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We have all seen movies where right before the hero starts fighting, he cracks his knuckles and makes it look like the coolest thing in the world! But then our parents told us that you should not crack your knuckles because that weakens your grip and hand strength. But is that true? While many people do say that they experience a small loss in strength immediately after they crack their knuckles, but are their long-term effects to it? And what is the sound actually coming from?
The reason why people crack their fingers is because the evident and sharp crack noise causes a sense of relief. Many people also do it when they have done an activity that required them to work with their hands a lot like typing or sewing, giving themselves a sense of satisfaction, similar to stretching after doing hard work. That "crack" sound can make some people cringe, while others find it strangely satisfying. Cracking your knuckles is a pretty common habit, but there are a lot of misunderstandings about it. Some people do it without even thinking, others can't stand the noise, and some can't crack their knuckles at all. You might have been told as a kid that it causes arthritis or makes your fingers swell up. But those are just old wives' tales. There's a real science behind this habit, and it's more interesting than you may think.
The "crack" isn't actually bones breaking or anything bad happening to your joints. It's a normal thing called "crepitus." This just means harmless popping, snapping, or grinding sounds that come from your joints. The main reason you hear this sound is because of gas bubbles in the fluid that cushions your joints. This fluid is called synovial fluid. When you move or stretch, these tiny bubbles form and then pop, making the sound. It's totally normal and doesn't hurt you. Sometimes, especially in bigger joints like your knees, shoulders, or ankles, the sound can also happen when the stretchy tissues that connect your bones (ligaments and tendons) move slightly and then snap back into place.
After you crack your knuckles, you can't usually do it again right away. You have to wait a bit. That's because the gas bubbles in your joint fluid have already popped, and it takes a little while for them to build up again. While cracking your knuckles doesn't give you arthritis, doing it too much might cause some problems. Doctors say that cracking them too often could make your joints a little wobbly and might even make your grip weaker. Also, if the stretchy tissues in your joints keep snapping over your bones, they can get irritated and sore.
Sometimes, a pop in your joint is just like cracking your knuckles, nothing to worry about. But other times, it can be a sign of something else. As we get older, the cushiony stuff in our joints, called cartilage, can start to wear down. This cartilage helps your bones move smoothly. When it gets thin or uneven, the bones can rub together, and that can make a grinding or popping sound. This is different from the pop you get from gas bubbles. If this grinding sound happens along with pain, it could be a sign of osteoarthritis. This is a type of joint problem that's more common in older people, but younger people can get it too, especially after a joint injury. If your joints hurt, especially in the morning or after you've been sitting still for a while, feel wobbly, or are hard to move, it's a good idea to see a doctor.
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For most people, dengue is associated with high fever, severe body aches, headache, fatigue, and a temporary drop in platelet count. With proper care, the majority of patients recover completely within a couple of weeks. However, doctors caution that in rare instances, dengue can leave behind an unexpected complication that affects the nervous system rather than the blood—Guillain-Barre syndrome (GBS).
GBS is an uncommon autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves. It usually develops after an infection, and growing evidence suggests that dengue can be one of the infections capable of triggering this immune response. While the chances remain low, the condition can progress rapidly and requires prompt medical attention.
The condition affects the nerves and can cause increasing weakness in the legs, arms, face and swallowing.
Also read: Do People With Type 2 Diabetes Face A Higher Risk of Severe Dengue? New Review Says Yes
Unlike the fever and body pain seen during active dengue infection, GBS often appears days or even weeks after the patient seems to be recovering. This delay can make it easy to overlook the connection.
Our immune system protects our body by fighting infections. In some rare cases an infection like dengue can trigger a strange immune response where our body mistakenly attacks its own nerves.
Nerves carry signals between our brain and the rest of our body allowing us to move and feel normally. When nerves get damaged it disrupts the signals from our brain leading to muscle weakness tingling and other symptoms.
Someone who has recently recovered from dengue may suddenly notice tingling in the feet or hands, weakness in the legs, difficulty climbing stairs, or an unsteady walk. As the condition progresses, the weakness may spread upwards, affecting the arms, facial muscles, swallowing, or even the muscles responsible for breathing.
The exact reason this happens is believed to be an abnormal immune response. Instead of switching off after fighting the dengue virus, the immune system mistakenly attacks the protective covering of the nerves, disrupting the signals between the brain and muscles. This results in the characteristic muscle weakness seen in GBS.
