Dr. Sylvester Ikhisemojie
In the usual manner in which some of the things we do ordinarily get to be interpreted in many different ways, none is more interesting than the simple act we often partake in however unconsciously; and that is the habit of cracking our knuckles. It is the usual traditional belief of many people across several centuries that the habit of cracking the knuckles can even lead to arthritis and other joint problems. Other people believe that the habit leads to the re-alignment of the bones that form the particular joint. None of these beliefs can be further from the truth. Thus far, medical research has failed to find a connection between the cracking of the joints with the development of any long-term problems with the joints or even short and medium-term problems for that matter.
The habit is often used by many people to deal with boredom while others use it as a form of exercise to satisfy themselves in a psychological sense that the particular body part remains present.
In a general way of looking at things of this nature, once the cracking of the joints is not accompanied with pain or swelling of the said joint, there is probably nothing to worry about. However, it must be borne in mind that when this kind of activity is engaged in too much or too frequently, there is the potential for joint damage and even injury. The joints can get dislocated or may indeed be disfigured with the tendons and ligaments surrounding the said joint becoming too loose and overstretched. The result is that the angles between the bones may become displaced and unduly mal-aligned. When these joints are pulled apart, a tiny cavity filled with gas forms which soon collapses and creates the popping noise that we hear. The noise itself is therefore caused by a gas bubble which builds up in the joint and gives the characteristic popping sound when it is released.
There are other scientists who believe that it may indeed be beneficial to health. Others feel it is a deeply psychological response to situations around us but may also cause irritation to those who hear it. What is clear is that while it does not appear to worsen arthritis or even cause it, it could soften up the joints even in those people who suffer from arthritis. In this connection, it is speculated that it may help such people with confirmed arthritis to include this little exercise in their range of physical therapies. A large study conducted at the University of Alberta in Canada first gave this indication but an even larger one done in the University of California at Davis showed conclusively that what happens in the joints when they are cracked resembles thunder and lightning; there was a firework going off in the affected joints as seen on ultrasound imaging when the popping sound was associated with a bright flash! There was then a conclusion that the sound and the visual flash seen on ultrasound were related to some dynamic changes in pressure associated with the formation of a gas bubble within the joint.
It is now clear that for whatever reason people crack their knuckles, some do it occasionally while others do so on a fairly regular basis. The lessons learnt are that some do it to relieve tension, others do it to keep themselves calm, while some others do it because of nervousness. In quite a few other people, this exercise is undertaken unconsciously but with immense benefits resulting. As it happens in the fingers, so it is in the neck.
Many people engage in cracking their neck. When you do so, the joint interfaces stretch and allows the fluid spread out within the capsule of the joint. That fluid is called the synovial fluid and it lines most of the joints of the body. Those joints are known as synovial joints. So that once the fluid becomes gas, the joints in the neck are able to pop just like they do in the fingers. That sound, that release of pent-up pressure is what makes the cracking sound in the neck appear as though it is releasing pressure. Indeed, it is and the benefits are psychologically immense. That said, many people have often done the cracking act to their neck when under immense psychological pressure and they all agree that it relieves their tension.
Cracking the neck can be harmful if done in a wrong manner. When it is too forceful or too frequent, it can pinch the nerves in the neck which can then make it extremely painful or impossible to move the neck freely. Besides, capitulation to the urge to crack the neck too frequently can unduly stretch the muscles and tendons around that neck. Pain and discomfort become the gain rather than relief. Worse, it can even cause a stroke. This is a bad result and a visit to the doctor and later to the physiotherapist may be required to make the feelings around the neck normal again. In the case of a stroke resulting, that should be seen as a major disaster and it can come about when the person who cracks his neck does not really know what he is doing.
When you think about the neck, it is essentially a small cylinder that makes it possible for your head to turn around the body and give you a wide spectrum of vision. There are lots of important structures housed within that cylinder. It is a small area relative to the head above it and the rest of the body below. It contains the spinal cord, the lower part of the brain stem, large arteries and other blood vessels, ligaments, nerves, bones, joints and muscles. The twisting and turning of the neck around could put any of those structures at immense risk by forcing the blood vessels, for example, to knot up thereby cutting off blood supply to the brain, with the result that permanent damage to the brain results.
It is not only the joints of the hands and neck that are capable of cracking. Indeed, all joints lined by synovial membranes around the body are capable of doing so. The knuckles, knees, ankles, toes, back and neck are all able to do so because the synovial fluid lining all these joints contain gases such as oxygen, carbon-dioxide and nitrogen. The fluid is the lubricant found in these joints and when you crack any of the joints named above, there is a corresponding stretch of the capsule of the joint.
