Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Snapping clicking and grinding noise and sensation in joints and muscles.

Resolved Question:

Hi,

Me and my condition
I’m a 44 year old male with an active lifestyle, normal weight and with no medical issues (past or present) other than those posted in this letter.
The condition that bothers me and that I need your opinion and advice on is as follows. For about 4 months now I’ve been experiencing a snapping, clicking and grinding noise and sensation in my joints and/or muscles. There is no direct paint related to this, more of a discomfort and a feeling of slowly falling apart. My symptoms is still progressing with more joints (I have gotten aware of joints in my body I didn’t know existed) making a loud noise and that those already making noise now make even louder noise. I also have a feeling of instability in those joints, as if they slightly slide out of position and back again with every move. If I turn my neck to either side it sounds like rocks being slowly crushed under a millstone. If I turn my head to one side and keep the position for a couple of seconds before I turn it back, I will feel (and hear) a click when one of my cervical joints slide back into place. When I walk my knee joints click and as I lift my foot off the ground it feels as if the weight of my leg and foot pulls the kneejoint slightly out off place and I feel and hear it sliding into place when I put my feet down again and put pressure on the knee. If I bend forward to pick up something I will feel and hear some of my spinal knuckles klick into place. Turning around in bed a night I feel all my ribs clicking and popping. I could provide more examples but I guess you get the picture.

First symptoms and progess
I had a spinal fusion surgery this February, fusing L4/L5 with titanium cage, screws and rods. The surgery went well, but about three weeks into my recovery I got a lot of pain in my right knee. My doctor and PT said it probably was caused by too much walking and changed gait after my surgery, which made sense. An MRI confirmed later on an inflammation under my kneecap, but I am able to control it by always making sure I do not put too much stress on the knee. Up until now I have not been allowed to use NSAID’s, so getting rid of the inflammation has been quite difficult. Except for the knee trouble, my recovery progressed nicely and I followed my PT’s instructions and did my daily exercises and walking. After about two months I was allowed and encouraged to take it further, and I had my first bicycle trip outside of the house. It all felt very good, but I guess I pushed it a bit too far and a couple of days later my immune system gave in and I got a bad cold which put me out for more than a week. About a week or two after recovering from the cold I noticed the first symptoms, which was this grinding sound when I turned my neck. Next, it was clicking and grinding from most of my upper body joints and I first noticed it during one of my daily exercise routines. After that it “exploded” and within 3 weeks it was all over my body, and I would guess I reached 80% of my current symptoms during this short period of time.

Examination and diagnosis
My primary physician considered my symptoms very strange and could not relate them to any known disease, but he checked me for hypermobility and took all kinds of blood test for arthritis, different viruses, Lyme disease and Epstein-Barr. They all came back negative. As the symptoms progressed I was sent to his colleague who specializes in physical medicine and he did a thorough test, checking “all” of my joints. He was able to confirm my symptoms, but he was also puzzled and could not find any diagnosis to fit my condition. He though it might be related to rheumatology and wrote a letter trying to refer me to the local hospital specializing in this field. He suggested reactive arthritis, but I was rejected by the hospital as none of my symptoms would fit anything related to rheumatism. I was sent back to my primary physician and I am now waiting for an MRI of my spine, neck and pelvis to check if they can find any degenerative indications. I also had my 6 month check up with my surgeon last week and asked her about my condition to hear if this could somehow be related to the surgery or to my spinal implants. She said no and also mentioned that they were using all titanium hardware and that no research indicated any trouble with these implants.

Why I contact you
Even though my physicians take me seriously, they have at this point no clue to what this is. It is hard to just sit still and wait when I feel my symptoms getting worse from one day to the next. It scares me and it’s difficult to think that this will disappear without some kind of treatment. A second opinion is also valuable. Even though all I have written is related to joints, and I can hear and feel them snap and click, I also have the feeling that my muscles “lag”. As if the layers of muscles don’t slide smoothly over each other. But it is hard to separate one thing from the other so this might just be a sensation, and might just be related to what I experience with my joints.
Looking forward to hearing from you,

Regards,
Oystein
Norway



Category: Internal Medicine Specialist

Ask Your Own Question

Category: HIV- AIDS Specialist
 21 Doctors Online

Hello,

I have discussed your case with our Orthopedician and unfortunately we will not be able to provide much insights into your problem. This is because of the limitation of the "online consultation model".

However we may be able to contribute some limited, but valuable information from our side. So if you wish to continue the consult, please let me know. ( In that I case I will replying from my email ID). Or else you can go for a refund.

Thank you


Patient replied :

I understand the challenges in doing online consultation, but I am happy to receive any useful information so please continue the consultation.

Thanks


Hello,

I would like some clarity and additional information on the symptoms :

1. Are the clicks, snapping or grinding noise audible to others. As in
like have the Doctor / friends or family has commented that they can
hear the click ? ( I read that your Doctor has confirmed your
symptoms. This mean the click ?)
2. Do you mean to say there is no pain at all ?
3. How prominent is the grinding noise ? Is it audible to others ?
4. If I say your major symptoms are the instability and the grinding
noises, am I correct ?
5. There are no joint swellings anywhere, I assume.
6. Is the mobility of the joint restricted ? . For example are you able
to raise the shoulder fully or bend the knee.
7. Do you have anything unusual in your ear, nose, eyes or throat ?
(anything unusual ? for example pain and warmth of ear )
8. Is there any darkening of urine (while standing, that is on the
toilet)

You can reply as a followup.
Thank you


Patient replied :

Hi,

You will find my answers under each question.

