Tara George is a GP trainer and TPD in Derbyshire, Honorary Senior Clinical Lecturer at University of Sheffield and a member of the Don’t Forget the Bubbles Executive, she is the host of the Bedside Reading Podcast. She is on BlueSky and X
Dani Hall is a consultant in Paediatric Emergency Medicine in Dublin, Senior Clinical Lecturer at Queen Mary University of London and a member of the Don’t Forget the Bubbles Executive. She is on X
Tessa Davis is a Consultant in Paediatric Emergency Medicine at the Royal London Hospital, a Senior Lecturer at Queen Mary University of London, and Co-Founder of Don’t Forget the Bubbles. She is on instagram: www.instagram.com/drtessardavis
Nicola O’Shea is an Assistant Librarian in Children’s Health Ireland at Crumlin, and Secretary of the Health Sciences Libraries Group of the Library Association of Ireland. https://www.linkedin.com/in/nicolaoshea-librarian/
Old wives’ tales are the cautionary tales we tell our children, passing down wisdom through generations. They often blend folklore with pseudoscience, but what does the actual science say? We conducted a straw poll* among colleagues who care for children in primary and secondary care for their favourite tales. After selecting the most popular, we conducted seven literature reviews, developing PubMed search strategies using MeSH terms and free text keywords, and performing citation searches on relevant articles. When research was sparse, we broadened our search to Google Scholar and grey literature, to explore the evidence behind these time-honoured claims.
1. Cracking knuckles gives you arthritis.
When research was sparse, we broadened our search to Google Scholar and grey literature, to explore the evidence behind these time-honoured claims.
Of all the body’s sounds, elderly relatives love to warn children about knuckle cracking. But is there any science behind the claim that it causes osteoarthritis? We cracked this myth open.
First, the anatomy. Knuckle cracking collapses the bubbles in synovial fluid, producing that satisfying pop. An n=1 case study conducted over a 50-year period compared a left hand that was knuckle-cracked (36,500 times) and a right hand that was not cracked at all.1 There was no correlation between habitual cracking and osteoarthritis.
Two other studies of 515 people also found no link to arthritis,2,3 although reduced grip strength was noted among avid crackers.3 Be warned, however, two cases of ligament injuries from overzealous popping have been reported.3
Bottom line: Knuckle cracking, a satisfying and relatively safe, if noisy, pastime, does not cause arthritis.
2. You will catch a cold if you go outside with wet hair.
Children have frequently been warned not to go out with wet hair in case they “catch cold”. One explanation is that sinus pain experienced in cold conditions might be mistaken as the beginning of a respiratory tract infection.4
One study showed no difference in colds based on the hair-drying methods of 102 swimmers in winter.5
A 2005 literature review found no significant increase in the risk of contracting a cold due to cold exposure.6 Interestingly, in a study of 180 subjects, acute chilling of the feet was found to cause the onset of common cold symptoms in 14%, though the authors did surmise that further studies are needed.7
Bottom line: Hats and hair dryers may be less important than warm socks and wellies in preventing colds.
3. Chicken soup cures common colds.
Science suggests there is more to Grandma’s cure-all than meets the spoon. For starters, chicken soup inhibits neutrophil activation,8 meaning it could reduce inflammation.
One study showed that sipping chicken soup increased nasal mucous velocity from 6.9 to 9.2mm per minute, faster than a hot water control.9
In one case report, a man abruptly stopping his chicken soup regimen developed pneumonia,10 solid proof you should take your chicken soup with a pinch of salt (and perhaps some crackers).
It might not be the chicken though. The warm, wet nature of chicken soup might generally help by loosening secretions and maintaining hydration.11
Bottom line: While the science simmers, it seems that a bowl of chicken soup may indeed be a cure for the common cold.
4. Swallowed gum stays in your stomach for seven years.
We found 12 reports of gum causing some sticky situations. These were some of our favourites.
Two 4-year-olds with severe constipation were found to have rectal gum bezoars. On questioning, all four parents admitted using gum as a potty-training prize.12 The same authors reported a 1-year-old with an oesophageal mass of coins and gum.12 Swallowing your savings is not so savvy.
An adult quitting smoking was investigated for anaemia. Their colonoscopy revealed 30 nicotine gum pieces in the colon.13 Some habits are tough to unstick.
A 40-year-old with vomiting and achalasia had a gastroscopy which unearthed a 5x5cm gum mass with, what the authors described as, “a minty aroma.”14
Bottom line: While gum might not stick around for seven years, it can gum up the works if swallowed excessively.
5. Sitting too close to the television makes you short-sighted.
There has been longstanding concern about television causing “eye-strain.”15 However, there is very little supporting this.16
Although a 1950s survey of 19,000 families concluded television caused eye-strain, their assumptions were short-sighted. They did not account for pre-existing myopia or that the wealthier demographic of television-owning parents might simply have been more vigilant about eye exams.17 Indirect evidence at best, certainly not 20/20 hindsight.
More robustly, a study of 1,312 children correlated eyesight with watching television. There was no correlation between hours watched and visual disturbance.18
In fact, television has been recommended for amblyopic eye exercises, and to improve diplopia after strabismus-operations.16
However, a study of 76 adults watching ultra-high-definition television found that those over 50, or with a tendency to dry eyes, reported increased ocular discomfort.19
Bottom line: While the jury’s still out, the old adage about television destroying your vision might be more fiction than fact. Keep your distance, but do not lose sight of the bigger picture.
6. Sitting on a cold wall gives you piles.
We could not find any evidence to support or refute the claim that sitting on a cold wall causes haemorrhoids.
