Skip to main content

Advertisement

Log in

Joint hypermobility syndrome pain

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Joint hypermobility syndrome (JHS) was initially defined as the occurrence of musculoskeletal symptoms in the presence of joint laxity and hypermobility in otherwise healthy individuals. It is now perceived as a commonly overlooked, underdiagnosed, multifaceted, and multisystemic heritable disorder of connective tissue (HDCT), which shares many of the phenotypic features of other HDCTs such as Marfan syndrome and Ehlers-Danlos syndrome. Whereas the additional flexibility can confer benefits in terms of mobility and agility, adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. There is hardly a clinical specialty to be found that is not touched in one way or another by JHS. Over the past decade, it has become evident that of all the complications that may arise in JHS, chronic pain is arguably the most menacing and difficult to treat.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Kirk JA, Ansell BM, Bywaters EG: The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis 1967, 26:419–425.

    Article  CAS  PubMed  Google Scholar 

  2. Grahame R: Joint hypermobility and genetic collagen disorders: are they related? Arch Dis Child 1999, 80:188–191.

    Article  CAS  PubMed  Google Scholar 

  3. Grahame R: Hypermobility: an important but often neglected area within rheumatology. Nat Clin Pract Rheumatol 2008, 4:522–524.

    Article  PubMed  Google Scholar 

  4. Tinkle BT, Bird H, Grahame R, et al.: The lack of clinical distinction between the hypermobility type of Ehlers-Danlos syndrome and the joint hypermobility syndrome (a.k.a. hypermobility syndrome). Am J Clin Genet Part A 2009 (in press).

  5. Beighton P, Solomon L Soskolne CL: Articular mobility in an African population. Ann Rheum Dis 1973, 32:413–418.

    Article  CAS  PubMed  Google Scholar 

  6. Hakim AJ, Grahame R: A simple questionnaire to detect hypermobility: an adjunct to the assessment of patients with diffuse musculoskeletal pain. Int J Clin Pract 2003, 57:163–166.

    CAS  PubMed  Google Scholar 

  7. Grahame R, Bird HA, Child A: The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000, 27:1777–1779.

    CAS  PubMed  Google Scholar 

  8. De Paepe A, Devereux RB, Dietz HC, et al.: Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet 1996, 62:417–426.

    Article  PubMed  Google Scholar 

  9. Beighton P, De PA, Steinmann B, et al.: Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK). Am J Med Genet 1998, 77:31–37.

    Article  CAS  PubMed  Google Scholar 

  10. De Felice C, Toti P, Di MG, et al.: Absence of the inferior labial and lingual frenula in Ehlers-Danlos syndrome. Lancet 2001, 357:1500–1502.

    Article  PubMed  Google Scholar 

  11. McCormack M, Briggs J, Hakim A, Grahame R: Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol 2004, 31:173–178.

    PubMed  Google Scholar 

  12. Briggs J, McCormack M, Hakim AJ, Grahame R: Injury and joint hypermobility syndrome in ballet dancers: a 5-year follow-up. Rheumatology (Oxford) 2009 Jul 9 (Epub ahead of print).

  13. Bravo JF, Wolff C: Clinical study of hereditary disorders of connective tissues in a Chilean population: joint hypermobility syndrome and vascular Ehlers-Danlos syndrome. Arthritis Rheum 2006, 54:515–523.

    Article  PubMed  Google Scholar 

  14. Grahame R, Hakim A: Joint hypermobility syndrome is highly prevalent in general rheumatology clinics, its occurrence and clinical presentation being gender, age and race-related [abstract]. Ann Rheum Dis 2006, 65(Suppl 2):263.

    Google Scholar 

  15. Adib N, Davies K, Grahame R, et al.: Joint hypermobility syndrome in childhood. A not so benign multisystem disorder? Rheumatology (Oxford) 2005, 44:744–750.

    Article  CAS  Google Scholar 

  16. Ferrell WR, Tennant N, Sturrock RD, et al.: Amelioration of symptoms by enhancement of proprioception in patients with joint hypermobility syndrome. Arthritis Rheum 2004, 50:3323–3328.