Ask the doctor
Dear doctor, I am a 28-year-old lady and don’t ovulate every month. However, I do see my cycles but have never been pregnant before. I have taken a lot of drugs prescribed by doctors before but it is still happening. Please what can I do about it? 0816xxxxxxx
Well, you have done what you must by first having appointments with your doctors. It is very possible for a woman to undergo the monthly period without ovulating and this is a fairly common problem which is caused by several factors. You should ask your doctors to refer you to a gynaecologist who will be able to determine what is responsible for your own problem and help you deal with it.
Dear doctor, many thanks for your labour of love. May God multiply your joy. My left knee aches intermittently and at times also, I feel a burning sensation in my left foot. My blood pressure oscillates between 135/86 and 150/90 mmHg. I am on a daily dose of amlodipine 10 mg and vasoprin. I am 58 years old. Kindly advise please. Thank you sir. 0803xxxxxxx
Amen sir. Thank you very much for your prayers. At your age, I would say that your blood pressure is fairly well-controlled. What you need to do with regards to the discomfort you feel in the left knee is some amount of physiotherapy. There will have to be many sessions and you will be put through a range of exercises designed to free up your joint. These, together with the medications which your doctor may prescribe for you to help deal with the pain, should be of immense benefit over several weeks. However, you do need to see your doctor first so that they can examine the affected knee and perhaps have X-rays of the knee so that the nature of the damage to that knee can be made clear.
Good day. I am a professor at the University of Ibadan. I read your article on “Some hard truths about cancer.” Thank you for the educative article. I will be contacting you on email for further information. Thank you once again. Have a blessed week. 0802xxxxxxx
Good afternoon professor and thank you so much for your compliments. We are pleased that you found the article useful. You are free absolutely to communicate by email and seek further information and clarifications. To be sure, the field of cancer research and the body of information gleaned within the last decade alone is comparable to the theory that the universe as we know it is constantly expanding, not static and so lots of efforts are required to make sense of what is known today about this baffling range of diseases.
Dear doctor, I have a teenage son who was diagnosed with tuberculosis about eight months ago. He has been on treatment since then and seemed to be doing well. The coughing stopped about three months after he started the treatment and he stopped sweating abnormally at night. He also began to put on weight and the doctors assured me that these are hallmarks of progress. Then, about 10 days ago now, he started coughing up blood and even vomiting blood sometimes. He has been complaining also of right sided chest pain. He breathes fast and seems to have gone back to the way he was before the treatment started. What do you now think has gone wrong? Please advise us. We are very worried in the entire household. His elder brother died of same disease six years ago. Please sir, help us. 0808xxxxxxx
That is a great emotional challenge for the entire family. My suggestion is simply that you have to go back to that hospital where he is being treated and have a range of new tests done to determine what might have gone wrong. He needs to have fresh chest X-rays done as well as efforts made to determine his current blood level and immune status. By immune status, I mean he needs to be screened for HIV/AIDS because the virus that causes AIDS co-exists very closely with tuberculosis. Following the conclusion of all that, a determination will then be made whether he has become resistant to the medications he is taking or not. And even though you did not disclose whether he has faithfully used his prescribed medications, a failure to do this can also lead to a worsening of his overall condition.
Dear doctor, I usually feel sharp pains in the left side of my stomach. It happens mostly when I walk long distances or when I walk for about eight to 13 minutes. I have been noticing it for some time now and I am scared. Is this not appendicitis? 0815xxxxxxx
When a problem like this occurs, it is often good to be examined initially by a doctor before making any conclusions. Now, the appendix is usually found in the lower right hand side of the abdomen in most people. Occasionally, it may be found in the left side in the area you have described but if this was the case with you, that fact would probably have become evident long before now because of other associated conditions you might also have had.
As for your current condition, I can say it is probably a muscle cramp associated with the exercise you do. Walking long distances can bring that about as can walking for several minutes if the pace of walking is fast.
Dear doctor, I have a 10-year-old daughter who still wets the bed. I was not able to get tofranil as you recommended for some other people but the pharmacist in charge of the chemist where I made the enquiry assured me that I could as well use klomipramine traded as anafranil 25mg.
Sir, I have started to administer the medicine and I am truly excited by what has happened that I have no option but to share my experience with other parents who have an absolute nightmare about how to deal with the problem. We have used the medicine for about 10 days now and she has only wet her bed once in that entire period instead of an average of two times per night. The only thing I have observed is that she seems to have reduced the amount of food she is able to eat but I am not worried about that because she weighs 58 kg which our doctor has told us is too much at her age. 0802xxxxxxx
Well, thank you for the courage you have exhibited in sharing this. May I therefore, offer you my congratulations? I am certain some other people will benefit from your experience. I might add here that this remedy will not work for everybody because the causes of enuresis are so varied but perhaps it is a good place to begin the quest for a durable treatment.
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