I can't stop cracking my knuckles, and I'm cracking up
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Excessive knuckle-cracking is causing lasting pain in my hand, but I can't stop doing it. First off, I realize I need professional help. I just don't know where to start - medical? psychological? psychiatric? pharmaceutical? I am a 35 year old woman. I was diagnosed with OCD in my early 20s, and dealing with a particular personal issue. Since then I have been seeing a psychologist as needed for some personal issues when they come up - anxiety, obsessive thoughts, worry, etc - but not on a regular basis. A couple of years ago, I developed a habit of running my finger along my eyelashes while reading or web surfing, more in my left hand than on my right. After several months I noticed I was starting to get some pain in my finger and wrist as I did it, but had trouble breaking the habit. A few weeks ago, after I noticed the pain being stronger, I quit "cold turkey" and haven't done it since. A week or so later, I noticed I was still having some pain, and noticed that it sometimes happened when I cracked my knuckles in my thumbs. This is something I've been doing since junior high, but I'm not sure if it really counts as knuckle cracking. Basically I noticed in junior high that if I flexed my thumbs so that they were completely straight, then bent them all the way, I would hear and feel a satisfying "crack." So I've been doing this for over 20 years, where sometimes I feel like my thumbs need a crack. There are some times when I think they feel like they need to be cracked, but I flex & bend my thumbs and get nothing. So getting back to the pain in my hand. I noticed that I still felt some pain in my left hand whenever I cracked that thumb knuckle. So I decided I would also stop doing that "cold turkey." Except I can't. It's like when you try to stop thinking about something, you think about it even more. I am now literally cracking my left thumb every five minutes all day - whereas I used to do it a few times a day at most. I seem to have lost the ability to know when it needs to be cracked, and I just keep doing it - so sometimes I hear and feel the satisfying crack, and sometimes I get nothing. I try to stop, and then I just keep thinking about it - what if my knuckle needs to be cracked? I suddenly have become conscious of every minute ticking by, wondering how long it's been and if maybe I could try cracking it again. I'm hoping that people who are regular knuckle-crackers will know what I'm talking about, where you feel the urge in your fingers to crack, and it's hard to ignore. Except like I said, I can't seem to tell anymore whether I really need to. So I only end up feeling a crack about 1/4 or 1/3 of the times I do it. But I keep cracking just in case. So now the pain in my left hand is worse. I have pain along the outside of my pinky finger the outside of the hand itself, the top of my hand, my wrist and sometimes my arm. I'm really scared that it's going to get worse and I'm going to end up not being able to use my hand. If I can inject a bit of humor into this rambling story, it reminds me of the Seinfeld episode where George was hand model. He was warned about a model who was not master of his domain and ended up with a deformed "claw" from overuse, and I keep thinking that the same thing is going to happen to me. So I don't know where to go now. I have a psychologist that I see occasionally, but she's mainly helped me with anxiety and worries - I'm not sure that stopping knuckle-cracking is within her expertise. Do I need a psychiatrist instead? Last year I was taking Wellbutrin for depression and it *really* helped with obsessive thoughts I was having at the time, and I keep wondering if I should take it again to make me stop thinking about cracking my thumb - but the original reason I had stopped taking it was due to bad side effects. After the Wellbutrin I had tried Cymbalta but it didn't seem to help as much. Back in college when I suffered from depression I had variously tried Prozac, Zoloft and Celexa, but had side effects from each of them. I'm wondering if it would be worth trying an over-the-counter product like 5-HTP. Then there is the option of going to an orthopedic doctor or other medical doctor about the pain, but I'm not sure if that would help if I can't stop the underlying (mental) cause. I feel like the only solution would be to somehow immobilize my thumb completely so that I can't move it at all, but I have no idea how that could be done. Just to reiterate, what I am doing is probably not how most people crack their knuckles. What I do is extend my thumb so it is completely straight, then bend it all the way (just using the thumb itself, I'm not using my other hand to bend it). Okay, enough rambling. As you can see, I'm a mess. Help?
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Answer:
I'm not sure that stopping knuckle-cracking is within her expertise Whoever you see to manage your OCD is who you should see about this. This is clearly related.
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Other answers
https://en.wikipedia.org/wiki/Cracking_joints mentions studies saying that cracking knuckles doesn't typically cause pain. And an http://www.improbable.com/ig/winners/#ig2009! He did not develop arthritis. Of course, that's only one person. Maybe realizing it's (probably) not causing your joints major damage will reduce your anxiety about it?
sarah_pdx
somehow immobilize my thumb completely so that I can't move it at all, but I have no idea how that could be done. Could get a splint, or fashion one from popsicle sticks and medical tape. But yeah, going back to the pysch and discussing this with her is a good idea. Even if it's not "within her expertise" she should be able to refer you to someone that can help. But as it's obviously (to me) part of the OCD I bet she'll be able to help more than you think.
ish__
Omigosh I had the same problem with one of my fingers. I don't have OCD, but I crack my knuckles regularly, and for a while, I ended up cracking my left middle finger every few seconds. I borrowed a plastic finger brace thing from my friend that fit my finger perfectly, and while it still took me a while to stop cracking that finger obsessively, it definitely cut down on me cracking it because it made me aware of it. Without a plastic thing on my finger, I'd be cracking it without even realizing what I was doing. This is kind of like the rubber band approach (wear one on your wrist and snap it every time you catch yourself doing something bad), but it was directly on my finger, so it actually helped me catch myself.
never.was.and.never.will.be.
Totally anxiety, totally ask your psychologist. This off the wall suggestion is not a substitute for talking to your psychologist but something that might be soothing for the short term: you could try noticing the urge to crack your knuckle, stopping, taking a deep breath, and icing the part of your hand that hurts for a little while. (I've pretty much quit a very old habit of chewing the skin around my fingernails using a similar method: notice, stop, breathe, moisturize fingers.)
clavicle
From the OP:Thanks for the comments. I have currently immobilized my thumb using a splint along with some of that self-adhesive bandage wrap. I haven't cracked in 14 hours now because of it, although it's always on my mind because I really REALLY want to crack it, and I feel like it needs it. I keep feeling like, if only I took off the splint and bent my thumb, I could have such a good satisfying crack. Sigh. I have an appointment to see my psychologist but the earliest time she had was next Thursday. My hesitancy in seeing her was in the fact that although she is technically a psychologist, I have been using her as a counselor - ie, to talk about personal issues and stress/worries in my life. I didn't specifically seek her out for OCD treatment, so I don't know if this is in her expertise. I managed to find one other psychologist in the area who takes my health insurance and has OCD as a specialty, but of course the earliest day she is available is in July. I also have an appointment with my primary care doctor today to look at my hand. I realize that cracking your knuckle, in the traditional sense, doesn't cause pain. But the way I crack is by flexing my thumb completely straight and then bending it all the way - using my thumb muscle rather than manipulating the joint with my other hand. So doing that every five minutes, or even every 1-2 minutes as I had been, was tiring out the muscles in my hands. I was (and am) worried about permanent damage to my hand, as the vast majority of my job involves typing at a computer. And with the OCD kicking into high gear, I started worrying about how I would care for my dogs (clipping nails, etc) with only one useful hand.
taz
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