We could not find any evidence to support or refute the claim that sitting on a cold wall causes haemorrhoids. But, as cold surfaces usually cause vasoconstriction, it might be argued that a cold wall should be a cure, not a cause.
Bottom line: Perching on a frosty wall will not give you piles, though it might give you a chilly behind.
7. Squeezing a spot on your nose could cause a brain abscess.
TikTok, Instagram and teenage magazines frequently caution squeezing spots on the nose due to the vascular connections in the facial “danger triangle” giving a risk of brain abscesses. However, there are no published case reports about brain abscesses secondary to squeezed acne.
Bottom line: This can safely be dismissed as a myth, though squeezing spots does risk scarring and local infection so cannot be recommended.
These cautionary tales are steeped in cultural lore and parental wisdom. However, they may not always be based in truth. We have lightly explored the evidence, underscoring that while such traditions hold value, a dose of scepticism often helps separate fact from folklore.
*Authors’ note: This poll was a mix of work colleagues of the authors and a question posted on the DFTB discord server which has 300+ members from around the world (though predominantly UK and Australia based)
Deputy Editor’s note: Can you (the reader) add any relevant medical research evidence to these cautionary tales? Share your links to relevant literature in the comments box below. Please do NOT share any confidential patient information.
References
1. Unger DL. Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum. 1998 May;41(5):949-50. doi: 10.1002/1529-0131(199805)41:53.0.CO;2-3. PMID: 9588755.
2. Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. J Am Board Fam Med. 2011 Mar-Apr;24(2):169-74. doi: 10.3122/jabfm.2011.02.100156. PMID: 21383216.
3. Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function. Ann Rheum Dis. 1990 May;49(5):308-9. doi: 10.1136/ard.49.5.308. PMID: 2344210; PMCID: PMC1004074.
4. Kaya A, Calışkan H. Does wet hair in cold weather cause sinus headache and posterior eye pain? A possible mechanism through selective brain cooling system. Med Hypotheses. 2012 Dec;79(6):744-5. doi: 10.1016/j.mehy.2012.08.017. Epub 2012 Sep 10. PMID: 22975448.
5. Burch DM. Incidence of Colds among College Women Who Swim During the Winter Months. [dissertation]. Stillwater (OK): Oklahoma State University; 1964. Available from: http://hdl.handle.net/20.500.14446/32588
6. Eccles R. Acute cooling of the body surface and the common cold. Rhinology. 2002 Sep;40(3):109-14. PMID: 12357708.
7. Johnson C, Eccles R. Acute cooling of the feet and the onset of common cold symptoms. Fam Pract. 2005 Dec;22(6):608-13. doi: 10.1093/fampra/cmi072. Epub 2005 Nov 14. PMID: 16286463.
8. Rennard BO, Ertl RF, Gossman GL, Robbins RA, Rennard SI. Chicken soup inhibits neutrophil chemotaxis in vitro. Chest. 2000 Oct;118(4):1150-7. doi: 10.1378/chest.118.4.1150. PMID: 11035691.
9. Saketkhoo K, Januszkiewicz A, Sackner MA. Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance. Chest. 1978 Oct;74(4):408-10. doi: 10.1378/chest.74.4.408. PMID: 359266.
10. Caroline NL, Schwartz H. Chicken soup rebound and relapse of pneumonia: report of a case. Chest. 1975 Feb;67(2):215-6. doi: 10.1378/chest.67.2.215. PMID: 1090422.
11. Bender BS. Barbara, what’s a nice girl like you doing writing an article like this? : the scientific basis of folk remedies for colds and flu. Chest. 2000 Oct;118(4):887-8. doi: 10.1378/chest.118.4.887. PMID: 11035648.
12. Milov DE, Andres JM, Erhart NA, Bailey DJ. Chewing gum bezoars of the gastrointestinal tract. Pediatrics. 1998 Aug;102(2):e22. doi: 10.1542/peds.102.2.e22. PMID: 9685468.
13. Magee JS, Bernick SJ. Undigested Gum Found During Colonoscopy. ACG Case Rep J. 2020 Mar 16;7(3):e00339. doi: 10.14309/crj.0000000000000339. PMID: 32337305; PMCID: PMC7162131.
14. Neuberger F, Collins J, Patel S. A sticky situation. Emerg Med J. 2014 Jul;31(7):592. doi: 10.1136/emermed-2013-203155. Epub 2013 Sep 16. PMID: 24042254.
15. Rones B. Does television damage the eyes? Sight Sav Rev. 1949;19(3):127-31. PMID: 15394256. Available from: https://archive.org/details/sim_sightsaving_fall-1949_19_3/page/n5/mode/2up.
16. Trevor-Roper PD. Television and the eyes. Proc R Soc Med. 1969 Apr;62(4):385-7. PMID: 5307002; PMCID: PMC1810679.
17. Griffith AH. Children’s vision and television. Br Med J. 1957 Nov 30;2(5056):1299-302. doi: 10.1136/bmj.2.5056.1299. PMID: 13479706; PMCID: PMC1963221.
18. Moore LH. Television-viewing habits of children with and without defects of vision. Br Med J. 1960 Apr 2;1(5178):1046. doi: 10.1136/bmj.1.5178.1046. PMID: 14423875; PMCID: PMC1967481.
19. Kim H, Yang HK, Seo JM, Lee S, Hwang JM. Effect of Ultra-high-definition Television on Ocular Surface and Fatigue. Korean J Ophthalmol. 2020 Oct;34(5):367-374. doi: 10.3341/kjo.2020.0032. Epub 2020 Oct 5. PMID: 33099558; PMCID: PMC7597618.
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