Crepitus: What Does The Grating Sensation Indicate?

Crepitus, which is the term used for the grating sensation that affects your joints, often indicates a more significant underlying problem. It is the crunching, cracking, or popping sound and sensation felt when your joints move. It can be caused by arthritis, tendinitis, or several other medical conditions. 

Of course, crepitus isn’t always something to worry about—it can be caused by everyday movements or activities. But if your crepitus is persistent, it’s essential to get it checked out by your doctor. You’ll want to seek medical advice and treatment to determine if it’s the result of an underlying cause and to prevent the condition from worsening.

Anatomy And Physiology Of Joints

Joints are the points at which two or more bones of our skeleton meet. They provide stability and flexibility, allowing us to move through a wide range of motions. Joints also act as shock absorbers, dispersing energy from everyday activities like walking and running. The most common joints in the body are those that form the shoulder, elbow, knee, wrist, hip, and ankle.

The joint comprises several parts, including the cartilage, ligaments, joint capsule, muscle tendons, and more. The cartilage works as a cushion between your bones to prevent them from rubbing together. Ligaments connect bones and keep them stable while providing flexibility. Muscles and tendons both attach to bones and muscles, allowing them to move. Finally, the joint capsule surrounds everything and helps keep it all together.

A diagram of a synovial joint

What Is Crepitus?

Crepitus is a symptom of an underlying medical condition that involves the bones, joints, or muscles. It is characterized by a grating sensation and/or sound when you move your joints. This can range from a light crackling to a loud popping noise. The sensation can be uncomfortable or even painful for some people. Crepitus can occur in any joint of the body, including the neck, shoulders, elbows, wrists, hips, knees, and ankles. It is usually caused by a lack of lubrication between bones or cartilage due to wear and tear or inflammation.

Different Types Of Crepitus

The following are the different types of crepitus:

• Joint Crepitus: Joint crepitus is the sound that occurs when the surfaces of two bones, such as the knee joint, rub together due to a lack of lubrication.
  
• Bone Crepitus: Bone crepitus is the sound that occurs when two fragments of a fractured bone rub together.
  
• Crepitus Of Bursitis: Bursitis is an inflammation of the bursa, which are small sacs of fluid that cushion and protect joints. Crepitus of bursitis is the sound that occurs if the bursa contains small, loose fibrous particles.
• Crepitus Of Tenosynovitis: Tenosynovitis is an inflammation of the tendons and tendon sheaths. Crepitus of tenosynovitis is the sound that occurs when the inflamed tendons rub against each other.

Symptoms Associated With Crepitus In Joints

If you have joint crepitus, there’s a good chance that the crepitus you’re hearing isn’t the only symptom. If there’s an underlying cause, you may also experience the following symptoms:

Joint Pain

Pain is the most common symptom that is associated with joint crepitus. The pain that is associated with crepitus can range from mild to severe. You may experience a dull ache, stiffness, and tenderness in the joint. You may also experience sharp, stabbing pains when you move the affected joint.

Swelling

Joint crepitus can also be accompanied by swelling around the affected joint. This swelling is caused by inflammation, which can occur for several reasons, including arthritis or tendonitis. The area may feel warm to the touch and appear red and swollen.

Conditions Associated With Grating Sensation In Joints

The following are some of the most common medical conditions associated with joint crepitus:

Fibromyalgia

Fibromyalgia can lead to a grating sensation, often referred to as “crepitus,” within the muscles. This sensation arises from the buildup of small calcium deposits in the muscle tissues, resulting in stiffness and discomfort. The presence of these calcium deposits is attributed to hormonal and chemical imbalances commonly observed in individuals with fibromyalgia.

Gout

Gout is a type of arthritis. It is caused when uric acid crystals accumulate in your joints. Gout affects the big toe, but it can also affect your other joints, such as the knee and ankle. The affected joint may become swollen, tender, and painful. Gout can cause crepitus when you move the joint due to the presence of crystals rubbing against each other.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder. It causes inflammation in the joints. As a result, pain, swelling, and stiffness can occur in the affected joint. It can cause crepitus when you move the joint due to cartilage deterioration or tendons rubbing against each other.

Osteoarthritis

Osteoarthritis is a degenerative joint disease. It causes the cartilage in joints to deteriorate. This can cause pain, stiffness, and swelling in the affected area. It can also cause crepitus when you move the joint due to the weakened cartilage wearing down even more.

