Crepitus and Joint Popping: Everything You Need to Know

Crepitus is a crackling or popping sound that occurs as a result of tissues rubbing together. The sound results from an unusual interaction between air, fluid, or bone. It is common among older adults, and it can sometimes signify an underlying condition. Crepitus does not always mean that there is an underlying health concern, but it can be the result of a disorder, injury, or disease.

It is more common in older adults but can affect anyone of any age.

If your symptoms of crepitus are persistent or cause you concern, seek prompt medical care.

This article covers the causes and treatments associated with crepitus. It also looks at some other symptoms that may occur.

Crepitus, also known as crepitation or crackles, refers to a crunching or grating sound or sensation that the body may produce. It is a symptom of a condition rather than a condition itself.

Clinicians may use the term “crepitus” to describe several cracking, popping, and grating sounds or sensations that parts of the body may produce.

Crepitus can happen both in the hard tissues (such as bone), due to the functional interaction of the musculoskeletal structure of the body, as well as in the soft tissues. For example, crepitus is common in the knees, but you may experience it in other joints all over the body.

Soft tissue crepitus, also known as subcutaneous crepitus, can be due to air inside body tissues, and it can indicate a serious condition.

Seek immediate medical care if you have a popping or crackling sound coming from your soft tissues.

A certain amount of joint sounds with movement can be normal, especially when they only occur occasionally.

Crepitus may present as crackling, grinding, creaking, or popping sounds. It may also present as a crunching sensation.

With soft tissue crepitus, these sounds may occur when applying pressure to the affected area. Crepitus in the lungs can sound like crackling, clicking, or popping.

Particularly, these sounds or sensations may occur when bending a joint or when moving or carrying body weight or other forms of weight. For example, such sounds may occur when climbing stairs or kneeling.

Crepitus may accompany other symptoms that can vary depending on the underlying disease, injury, or condition.

Related symptoms may also vary depending on whether the crepitus relates to the joints or bones, soft tissues, or other body parts.

Additional symptoms can include:

• pain
• joint stiffness that may also be worse in the mornings
• discoloration and warmth of the skin over the joint
• reduced mobility
• occasional or continual swelling around a joint

In some cases, crepitus may be associated with a life threatening condition that requires immediate evaluation in an emergency setting. 

Seek immediate medical care or call 911 for anyone with any of these life threatening symptoms:

• bluish discoloration of the skin or lips
• chest pain or pressure
• confusion or a loss of consciousness, for even a brief moment
• difficulty breathing
• high fever, around 101ºF (38.3ºC)
• nausea and vomiting

Crepitus is the result of tissues interacting to produce sound or friction. This can happen due to:

• the air inside soft tissues of the body
• air bubbles popping in the fluid of the joints
• the rubbing of hard tissues, such as bone
• damaged, eroded, or rough cartilage
• tendons or ligaments snapping over the joint’s bone structure

Causes of the interactions that result in crepitus can include both normal movements of the body’s structure and serious underlying conditions.

However, as crepitus can sometimes be the result of a serious underlying condition, it is important not to assume that any instance of crepitus is benign. Contact your doctor promptly if you experience crepitus alongside other symptoms or if the crepitus is persistent.

Musculoskeletal causes and conditions that may result in crepitus can include:

• arthritis, such as osteoarthritis or rheumatoid arthritis
• normal movements of the joints that occasionally burst air bubbles
• patellofemoral pain syndrome, also known as runner’s knee, wherein an increase in activity causes pain or discomfort behind the kneecap

Learn more about runner’s knee — including its causes, diagnosis, and treatment — here.

Subcutaneous crepitus can be the result of conditions including:

• pneumothorax, or a collapsed lung
• subcutaneous emphysema
• a rupture or tear to the esophagus
• certain types of bacterial infections
• chest trauma
• a penetrating wound to the chest, back, or abdomen, such as a knife wound
• perforation of the gut
• mechanical ventilation

Many of the causes of subcutaneous crepitus — such as trauma, infection, and perforation — may require immediate medical evaluation in an emergency setting.

