Can osteoarthritis cause grinding or clicking sensations? 

The experience of hearing or feeling a grinding, popping, or clicking sensation within a joint is a very common feature of osteoarthritis. Known medically as crepitus, these sensations occur when the usually smooth, frictionless surfaces of a joint become uneven due to the thinning of protective cartilage. In a healthy joint, the ends of the bones are covered in a slippery tissue that allows them to glide silently over one another, but as osteoarthritis progresses, this tissue can become pitted or rough. When the joint moves, these irregular surfaces rub together, or the ligaments and tendons may snap over newly formed bony growths, creating the characteristic sounds and physical vibrations. While these sensations can be disconcerting and sometimes even audible to others, they are a direct reflection of the structural changes occurring as the body attempts to repair and stabilise the joint. Understanding why these sounds happen and recognising that they do not always correlate with the level of pain can help individuals manage their condition with less anxiety and focus on effective strategies to maintain joint lubrication and mobility. 

What We’ll Discuss in This Article 

• The clinical definition of crepitus and how it manifests in the body 

• Why thinning cartilage leads to increased friction and grinding sounds 

• The role of bony osteophytes in creating clicking or catching sensations 

• How changes in synovial fluid viscosity contribute to joint noises 

• Why the knee and neck are particularly prone to these sensations 

• Identifying common triggers that make grinding and clicking more noticeable 

• Differentiating normal joint popping from structural osteoarthritis crepitus 

Defining crepitus and joint friction 

Crepitus is the medical term used to describe the grating, crackling, or popping sounds and sensations that occur during joint movement. In the context of osteoarthritis, this is primarily caused by the loss of the smooth articular cartilage that normally cushions the bone ends. As this cartilage wears down or becomes uneven, the joint surfaces no longer glide perfectly. Instead, they rub against each other, creating a physical vibration that can often be felt by placing a hand over the joint while it moves. 

The NHS explains that while many people find these sounds alarming, they are a very common symptom of the condition’s ‘wear and repair’ process. In some cases, the grinding is so subtle it is only felt by the individual, while in others, a distinct clicking or popping sound may be audible to people nearby. It is important to note that the presence of crepitus does not necessarily mean the joint is being further damaged by movement; rather, it is a sign that the joint’s internal architecture has already changed. 

The role of bony growths and loose fragments 

Beyond the thinning of cartilage, structural changes to the bone and the joint space also contribute to clicking and catching sensations. As the body attempts to compensate for cartilage loss, it often grows small, bony spurs called osteophytes at the edges of the joint. These spurs can alter the path that ligaments and tendons take as they move across the joint. When a tendon snaps over one of these bony protrusions, it creates a distinct clicking or snapping sound. 

Additionally, small fragments of cartilage or bone can sometimes break off into the joint space. These are often referred to as ‘loose bodies’. If one of these fragments gets temporarily caught between the moving surfaces of the joint, it can cause a sudden popping sensation or even a temporary ‘locking’ of the joint. Clinical guidance from NICE suggests that while these structural changes are permanent, keeping the surrounding muscles strong can help the joint move more predictably, reducing the frequency of these catching sensations. 

Synovial fluid and the ‘suction’ effect 

Not all joint noises are caused by bone rubbing on bone; some are related to the fluid that lubricates the joint. Every joint contains synovial fluid, which helps reduce friction. In an osteoarthritic joint, the quality and amount of this fluid can change. Sometimes, tiny bubbles of gas can form within the fluid. When the joint is moved or stretched, these bubbles can burst or rapidly move, causing a popping sound similar to when someone cracks their knuckles. 

Furthermore, if the joint fluid is particularly thick, a common occurrence after a period of rest, the surfaces of the joint can stick together slightly. When you first move the joint, the sudden separation of these surfaces creates a ‘suction’ pop. This is often why clicking is most noticeable first thing in the morning or after sitting for a long time. Once you begin moving and the fluid thins out and circulates, these specific types of noises often decrease. 

