TIME Research

You Asked: Is Cracking Your Knuckles Bad?

Illustration by Peter Oumanski for TIME

And just what is that cracking sound, anyway?

From fingers and toes to necks and knees, everyone knows a “cracker.” And most habitual joint poppers have heard rumors their habit may cause arthritis. But are those rumors true?

First, a quick anatomy lesson: Many of your joints—including those that allow your fingers to beckon or point—feature small pockets or gaps that are filled with synovial fluid. Like axle grease, this fluid allows the bones that commingle in your joints to glide close to one another without grating, explains Dr. Pedro Beredjiklian, chief of hand and wrist surgery at Philadelphia’s Rothman Institute.

When you pull, twist or otherwise “crack” a joint, you’re expanding the volume of space between your bones, Beredjiklian says. That volume expansion creates negative pressure, which sucks the synovial fluid into the newly created space. This sudden inflow of fluid is the popping you feel and hear when you crack a knuckle, he adds.

The more you crack your joint, the more you stretch and loosen both its capsule and the surrounding ligaments. And the looser those components become, the more easily your joint will pop, Beredjiklian says.

So is this bad for your joints? Almost certainly not, he assures. Multiple studies have looked into the prevalence of “crackers” among large groups of osteoarthritis patients. They found no evidence that finger pullers and poppers are more likely to suffer from arthritis than those who don’t crack their knuckles. One devoted researcher—a man who habitually cracked the joints on his left hand—actually studied himself. After roughly six decades of lopsided joint popping, this case study of one showed no increased presence of arthritis in his left hand as opposed to his right.

“Finger cracking is so common you would expect to see a lot of causal reports if it was harmful,” Beredjiklian says. “But you don’t. So I think it’s unlikely cracking joints in hands leads to arthritis.”

While one 1990 study linked long-term joint popping to hand swelling and lower grip strength, there isn’t any more research to back up that finding. On the other hand (pun intended), at least one study concluded that knuckle cracking offers those who do it a sense of almost therapeutic “release.”

Poppers, you can ignore your fusty aunt or cranky coworker when they try to scare you with talk of debilitating cracking-related ailments.

Just one note of caution: Tendons catching on irregular bone or joint formations can also explain some clicking or popping sounds, especially in places like your neck, Beredjiklian says. Whether this can cause harm will depend on the person and his or her anatomy. But if a weird sound emanates from your shoulder or knee when you flex it a certain way, you may want to avoid angering that area with deliberate cracking.

TIME Drugs

Go Inside the Harvest of Colorado’s Most Controversial Marijuana Strain

Take a look at how Charlotte's Web transforms from plant to medicine.

The Stanley brothers of Colorado grow a strain of cannabis called Charlotte’s Web on a farm near Wray, Colo. An oil made from the plant is being used to treat children with epilepsy in Colorado and California and is in high demand throughout the country. Until this year, the Stanleys cultivated and sold Charlotte’s Web as medical marijuana. But because the plant meets the legal definition of hemp, containing less than 0.3 percent THC, the Stanleys are hoping they will be legally allowed to ship Charlotte’s Web oil across state lines.

TIME Infectious Disease

There Are Half a Million More Tuberculosis Cases Than Once Believed

INDIA-HEALTH-TB-TREATMENT-MSF FRANCE
An Indian tuberculosis patient rests at the Rajan Babu Tuberculosis Hospital in New Delhi on March 24, 2014. AFP—AFP/Getty Images

The disease killed 1.5 million people last year

Nearly half a million more people have tuberculosis than was previously estimated, the World Health Organization said Wednesday, adding to the 9 million people who developed the disease in 2013.

The epidemic killed 1.5 million people in 2013, including 360,000 people who were HIV positive, according to the WHO. The disease has been declining, however, by a rate of 1.5% per year, while its mortality rates have dropped 45% since 1990.

“Following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased,” said Dr. Mario Raviglione, director of the WHO’s Global Tuberculosis Program. “This is providing us with much more and better data, bringing us closer and closer to understanding the true burden of tuberculosis.”

The WHO said $8 billion is needed each year to combat the epidemic, but there’s currently a $2 billion annual shortfall.

TIME ebola

American Freelance Cameraman Is Officially Free of Ebola

US Journalist Who Contracted Ebola In Liberia Treated At Nebraska Medical Center
An ambulance carrying an American freelance cameraman who contracted Ebola in Liberia, Ashoka Mukpo, arrives at the Nebraska Medical Center October 6, 2014 in Omaha, Nebraska. Eric Francis—Getty Images

Ashoka Mukpo was diagnosed with Ebola on Oct. 2 while working in Liberia

An American journalist who contracted Ebola while working in Liberia is officially clear of the virus, the hospital where he was treated said Tuesday.