Guillain-Barre syndrome usually develops when we are recovering from dengue or even days to weeks after the fever has gone away.
Also read: India’s First Approved Dengue Vaccine: Takeda’s QDENGA Protects Against All Four Virus Serotypes
Feeling tired and fatigued is common, after dengue. Usually gets better slowly. However, we need to differentiate it from weakness. Neurological weakness means our muscle movements are affected.
It often starts in our legs. We may notice it is getting harder to climb stairs get up from a chair or walk normally. This weakness can sometimes spread to our arms and face. In cases it can even affect our swallowing or breathing which may require ICU and ventilator support.
Although dengue-related GBS is rare, recognising the warning signs early can make a significant difference. Timely diagnosis and treatment can help reduce complications and improve recovery.
Any person who develops new weakness, numbness, difficulty walking, facial drooping, trouble swallowing, or breathlessness in the weeks following dengue should seek immediate medical evaluation rather than assuming it is part of normal post-viral fatigue.
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The reassuring news is that most people with dengue will never develop Guillain-Barre syndrome. Nevertheless, awareness remains important because the condition can become serious if left untreated.
Preventing mosquito bites, eliminating stagnant water around homes, and seeking medical care early for suspected dengue remain the best ways to reduce the risk of both the infection and its uncommon complications.
The main thing to remember this monsoon is simple: feeling tired after dengue's normal but if our weakness is getting worse we should not ignore it. Recognizing this difference. Getting medical help early can help us identify this rare but treatable complication on time.
As dengue cases rise during the monsoon, recovery should not simply be measured by the disappearance of fever. Paying attention to new neurological symptoms after the illness has resolved can help ensure that a rare but potentially life-threatening complication is recognised before it becomes an emergency.
By Dr. Abizer Manked, Consultant Physician and Diabetologist at Saifee Hospital, Mumbai and Dr. Arun Shah, Director Neurosciences, Sir HN Reliance Foundation Hospital, Mumbai
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A small lump in the neck is easy to overlook. In many cases, such swellings are linked to minor infections and settle on their own. But not every neck lump is harmless. The neck houses numerous vital structures, including lymph nodes, glands, blood vessels, and nerves, all within a compact area.
As a result, a seemingly minor swelling can sometimes be an early sign of an underlying condition that requires timely medical attention.
The neck houses important organs and tissues, including the thyroid gland, lymph nodes, salivary glands, major blood vessels, and nerves.
This area can be deceptive for two reasons:
Adding to the challenge, many serious neck conditions, including certain cancers may not cause pain in their early stages.
It’s been observed that the majority of neck swellings are benign.
Common non-cancerous causes include:
Reactive lymph nodes: Often develop after a cold, sore throat, dental problem, or skin infection. They are usually tender and tend to resolve within a few weeks.
Thyroid nodules: Quite common in adults and often harmless. These lumps typically move when swallowing.
Cysts: Such as branchial cleft cysts or sebaceous cysts, which are generally smooth, rounded, and slow-growing.
Lipomas: Soft fatty growths that can move easily beneath the skin.
Tubercular lymph node enlargement: Still frequently seen in India, presenting as gradually enlarging, usually painless neck nodes.
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While many neck lumps are harmless, certain features warrant a consultation with a doctor within one to two weeks:
Associated symptoms such as unexplained weight loss, mouth ulcer, persistent fever, night sweats, hoarseness, difficulty swallowing, chronic cough, or unexplained ear pain
Individuals with a history of tobacco use, alcohol consumption, previous radiation exposure, HPV-related disease, or a family history of thyroid cancer or lymphoma should be especially vigilant.
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Early diagnosis is key to ensuring the most effective treatment.
Evaluation typically begins with a detailed clinical examination, as the location of the lump often provides important clues.
Common investigations include:
When cancer is detected early, treatment is often less extensive and outcomes are significantly better.
Several common mistakes contribute to delayed diagnosis:
Seeking expert assessment early can prevent complications and improve treatment options.
A quick self-examination can help identify changes early.
A neck lump is often nothing more than a temporary response to infection or inflammation. However, some conditions, including cancers of the thyroid, lymph nodes, and head and neck region can present as painless swellings long before other symptoms appear.
The key is not to panic, but not to ignore it either. When it comes to neck swellings, early evaluation can make the difference between a straightforward treatment and a much more complex journey later on.