    Article  PubMed  Google Scholar 

  17. Mallik AK, Ferrell WR, McDonald AG, Sturrock RD: Impaired proprioceptive acuity at the proximal interphalangeal joint in patients with the hypermobility syndrome. Br J Rheumatol 1994, 33:631–637.

    Article  CAS  PubMed  Google Scholar 

  18. Sacheti A, Szemere J, Bernstein B, et al.: Chronic pain is a manifestation of the Ehlers-Danlos syndrome. J Pain Symptom Manage 1997, 14:88–93.

    Article  CAS  PubMed  Google Scholar 

  19. Hakim AJ, Grahame R, Norris P, Hopper C: Local anaesthetic failure in joint hypermobility syndrome. J R Soc Med 2005, 98:84–85.

    Article  PubMed  Google Scholar 

  20. Gazit Y, Nahir AM, Grahame R, Jacob G: Dysautonomia in the joint hypermobility syndrome. Am J Med 2003, 115:33–40.

    Article  PubMed  Google Scholar 

  21. Hakim AJ, Grahame R: Non-musculoskeletal symptoms in joint hypermobility syndrome. Indirect evidence for autonomic dysfunction? Rheumatology 2004, 43:1194–1195.

    Article  CAS  PubMed  Google Scholar 

  22. Farmer AD, Zarate-Lopez N, Mohammed S, et al.: Unexplained gastrointestinal symptoms and joint hypermobility: is connective tissue the missing link? Rheumatology 2009, 48(Suppl 1):i95.

    Google Scholar 

  23. Acasuso-Diaz M, Collantes-Estevez E: Joint hypermobility in patients with fibromyalgia syndrome. Arthritis Care Res 1998, 11:39–42.

    Article  CAS  PubMed  Google Scholar 

  24. Gedalia A, Press J, Klein M, Buskila D: Joint hypermobility and fibromyalgia in schoolchildren. Ann Rheum Dis 1993, 52:494–496.

    Article  CAS  PubMed  Google Scholar 

  25. Martin-Santos R, Bulbena A, Porta M, et al.: Association between joint hypermobility syndrome and panic disorder. Am J Psychiatry 1998, 155:1578–1583.

    CAS  PubMed  Google Scholar 

  26. Gratacos M, Nadal M, Martin-Santos R, et al.: A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders. Cell 2001, 106:367–379.

    Article  CAS  PubMed  Google Scholar 

  27. Aktas I, Ofluoglu D, Albay T: The relationship between benign joint hypermobility syndrome and carpal tunnel syndrome. Clin Rheumatol 2008, 10:1283–1287.

    Article  Google Scholar 

  28. Rozen TD, Roth JM, Denenberg N: Cervical spine joint hypermobility: a possible predisposing factor for new daily persistent headache. Cephalalgia 2006, 26:1182–1185.

    Article  CAS  PubMed  Google Scholar 

  29. Schievink WI, Gordon OK, Tourje J: Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery 2004, 54:65–70.

    Article  PubMed  Google Scholar 

  30. Vlaeyen JW, Linton SJ: Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000, 85:317–332.

    Article  CAS  PubMed  Google Scholar 

  31. Keer R, Grahame R: Hypermobility Syndrome: Recognition and Management for Physiotherapists, edn 1. Philadelphia: Butterworth Heinemann; 2003.

    Google Scholar 

  32. Simmonds JV, Keer RJ: Hypermobility and the hypermobility syndrome. Man Ther 2007, 12:298–309.

    Article  PubMed  Google Scholar 

  33. Simmonds JV, Keer RJ: Hypermobility and the hypermobility syndrome, part 2: assessment and management of hypermobility syndrome: illustrated via case studies. Man Ther 2008, 13:e1–e11.

    Article  PubMed  Google Scholar 

  34. Daniel HC: Pain management and cognitive behavioral therapy. In Hypermobility, Fibromyalgia and Chronic Pain. Edited by Hakim A, Keer R, Grahame R. Oxford: Elsevier Limited; 2009 (in press).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rodney Grahame.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grahame, R. Joint hypermobility syndrome pain. Current Science Inc 13, 427–433 (2009). https://doi.org/10.1007/s11916-009-0070-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-009-0070-5

Keywords

Navigation