The Nebraska Medical Center made the announcement of NBC freelance cameraman Ashoka Mukpo’s recovery after the Centers for Disease Control and Prevention confirmed his blood test no longer showed presence of the virus, according to NBC News. The 33-year-old, who arrived at the hospital on Oct. 6 after being evacuated from Liberia, will now be allowed to leave his isolation unit and return home to Rhode Island, the hospital said.

“Recovering from Ebola is a truly humbling feeling,” Mukpo told the hospital. “Too many are not as fortunate and lucky as I’ve been. I’m very happy to be alive.”

As part of his treatment, Mukpo had received a blood donation from Dr. Kent Brantly, the first American to be diagnosed with Ebola and who was also treated at the Nebraska Medical Center, in addition to an experimental drug called brincidofovir.

The photojournalist was diagnosed with Ebola on Oct. 2 in Liberia, making him the fourth American to contract the virus. That number has since risen to eight Americans who have developed the deadly disease in an outbreak that has claimed over 4,500 lives, according to the World Health Organization.

The only Ebola fatality in the U.S. thus far has been that of Thomas Eric Duncan, a Liberian who died in Dallas on Oct. 8. Meanwhile, an unnamed patient and two Dallas nurses, Amber Vinson and Nina Pham, remain in treatment, according to CNN. Pham’s condition was upgraded from “fair” to “good” Tuesday, while Vinson’s mom told ABC Tuesday that her daughter is “doing OK, just trying to get stronger.”

[NBC News]

TIME ebola

First U.S. Nurse With Ebola Upgraded to ‘Good’ Condition

Ebola patient and nurse Nina Pham is flown into Frederick Airport and transfered to NIH
Ashley King of Walkersville came out to send a positive message to Nina Pham, a nurse who treated Thomas Duncan, the Liberian man, who died of Ebola, who was flown into Frederick Airport and transferred to NIH to treat her now that she has Ebola October 16, 2014 in Frederick, Maryland. The Washington Post/Getty Images

Nina Pham was previously listed in "fair" condition

The clinical status of the first of two Dallas nurses to contract Ebola has been upgraded from “fair” to “good,” the National Institute of Health (NIH) said Tuesday.

Nina Pham, 26, had been transferred Thursday to the NIH Special Clinical Studies Unit in Maryland, where a doctor said in a statement that she was in fair condition and resting comfortably. The NIH also said that Pham has expressed gratitude for her well-wishers, but that “no additional details are available at this time.”

The unit where Pham is being treated has a staff of 50 to 60 personnel who are trained to deal with biohazards like the Ebola virus, Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases, said Friday. While Fauci did not disclose Pham’s treatment plan, he revealed that Pham had already received plasma donated from Ebola survivor Dr. Kent Brantly.

Pham, who last week released a tearful video from inside her Texas isolation unit, is the first known person to develop Ebola within the United States. Pham contracted the virus at Dallas’ Texas Health Presbyterian Hospital while treating Thomas Eric Duncan, the first person to be diagnosed with Ebola in the U.S. Duncan died of the virus Oct. 8.

A second Dallas nurse who worked alongside Pham in Duncan’s treatment was also diagnosed with Ebola two days after Pham’s diagnosis.

 

TIME ebola

U.S. Will Restrict Travel From Ebola-Hit West African Countries to 5 Airports

IINTERNATIONAL PASSENGERS BEING SCREENED FOR MEDICAL CONDITIONS RELATED TO EBOLA AT  THE CHICAGO INTERNATIONAL AIRPORT BY MEMBERS OF THE US CUSTOMS AND BOARDER PATROL AND A US COAST GUARD MEDICAL TEAM, BOTH PART OF THE US DEPARTMENT HOMELAND SECURITY. THE
U.S. Customs and Border Protection Officers conduct enhanced screening at JFK International Airport in New York City on October 11, 2014. Donna Burton—UPI/CBP/Landov

Fliers from Ebola-affected countries must travel to New York, Newark, Washington, Atlanta or Chicago

The Department of Homeland Security announced Tuesday that airline passengers traveling to the United States from the the countries most affected by the Ebola outbreak must travel through one of five U.S. airports, where they will undergo screening.

The new restrictions take effect Wednesday and expand on a previous requirement that passengers whose travel plans originate in Liberia, Guinea and Sierra Leone must undergo screening if they arrive at airports in New York, Newark, Washington, Atlanta or Chicago. Now, passengers must modify their itinerary to ensure they arrive at one of the five airports where they can be screened.

Though the tighter security measure is symbolically significant, it will likely only impact a small minority of travelers who arrive in the U.S. from West Africa. More than 9o% of passengers from the affected countries already arrive at those five airports via air connections in Europe or elsewhere in Africa. There are currently no direct flights from Liberia, Guinea or Sierra Leone to the U.S.

