Will Cracking My Knuckles Lead to Permanent Damage?

What’s the data on cracking knuckles? Does it lead to permanent damage, arthritis, etc.? I’ve been cracking my knuckles for what feels like my whole life, and now I’m wondering if I should discourage my children from doing so.
—Lifetime knuckle cracker, then parent

There is relatively little data on this, but there is one excellent 2017 paper that studied 400 fingers (40 people, 10 fingers each). Some of them were habitual knuckle crackers and some were not. The authors had orthopedic surgeons examine the hands without knowing who was a knuckle cracker and who was not. Broadly, they found that there were no differences in joint-associated measures. Knuckles that were habitually cracked had a slightly higher range of movement, but that’s not a bad thing. Overall: it didn’t matter. That’s the most comprehensive paper on this.

The best evidence, though, is from a 1998 letter to the editor in the journal Arthritis and Rheumatism. It begins, “During the author’s childhood, various renowned authorities (his mother, several aunts and, later, his mother-in-law [personal communication]) informed him that cracking his knuckles would lead to arthritis of the fingers.”

The author then proceeds to explain a study he has performed: “For 50 years, the author cracked the knuckles of his left hand at least twice a day, leaving those on the right as a control. Thus, the knuckles on the left were cracked at least 36,500 times while those on the right were cracked rarely. At the end of the 50 years, the hands were compared for the presence of arthritis.”

Result? No arthritis in either hand. The conclusion: knuckle cracking doesn’t matter.

Sure, it’s an n of 1. But the time frame is long. So I’m inclined to believe it, and I am grateful to Donald Unger, MD, for his tireless pursuit of truth.