Why certain joints are noisier than others 

The sensations of grinding and clicking are most commonly reported in the knees, the neck, and the hands. The knee is particularly prone to crepitus because the kneecap (patella) must glide through a groove in the thigh bone (femur) every time you bend your leg. If the cartilage behind the kneecap is uneven, the grinding sensation can be quite pronounced, especially when walking up or down stairs. 

In the neck, the many small joints between the vertebrae can create a ‘crunching’ or ‘gritty’ sound when you turn your head, often compared to the sound of walking on gravel. In the hands, the base of the thumb and the finger joints may click or pop during fine motor tasks. While these sounds can be loud, they are rarely a cause for concern on their own unless they are accompanied by a sudden increase in pain or a loss of joint function. 

Investigating the causes of catching sensations 

A ‘catching’ sensation is a specific type of crepitus where the joint feels like it momentarily hit an obstacle before continuing its movement. This is usually caused by the physical interaction between an osteophyte and a ligament, or a slight misalignment of the joint surfaces due to cartilage loss. As the joint moves, the tissues must ‘jump’ over these irregularities. Over time, the body often adapts to these changes, and the surrounding muscles learn to support the joint in a way that minimises the catch, highlighting the importance of targeted strengthening exercises. 

Identifying triggers for increased joint noise 

While the structural changes of osteoarthritis are constant, the intensity of the grinding and clicking can fluctuate based on daily activities and environmental factors. Recognising these triggers can help you manage the sensations more effectively. 

Typical triggers for increased joint noise include: 

• Cold weather: Low temperatures can make joint fluid more viscous, increasing the initial friction during movement. 

• Prolonged inactivity: Staying still allows the joint surfaces to ‘settle’ and the fluid to thicken, making the first movements noisier. 

• Dehydration: Since synovial fluid is mostly water, being dehydrated can affect the lubrication quality of the joint. 

• Sudden high-impact movement: Putting a sudden load on the joint can force the uneven surfaces together more firmly, making the grinding more noticeable. 

Differentiation: Normal popping vs OA crepitus 

It is important to differentiate between the normal, painless popping that many people experience and the crepitus of osteoarthritis. Many healthy joints pop or click occasionally due to gas bubbles in the fluid or tendons moving over normal bone structures; this is usually painless and inconsistent. In contrast, the crepitus associated with osteoarthritis is typically more persistent, often feels like a fine grinding or ‘sandpaper’ sensation, and is frequently accompanied by an ache or stiffness in the joint. If your joint noises are accompanied by a sudden ‘locking’ where you cannot move the joint at all, or if the clicking is followed by significant swelling, you should seek a medical evaluation to check for loose fragments or other internal joint issues. 

Conclusion 

Osteoarthritis frequently causes grinding, clicking, and popping sensations due to the thinning of protective cartilage, the formation of bony osteophytes, and changes in the quality of joint lubrication. While these sounds, known as crepitus, can be unsettling, they are a physical manifestation of the joint’s structural adaptation to the condition. In most cases, the noise itself is not a sign of immediate danger, but rather an indicator that the joint surfaces are no longer perfectly smooth. By staying active with low-impact exercises, maintaining hydration, and keeping the supporting muscles strong, individuals can help ensure their joints remain as well-lubricated as possible. Most people find that the more they move gently, the less prominent these sensations become as the joint fluid circulates and the muscles provide better stability. 

If you experience severe, sudden, or worsening symptoms, call 999 immediately. 

Authority Snapshot 

This article was written by Dr. Stefan Petrov, a UK-trained physician with an MBBS and postgraduate certifications including Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and the UK Medical Licensing Assessment (PLAB 1 & 2). He has hands-on experience in general medicine, surgery, anaesthesia, ophthalmology, and emergency care. Dr. Petrov has worked in both hospital wards and intensive care units, performing diagnostic and therapeutic procedures, and has contributed to medical education by creating patient-focused health content and teaching clinical skills to junior doctors.