To diagnose your condition, your doctor will use different sources of information and tests to understand the cause of the crepitus.

If your crepitus is severe or persistent or presents alongside further symptoms that indicate an underlying condition, your doctor may use:

• your medical and patient history
• information about the history of the symptoms, including their onset and any related symptoms
• blood tests
• imaging tests, such as X-ray or CT scans
• arthrocentesis, which involves using a syringe to take a tiny amount of the fluid from the joint, called synovial fluid, in order to examine the contents

When crepitus results from normal movements and produces only occasional sounds, it may not be a cause for concern nor require treatment.

However, if the crepitus is regular and accompanies other symptoms — including pain, reduced mobility, swelling, or respiratory problems — any underlying condition that is causing it will require treatment to correct it.

Treatment options for the clinical causes of soft tissue crepitus can include:

• surgery to address wounds or trauma
• antibiotics for bacterial infections
• removal of any infected tissue
• supplemental oxygen, fluids, or medication
• chest drains to treat a collapsed lung and allow the lung to reinflate
• intubation to drain fluids from gut perforation

Many treatments for musculoskeletal causes of crepitus focus on management methods to reduce pain or complications.

Clinical treatments may include pain relief and anti-inflammatory medication, physical therapy, and steroid injections.

Some underlying conditions that cause crepitus may also require surgery. Surgical procedures may include:

• arthroscopic surgery, in which the surgeon can remove or treat damaged tissue
• debridement, which smoothes damaged cartilage to reduce friction
• osteotomy, which cuts the bone to improve the alignment of mechanisms acting on the joint
• joint replacement

In some cases, at-home methods for managing certain underlying causes of crepitus can effectively improve associated symptoms and discomfort.

At-home management methods can include supporting healing from injury and improving joint health.

If crepitus is the result of an injury, using a brace or splint on the affected joint can sometimes help with alignment. This can further help healing.

Orthotics, or shoe inserts, are medical devices that can help stabilize the feet and legs. They may help relieve pain and support activity.

Certain vitamins and supplements may help improve joint health and relieve symptoms.

Supplements that may help include:

• chondroitin
• fish oil or omega-3 supplements
• vitamins D and K
• curcumin taken with other supplements, such as black pepper or sources of fats, to aid absorption

The researchers behind a 2021 review also suggest that magnesium may help with arthritis and joint health.

However, vitamins and supplements can cause side effects and may interact with other medications. Only introduce new supplements under the supervision of your doctor.

For the relief of mild pain, discomfort, or inflammation, over-the-counter pain medication or anti-inflammatory drugs may help relieve the symptoms.

However, as with any medication, you should not use these without first seeking advice from a pharmacist or doctor. This is because these drugs will not be suitable or safe for everyone.

Some causes of crepitus are benign. However, certain cases of crepitus — particularly subcutaneous crepitus — can relate to very serious conditions that have life threatening complications. Not seeking treatment can also result in serious complications and permanent damage.

Once your doctor diagnoses the underlying cause, it is important for you to follow the treatment plan that they design specifically for you to reduce the risk of potential complications.

Complications of some of the conditions that cause crepitus include:

• chronic or persistent pain
• widespread inflammation
• joint damage
• cardiovascular disease
• carpal tunnel syndrome
• further respiratory illness Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source
• respiratory failure
• bleeding or hemorrhage
• infection
• unsuccessful surgery
• complications of surgery, including reactions to anesthetics, blood clots, infections, bleeding, and shock

Crepitus is a symptom wherein the joints or soft tissues of the body produce creaking, grating, popping, or cracking sounds or sensations. This can happen with movement or when applying weight or pressure to the affected area.

Some causes of crepitus are benign, especially when the body produces such sounds only occasionally.

However, crepitus can also be the result of a more severe underlying musculoskeletal or subcutaneous condition. These conditions — which include infections, trauma, arthritis, and respiratory disorders — will require medical treatment.

Seek immediate medical help for any crepitus in the soft tissues or for crepitus that is persistent and accompanies other symptoms.