Joint Noises: Causes, Clinical Significance, and Treatment

Joint noises, also known as clicks, pops, or crepitus, are a frequent reason for physical therapy consultations. They are often heard in the knees, shoulders, or temporomandibular joints (TMJ). Scientific evidence from sources such as PubMed and SciELO confirms that when these sounds occur without pain or functional limitation, they are usually harmless. However, in certain contexts they may reflect an underlying condition and deserve professional attention.

Joint noises are audible sounds that occur when moving a joint. They may present as cracking, popping, or a “grinding” sensation. They are caused by different physiological or pathological mechanisms:

• Tribnucleation: formation and release of gas bubbles in the synovial fluid when joint surfaces are rapidly separated.
• Crepitus: friction of irregular surfaces, often seen in knees with joint wear.
• Anatomical variations or disc displacement: as commonly occurs in the TMJ.

In people without pain or limitations, isolated joint noises are typically physiological. Observational studies have shown that:

• They do not increase the risk of developing osteoarthritis or other joint conditions.
• They do not require treatment if they are not accompanied by symptoms.
• They may become more frequent with age without indicating disease.

In some cases, joint noises are associated with pathology and should be thoroughly evaluated:

• Persistent pain: especially when moving the joint.
• Functional limitation: difficulty performing usual movements.
• Rheumatic conditions: such as rheumatoid arthritis or advanced osteoarthritis.
• Recent trauma: whiplash, sprains, or sports injuries.

In these scenarios, joint noises may indicate structural damage, and a physical therapist or specialist should perform a detailed evaluation.

Knee crepitus is one of the most studied examples. Recent research (PubMed 2024) concludes that, in the absence of pain, crepitus is not a predictor of deterioration or future disease. However, when accompanied by swelling, stiffness, or loss of strength, it may be linked to meniscal injuries or osteoarthritis.

• Age: prevalence increases over time.
• Physical activity: athletes and active individuals often report more joint noises, most of which are not clinically relevant.
• Pre-existing conditions: rheumatic, metabolic, or inflammatory diseases increase the likelihood of noises accompanied by symptoms.

Digital physical therapy offers key tools to address cases where joint noises cause patient concern. With TRAK, physical therapists can:

• Educate patients about the benign nature of many joint noises.
• Provide personalized exercise programs to improve strength, mobility, and motor control.
• Remotely monitor progress, tracking pain, inflammation, or functional limitations.
• Boost adherence through AI-powered real-time correction.

• Avoid prolonged static postures that overload joints.
• Incorporate strength and mobility exercises into your weekly routine.
• Maintain a healthy weight to reduce pressure on knees and hips.
• Consult a professional if joint noises appear along with pain or swelling.

Joint noises are common and, in most cases, are not a health concern. Scientific evidence is clear: without pain or limitation, they do not require treatment. However, when symptoms are present, they may indicate an underlying condition that does need attention. Digital physical therapy with TRAK provides a modern, accessible approach to managing these situations, ensuring education, prevention, and personalized treatment.