1. Are the clicks, snapping or grinding noise audible to others. As in
like have the Doctor / friends or family has commented that they can
hear the click ? ( I read that your Doctor has confirmed your
symptoms. This mean the click ?)

“The clicking sounds are audible to others and typically come from my knees, ankles, elbows, wrists and shoulders. If I repeat a motion (many times in a short timespan) with one of those joints I will, usually, be able to stop the clicking. Still, it will be just a few seconds without movement until the joint will start clicking again. My doctor has confirmed my symptoms. The clicking is audible to everyone, so this was confirmed right away. In addition he “tested” my joints by touching the joints while I moved, pulling my fingers and legs, “twisting” my knee etc. He did this all over. He found two things. 1. He could feel the laxity in the joints and the grinding sensation. 2. He could not find any abnormalities, swelling or signs of inflammation”

2. Do you mean to say there is no pain at all ?

“Yes. Up until now I have not felt any actual pain, just a highly uncomfortable feeling”

3. How prominent is the grinding noise ? Is it audible to others ?

“The grinding noise is usually not audible to others unless I provoke it by rolling my arms (shoulderjoints) around in a circle. This will create so much grinding noise that it is audible to others. The clicking sound (question 1) is more high pitched and the sound is something like what you get if you break off dry wooden sticks. The grinding sound is most prominent in my upper body, especially the sternum / ribcage, shoulders and neck. Typically, when bending slightly forward doing some housekeeping, I will hear and feel this grinding in my shoulders and ribs. The sound itself is low pitched, like my example with the wooden sticks but this time with a layer of cotton insulating the sticks. (Might be a bad example but I guess you see what I’m trying to say ?)”

4. If I say your major symptoms are the instability and the grinding
noises, am I correct ?

“Yes, grinding and instability are my major symptoms. The high pitched clicking sounds from knee joints etc. is somewhat common I guess. I mean, most people experience this from time to time. Some more than others. For me though, this is all new and in addition it is widespread. The grinding is more uncomfortable, and the sensation I get moving my upper body (torso) is as if none of my ribs is really attached to the sternum and spine. As if they are floating freely. One exercise that really provokes this is doing regular pushups. Did this as part of my exercise routine after back surgery, but now it is so uncomfortable that I have stopped. “

5. There are no joint swellings anywhere, I assume.

“No, no swellings. This is partly the reason why I was rejected by the specialists in rheumatology. That, and the fact that none of my blood samples indicated rheumatic diseases.”

6. Is the mobility of the joint restricted ? . For example are you able
to raise the shoulder fully or bend the knee.

“No, the mobility is not restricted. “

7. Do you have anything unusual in your ear, nose, eyes or throat ?
(anything unusual ? for example pain and warmth of ear )

“No, just tinnitus in my left ear, but this has been going on for more than a year so I guess it is not related to this problem? I also experience more sound when I swallow and a feeling that there is more “motion” in my throat. A bit hard to explain really.”

8. Is there any darkening of urine (while standing, that is on the
toilet)

“No, I haven’t noticed any change. My urine is a bit darker in the morning, as always, and gets brighter during the day.”


One thing I could mention is that I do not need to put much stress on my joints to make them click or grind. For instance, sitting down I just need to flex my chest muscles (with my arms hanging straight down) do provoke a small snap or grind in one or more of my ribs or in the joint between the clavicle and the sternum (if that is where it is attached?). If I put a couple of fingers on this joint while flexing the chest muscle I will feel the bones move slightly apart, creating the grinding sound, and slide back into place as I relax my chest muscle. I feels like the joint moves a little too much and that the knuckles grind on each other bone against bone creating an uneven motion. As if there is no coating or fluid to cushion the joint. But again, no pain, just a faint soreness in the muscle if I repeat it too much.

regards,
Oystein


With Inputs from Dr.Bimalesh Pandey, (SR. Rheumatologist), Dr. Tiwari (Orthropedic Surgeon)

1. We recommend evaluation in line of a “polyarthritis”. That is arthritis of multiple joints. This is based on the dictum that ‘uncommon presentations of common disease is more common that common presentation of uncommon disease’. You will require a basic work up and Xrays to rule out Rheumatologic disease like Rheumatoid Arthritis. If these are already done and found negative then there is no need to repeat the tests.

2. The clicks and grinding can be present normally. But since it is widespread there is possible involvement of cartilage. When cartilage is lost or damaged there can be friction between bone and ligaments causing this kind of sounds. Trauma or mechanical damage will not cause this widespread disease. Since multiple joints are involved, autoimmune cartilage damage could be considered. In this condition there are antibodies against the type of cartilage causing widespread cartilage damage.

This is the mechanism of disease in Relapsing polychondritis. (You do not have the typical symptom pattern of RP though). But a similar mechanism can exist.

3. Besides the baseline investigation for arthritis, you might need a synovial fluid analysis, cartilage biopsy and MRI of multiple joints


4. The absence of pain is a good sign. The symptoms could be part of a hypermobility syndrome, which usually is harmless.

5. If everything is normal (after the investigations) a wait and watch approach can be considered.

Hope this helps
Please feel free to ask followup questions.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news