In a statement, Homeland Security Secretary Jeh Johnson said that the agency would continue monitoring the situation to determine whether additional restrictions are necessary.


Read next: Texas Tells Ebola Health Care Workers Not to Travel

TIME ebola

More Than 5,000 Health Care Workers Attend Ebola Training

CDC and Mount Sinai health workers demonstrate how to put on and off Ebola personal protective equipment at an Ebola education session in New York City Alexandra Sifferlin

"We are having a family meeting"

More than 5,000 health care and hospital infection control workers gathered at the Javits Center in New York City for an Ebola education session amid growing concern among hospital workers over Ebola preparedness.

“We are having a family meeting,” Kenneth Raske, president of the Greater New York Hospital Association (GNYHA) told TIME. “The turnout is spectacular. We may not answer every question [today], but we are committed to finding the answers.”

The event, which was streamed live nationwide, featured Centers for Disease Control (CDC) experts offering live trainings on how to safely care for patients with Ebola. It was hosted by the Healthcare Education Project from GNYHA/1199SEIU and Partnership for Quality Care.

New York governor Andrew Cuomo helped kick off the event, touting New Yorkers’ resilience and ability to always “rise to the occasion” from 9/11 to Hurricane Sandy. “We have a new challenge we must meet today,” said Cuomo. New York City Mayor Bill de Blasio also made an appearance, thanking health care workers.

“Regardless of immigration status, we will help them all,” said de Blasio, referring to the possibility of patients with Ebola coming into a New York City emergency room.

The session included a hands-on demonstration of personal protective equipment (PPE) led by Dr. Bryan Christensen of the CDC’s domestic infection control team for the Ebola response. On Oct. 20, the CDC revised its guidelines for Ebola-related care, recommending full-coverage PPE and supervision while taking PPE on and off.

Christensen supervised registered nurse Barbara Smith of Mount Sinai Health System as she demonstrated how to put on and take off all the pieces of PPE: sanitizing her hands, putting on her first set of gloves, sitting in a chair to put on her foot covers, donning her suit—and finally doing a little jig, to audience laughter, once she was completely suited. Afterward, she took off each piece, sanitized her gloves numerous times and checked for any holes. The entire process took 15 to 20 minutes, which the CDC said cannot be rushed.

Over 5,000 health care workers gather in the Javtis Center in New York City to attend an Ebola education session. Alexandra Sifferlin

CDC officials also reviewed Ebola care protocols in detail, from what to wear and how to discard linens (they can’t be washed) to the way hands should be washed and how to use an alcohol rub to clean gloves before removing them, something that is not usually part of standard procedure. For respiratory protection, the CDC recommends either a powered air purifying respirator (PAPR) or a disposable respirator like N95. Emory University Hospital uses the former; the Nebraska Medical Center uses the latter. “When we use equipment we are not used to, it makes it difficult,” said CDC’s Dr. Arjun Srinivasan. “The way we address this is practice, practice, practice.”

Massive education sessions like this have been held before over health threats like anthrax, H1N1 and smallpox. “We had to have this in a convention center to accommodate folks,” George Gresham, president of 1199SEIU United Healthcare Workers East told TIME. “Back in the 80s when the AIDS epidemic first started, I was a health care worker myself, and it was the unknown that was the mystery, and the fear, and I think that’s the same here. “

The massive number of health care workers that crowded into the conference center proves that they crave more education about caring for potential Ebola patients. Even though some states, including New York, are identifying specific hospitals that will take in any Ebola patients for actual care, all health facilities have to be prepared for the possibility that a patient like Thomas Eric Duncan could walk through their doors.

The hope is that the session was helpful and positive. “I think this is another moment we can calm the public and reassure the public of health care workers’ commitment,” Gresham said.

TIME ebola

How Ebola Hysteria Could Help Contain Flu Season

Since Ebola’s first symptoms resemble that of the flu, fears about Ebola could drive an influx of patients to doctors and emergency rooms with flu symptoms, who might otherwise have stayed home, doctors say. Each year, the Centers for Disease Control and Prevention estimates that between 5% and 20% of Americans get the flu, though most don’t see their doctor. In 2011, the last year for which data is available, 1,532 Americans died from influenza.

That number gives a sense of which disease is more dangerous to the greatest number of Americans. While only three people have been diagnosed with Ebola in the United States, nearly 40 percent of Americans say they are concerned that someone in their family will get the deadly virus within a year, a Harvard Public Health poll found last week.