Lyme Disease

Lyme disease is an infection that’s caused by bacteria that is spread via the bite of an infected tick.  It can lead to crepitus because the bacteria can cause inflammation in joints, which then rub against each other and create a grating sensation.

Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by joint inflammation. It’s caused by the body’s immune system attacking its own tissues and organs. It can lead to joint pain, stiffness, and swelling that can cause crepitus when you move the affected joint. 

Ankylosing Spondylitis

Ankylosing spondylitis is a chronic autoimmune disorder that can cause spine and joint inflammation. It can cause pain, stiffness, and swelling in the affected areas. The joint may creak when you move it due to the inflammation and deterioration of the cartilage.

Why Immediate Diagnosis Is Important

Getting a proper diagnosis when experiencing a grating sensation in the joints is vital, as it could indicate an underlying condition. Prompt diagnosis can help determine what is causing the condition and allow for proper treatment to begin. If the underlying cause remains undiagnosed, it could lead to further complications or permanent joint damage. 

A diagnosis can also rule out more serious conditions, such as cancer or arthritis. Be sure to seek medical advice if you experience additional symptoms, such as pain, swelling, or discomfort in your joints, to ensure early diagnosis and treatment.

How Do You Check For Crepitus?

The first thing a doctor will likely do is ask about any symptoms you may be having, including the grating sensation in your joints and any additional symptoms. They will also take a detailed medical history to look for any underlying conditions causing the crepitus. 

A physical examination will then be done to diagnose joint crepitus. Your doctor will closely examine the affected joint and ask you to move it in various directions. This can help them determine if there’s a grating sensation or sound when you move your joint. 

Your doctor will also order imaging tests that include X-rays or MRI scans to examine the affected joint further. These tests can help them detect any damage or irregularities in the joint that could be causing the crepitus. Your doctor may also order a lab test to analyze a fluid sample from the affected joint and check for signs of infection, inflammation, or an autoimmune disorder.

Conventional Treatment For Crepitus

Treatment for crepitus will depend on if there’s an underlying cause and what it is. Common treatments include:

Conservative Measures

Conservative measures are often the first line of treatment for crepitus, especially if no serious underlying cause is identified. These measures include:

• Rest And Activity Modification: Depending on how severe your underlying condition is, your doctor may recommend that you rest and avoid any activities that could worsen your condition. They may also suggest switching to low-impact activities when exercising and using heat or cold therapy to treat any inflammation or pain.
  
• Assistive Devices: You may be prescribed assistive devices, such as canes or braces, to help relieve stress on the affected joint and provide extra support while walking or standing. If the affected joint is in the upper body, such as the arms or hands, your doctor may recommend that you use a splint or brace to help limit movement and provide extra support.
  
• Physical Therapy: Your doctor could recommend physical therapy to help strengthen the muscles around the affected joint and improve your range of motion. A physical therapist will provide exercises and stretches that can help reduce joint pain and improve your mobility.
  

Medications

In cases where your crepitus is accompanied by joint pain or inflammation, a more conventional doctor may recommend medications. Be wary that medications only mask the symptoms and may have adverse side effects. With that in mind, medications prescribed by traditional doctors include:

• Over-The-Counter Pain Relievers: Your doctor may suggest taking over-the-counter medications. These can include ibuprofen or acetaminophen and can help reduce any pain or inflammation associated with crepitus.
• Topical Creams Or Ointment: If over-the-counter pain relievers don’t work, your doctor may prescribe topical creams or ointments that can help reduce pain and inflammation, such as a corticosteroid cream.

Surgical Interventions

If your condition is severe or if there’s an underlying cause that has to be addressed, your doctor may recommend surgical intervention. Surgery should always be considered a last resort since it’s expensive and invasive, which means there are risks of complications, such as infections, allergic reactions, and even potential damage if the surgery is not successful. Some common surgical interventions include:

• Arthroscopy: This procedure involves the use of a small camera and tiny surgical tools to look inside the joint. Your doctor can then remove any damaged cartilage or bone fragments that could be causing the crepitus.
• Joint Replacement: If your joint has been severely damaged, your doctor may suggest replacing it with an artificial joint. This will help reduce pain and improve mobility in the affected area. However, joint replacement is extremely invasive and often requires lengthy recovery times.