By Dr Akshay Kudpaje, HOD/Senior Consultant - Head & Neck Oncology at HCG Cancer Hospital, Hebbal, North Bangalore
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For decades, melasma treatment began and ended with a tube of cream. The typical first treatment for those stubborn brown-grey patches on the forehead, upper lip and cheeks that are typically caused by sun exposure, hormones or pregnancy was once hydroquinone, retinoid and steroid combinations.
Patients would put some cream on for months, and get some improvement, and then when they stopped, the pigmentation would reappear. Today, these creams have still got a role but dermatology has come a long way and now, patients have so much more to work with, acting on the melasma from different angles at the same time.
There are more choices available within the realm of creams. Gentler brightening agents like thiamidol and 2-MNG have been developed to do the same job as hydroquinone, but they do it in a different way in the body.
Initial studies indicate that these ingredients can be as effective as older favourites, irritating less than older ingredients that are already doing their job of irritating sensitive skin prone to developing melasma in the first place.
Another compound, malassezin, has shown promising early results in that it has been found to inhibit the process of pigment production itself. Due to the chronic and relapsing nature of melasma, dermatologists are more inclined to use these less aggressive, but more tolerated long term maintenance treatments as opposed to short term treatments alone.
Also read: Secret To Glowing Skin: How Face Acids Can Revolutionize Your Skincare Routine
The most obvious change in how the skin is treated for melasma is the way of lasers and light-based treatments. A side advantage of the low-fluence picosecond lasers is that they break up excess pigment with very short, gentle energy pulses, meaning that there's less skin damage as a side effect, which is a drawback of older, more aggressive laser settings.
Fractional lasers are now also employed in conjunction with topical treatments to enhance drug delivery into the skin, essentially combining the two treatments. They are regarded as non-invasive technologies since they do not involve any incisions or extended downtime and most patients are able to return to their pre surgery routine within a day or two.
Chemical Peels are also available in a re-optimized formulation for the skin that tends to melasma. Newer types of combination peels use lesser amounts of various active ingredients and less of a single strong acid, reducing the chances for additional pigmentation, which is a common worry in dark skin tones.
They are now more frequently prescribed with topicals and lasers as part of a multi-pronged approach, rather than as a treatment on their own, as they are done in a series of milder sessions.
Also read: Scientists Find Rare Contagious Skin Cancer In Fish From US, Canada: Should Humans Worry?
The technology of microneedling has also come a long way. This once again basic but now formulated with serums and even exosome-based formulations is an area that calms inflammation and helps to regulate the pigments of the skin as it recovers.
This "angle" is called "regenerative" because newer treatments aren't just intended to lighten or fade existing skin melanin, but seek to address the skin's environment that is causing melasma to reappear.
Non-invasive is more than just procedures performed in the clinic. In recent years, low doses of tranexamic acid taken orally under medical supervision has been added to the melasma tool box.
It is internally active, in that it slows blood flow in the blood vessels, which is now known to help trigger the production of pigment in the skin, and is therefore a valuable addition to the treatment of melasma, particularly when other topical treatments are not effective.
There's one thing that sets the tone for the ever-changing landscape of melasma treatment: there's no single answer. It is now known that melasma is a real multi-faceted skin problem that is influenced by multiple factors such as genetics, hormones, sun exposure, heat and inflammation.
Many dermatologists prefer to use a multi-layered approach to skin care for treatment, such as a topical therapy, an in-office procedure and, if applicable, oral skin care therapy, depending on the skin type and pigmentation of the patient. That's not only for quicker results, it also helps to reduce the likelihood of the skin darkening more after treatment, which is more common in patients with darker skin tones.
Today, instead of a one-and-done, dermatologists are more apt to craft a gradual approach that involves calming active pigmentation, then moving to a maintenance regimen that is lighter to avoid pigment re-flash.
“As it is a multi-factorial disease, using any one modality is always going to be limited and a multi-modal approach that combines topical, procedural and sometimes systemic treatment, is what is helping us achieve more lasting results and reduced relapse rates,” says Dr. Ajay Rana.
Despite such innovation, one thing is true: sun protection is a must. If they're going to hold up, it's going to be because of the broad-spectrum sunscreen and the consistent application of it, along with physical protection such as sun hats.
If not, the most sophisticated of the procedures will eventually be replaced by renewed pigmentation.
Although it's a challenging condition to treat, melasma is not a quick fix. However, today there are more ways for patients to visibly improve, and even more of them are not invasive, and have less side effects than five years ago.
If you've used a cream before and stopped using it, it might be worth talking to a dermatologist again; the treatment options are quite different now.
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