While the media and polls depict an American public that is acutely fearful about Ebola, there is only modest evidence of a widespread change in behavior thus far. That could change as flu season kicks off, especially if new cases of Ebola arise in the United States. “We might expect to see an increase in people seeking health care for influenza like illness this season,” said Dr. Richard Webby, the director of a World Health Organization center studying influenza. But Webby described the flu as “background noise,” for its potential interference in efforts to contain Ebola.

For those who do see a doctor, the CDC tracks the percentage of visits in which the patients report flu-like symptoms, regardless of whether he or she actually has the flu. This figure is the best to follow to determine how fears over Ebola are influencing Americans’ response to the flu. Since March of this year, the percentage of flu related visits has been higher than the same period in 2013. This uptick approximately correlates with the rise of Ebola new coverage.

Percentage of Outpatient Visits Reporting Flu Symptoms

There is a historical precedent for fears of a pandemic raising concerns among those with the regular flu. CDC epidemiologist Lynnette Brammer, who developed the surveillance program for tracking flu cases, recounts a more dramatic trend in 2009. “During the H1N1 pandemic in 2009, we did see an increase of people going to the doctor with flu-like symptoms,” she said. “Normally they would have stayed at home, but because they were worried about H1N1, they got tested.”

Over 200 labs submit specimens tested for flu to CDC’s flu surveillance network. The number of specimens tested each week, graphed below, rises along with the increase in patients with flu symptoms. Fear over Ebola may explain this rise, though the most recent uptick in October marks the beginning of a new flu season, in which CDC added 120 new laboratories.

Number of Specimens Tested for Flu

Of course, the severity of the flu varies from year to year, which could also account for any change. Of the specimens tested above, the 2014 strain of the flu outpaced the 2013 version through May, but now appears indistinguishable.

Percent of Specimens Tested Positive for Flu

With additional reporting by Pratheek Rebala.

Methodology

Data from the Centers for Disease Control weekly influenza reports.

TIME Cancer

Study Links Latina Women With Gene That Lowers Breast Cancer Risk

Some Latina women have a gene that significantly lowers the risk of getting breast cancer, according to a new study.

The study, published in the journal Nature Communications, suggests that the gene is most effective at protecting against the variations of the disease that lead to the worst prognosis.

Researchers at the University of California San Francisco reported that 20% of self-identified Latinas had one copy of the gene, which led to 40% reduced risk of breast cancer. The 1% of Latinas who had two copies of the gene were about 80% less likely to have breast cancer, the study found.

Other medical research has shown that Latina women have lower a incidence of breast cancer than women with other backgrounds, but it wasn’t clear from what caused the disparity.

“After our earliest studies, we thought there might be a genetic variant that led to increased risk in European populations,” said UCSF professor and study author Elad Ziv in a press release. “But what this latest work shows is that instead there is a protective variant in Native American and Latina populations.”

Mammograms conducted for the study showed that women with the genetic variation had less dense breast tissue, which is thought to correlate with reduced breast cancer risk.

“We have detected something that is definitely relevant to the health of Latinas,” said Laura Fejerman, UCSF assistant professor and an author of the study, in a press release. “As a Latina myself, I am gratified that there are representatives of that population directly involved in research that concerns them.”

TIME Diet/Nutrition

This Kind of Tea Lowers Blood Pressure Naturally

green tea
Getty Images

The best brew for your heart

Recent research has come down squarely on the side of caffeinated morning beverages, suggesting that coffee can protect against cancer and type 2 diabetes. Tea has enjoyed a healthy reputation for years as a heart-protector, and a study published in the October issue of British Journal of Nutrition suggests it might even help lower blood pressure.

Researchers were intrigued by the inconclusive link in studies so far regarding blood pressure and tea intake, so they analyzed 25 randomized controlled trials—the gold standard of scientific research—to further explore on the association.

They found that in the short term, tea didn’t seem to make a difference for blood pressure. But long-term tea intake did have a significant impact. After 12 weeks of drinking tea, blood pressure was lower by 2.6 mmHg systolic and 2.2 mmHg diastolic. Green tea had the most significant results, while black tea performed the next best.

Those might not seem like big numbers, but small changes in blood pressure can have a significant impact on health, the study authors write. Reducing systolic blood pressure by 2.6 mmHg “would be expected to reduce stroke risk by 8%, coronary artery disease mortality by 5% and all-cause mortality by 4% at a population level,” they write.

Tea is thought to offer endothelial protection by helping blood vessels relax, allowing blood to flow more freely. It’s a high source of antioxidants that have been linked to better cardiovascular health.

The researchers weren’t able to pinpoint the optimal number of cups to drink to get the benefit, but other studies have shown protective effects at 3-4 daily cups. The researchers said they didn’t see a difference in caffeinated tea vs. decaf.

“These are profound effects and must be considered seriously in terms of the potential for dietary modification to modulate the risk of CVD [cardiovascular disease],” the authors write.

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