or other symptoms, and not an isolated finding.
There has been research that has investigated the question about how much knee noise tells you about your chance of developing arthritis in the joint. In these studies, individuals are asked to rate the noise levels of their knee, how much crepitus they notice, and then they are followed over time. It is true that people who have noisier knees are more likely to develop arthritis of the joint compared to people who have quiet knees.
Doctors believe that crepitus is often an early sign of a more serious problem inside the knee joint. While it may not be the precursor to needing a knee replacement surgery, it may be an early sign of arthritis in the joint. On a positive note, the noise in the knee does not necessarily mean that you have late stage arthritis of the joint that requires invasive treatment. Rather, the research simply shows that people who have noisy knees are more likely than others to develop osteoarthritis. In fact, some people who didn’t notice any abnormal noises in their joints also developed arthritis. The noise simply meant that these individuals were more likely to develop arthritis in their knee joints.
What to Do
So you have a noisy knee, and now you’re worried you are going to get arthritis: What should you do next? Well, there are steps you can take to help prevent the progression of arthritis. Most importantly, take good care of your joints. Keep your weight down and your muscles strong. Make sure you are getting regular exercise. Many people worry that exercise will accelerate cartilage loss. In general, that’s not true; exercise keeps your weight down and helps support and nourish a joint. High impact exercise may be problematic in people with osteoarthritis, but there are many low-impact activities such as cycling, swimming, and yoga that are well tolerated and can be beneficial to your joints.
Other steps you can take to maintain healthy cartilage include eating a good diet and avoiding tobacco products. Joint supplements, such as glucosamine and chondroitin, have not been shown to prevent the progression of arthritis, but these are very safe supplements and many individuals choose these to help their joints. Other natural anti-inflammatory treatments as well as nonsteroidal anti-inflammatory medications can help to control inflammation in the knee joint.
When wear-and-tear arthritis does progress to its later stages, sometime there is a surgical solution to the problem. The usual surgery for later stage arthritis is a knee replacement surgery to remove the damaged cartilage and bone, and replace with an artificial implant made of metal and plastic. As stated, this treatment is generally reserved for the latest stages of arthritis when the cartilage has completely worn away from the joint.
A Word From Verywell
Bottom line: If you have noisy knees, you may be more likely to develop arthritis in the joint than someone with quiet knees. However, not everyone with knee noises will develop arthritis symptoms, and you shouldn’t worry about seeking special treatment just because you hear noise. However, having a noisy knee is a great reason to take some simple steps to prevent the progression of arthritis, so that you can keep your knees healthy and active for a long time!
Lo GH, Strayhorn MT, Driban JB, Price LL, Eaton CB, McAlindon TE. “Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative” Arthritis Care Res. 2017 May 4.
Centers for Disease Control and Prevention (CDC). “Arthritis Types.” Atlanta, Georgia; updated April 12, 2017