What Do Cracking Toes Mean?

The cracking sound that toes sometimes make may be harmless, or it could be a sign of arthritis or other conditions in need of medical treatment. The grating, cracking, or popping noise made by joints—referred to as crepitus—is rarely serious, but there are times when it may be a sign of fracture or other problems in need of immediate care.

This article explains the causes of cracking or popping toes, both harmless and serious. It also takes an extended look at the symptoms and treatment of foot and toe arthritis.

Why Joints Crack or Pop

No one exactly knows why crepitus occurs. With that said, it is a common condition thought to be caused by one of several processes, including:

• Cavitation: This is a harmless phenomenon in which a vacuum develops in the lubricating fluid surrounding a joint, called synovial fluid. When a joint quickly bends, the rapid release of pressure can cause a cracking sound.
• Escaping gas: If a joint is expanded or flexed, air bubbles can gradually build up in the synovial fluid in the joint space. When the joint is bent, the rapid escape of gas can cause a popping or cracking sound.
• Rapid stretching of ligaments: Ligaments are fibrous tissues that connect bone to bone. If a joint is rapidly bent, the ligament can sometimes make a snapping sound, particularly if it is displaced.
• Joint erosion: When the smooth white tissues between joints, called cartilage, are worn away, they can cause bone to rub against bone. This can cause grating or crunching sounds with movement.
• Broken adhesions: An adhesion is the sticking together of tissues. This can occur after an injury when scar tissues effectively "glue together" adjacent membranes or tissue. When this occurs between the joints, the rapid bending of the joint can cause the adhesion to break, creating a snapping or popping noise.

Generally speaking, if crepitus isn't accompanied by pain or affecting your mobility, treatment isn't necessary.

Underlying Causes of Toe Popping

While crepitus is generally harmless, there can be times when the sound indicates a bigger problem in need of treatment. As a general rule, if the popping or cracking is accompanied by pain or other symptoms, you should see your healthcare provider.

Prior Toe Injuries

Sometimes a cracking toe is caused by an old injury that has either disrupted the normal position of a joint or caused scar tissues to develop in the joint space. The uneven alignment of the joint or uneven joint surfaces can cause grating, crunching, or popping sounds.

One such example is the development of bone spurs, also known as osteophytes. Bone spurs are tiny projections of bone that can develop after an injury when the body tries to rapidly repair bone. The haphazard way in which the new bone develops can result in a spur.

A popping sound can often be heard when smooth cartilage meets the rough surface of the bone spur.

Stress Fracture

A stress fracture of the foot is a tiny crack in the bone that often occurs due to repetitive low-impact force. It is a common occurrence among athletes, including long-distance runners, but can also be caused by a traumatic injury.

The symptoms of a stress fracture may not be overt and may only cause pain when pressure is placed on the joint. But, if crepitus develops alongside toe pain, it is often a sign that the stress fracture is progressing to a complete fracture.

Immediate medical care should be sought if toe pain with movement is suddenly accompanied by cracking, popping, or grating sounds.

Arthritis

A popping toe joint is common with arthritis. There are two main types of arthritis, both of which can cause the progressive loss of joint cartilage and the development of osteophytes:

• Osteoarthritis (non-inflammatory arthritis): Also known as wear-and-tear arthritis
• Inflammatory arthritis: Including rheumatoid arthritis, psoriatic arthritis, and gout

Osteoarthritis tends to occur at an older age, while rheumatoid arthritis can develop at any age. Osteoarthritis will often affect a particular joint on one side of the body, unlike rheumatoid arthritis which will commonly affect the same joint on both sides of the body.

With rheumatoid arthritis, there will often be joint swelling and fatigue, symptoms that are not typical with osteoarthritis.

Gout

An inflammatory arthritis that primarily targets the toes (especially the big toe) is called gout. Also known as gouty arthritis, the condition is caused by the build-up of uric acid crystals in the joint space. The resulting inflammation causes toe pain and swelling, which tends to develop rapidly and can often be extreme.

Over time, gout can cause joint damage that increases the odds of crepitus. It can also cause the formation of lumpy deposits, called tophi, that erode bone and cartilage and further increase the risk of crepitus and other arthritis symptoms.

How Arthritis Affects the Toes

Our feet are the workhorses of the body with more than 30 joints and 28 bones in each foot. More than 100 types of arthritis can affect the foot and ankle, the most common of which include osteoarthritis and rheumatoid arthritis.

Insofar as the toes are concerned, arthritis will often affect the forefoot (the ball of the foot), including the adjacent toes joint referred to as:

• Metatarsophalangeal joint (MCP) found at the base of the toe
• Proximal interphalangeal joint (PIP) found in the middle of the toe
• Distal phalangeal joint (DP) found near the tip of the toe

Symptoms

When the MCP, PIP, or DP joints are affected, they can cause a cascade of symptoms that will generally get worse as arthritis progresses.

Symptoms of arthritis specific to the toes include:

• Toe pain with movement, particularly when walking or running
  
• Joint stiffness, which may improve with movement
  
• Walking flatfooted, to avoid placing pressure on the toes
• Difficulty walking or climbing stairs
• Crepitus, due to progressive joint damage
• Joint locking
• Joint deformity

Treatment

Depending on the type of arthritis you have, the treatment may be focused on relieving symptoms or, in the case of autoimmune arthritis, treating the underlying disorder.

Options may include:

• Rest with foot elevation to reduce inflammation and pain
• Ice application to relieve swelling and pain
• Heat application to improve joint mobility and reduce stiffness
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve (naproxen) or Celebrex (celecoxib) to reduce inflammation and pain
• Cortisone injections into the joint space to alleviate joint inflammation longer
• Foot orthotics and shoe inserts to alleviate pressure on the toes
• Immunosuppressant drugs to help control the underlying autoimmune disorder
• Surgery, when toe deformity and/or the loss of mobility is extreme
  

Summary

When the bending of the toes causes clicking, popping, or grating sounds (referred to as crepitus), the cause will most likely be harmless. It may be due to pressure or trapped gas in the joint space or caused by the "snapping" of a ligament with rapid movement. The sound may also be caused by something more serious, like bone spurs or the loss of cartilage in a joint space.

Crepitus of the toes may also be a sign of an underlying condition in need of treatment. This includes a stress fracture or a prior toe injury. It may also be due to osteoarthritis ("wear-and-tear arthritis") or long-term complications of inflammatory arthritis (including rheumatoid arthritis and gout).

Crepitus typically doesn't require treatment if it isn't accompanied by pain and doesn't interfere with mobility. However, if there are other symptoms like pain or the loss of mobility, treatment may be needed and can vary by the cause.

A Word From Verywell

Cracking or popping noises in joints can come with age, but it is not an inevitable part of aging. By keeping active and fit, you can maintain mobility well into your 70s and beyond. By doing so, vulnerable joints of the knees, ankles, feet, and toes are less likely to experience chronic popping or cracking sounds indicative of osteoarthritis.

With that said, overdoing it and placing excessive stress on the joints can contribute to the onset of osteoarthritis.

As you get older, speak with a personal trainer or physical therapist about ways to move from high-impact activities (like running) to low-impact activities (like swimming) to protect your joints and long-term mobility.