Understanding Joint Hypermobility
Hypermobility encompasses more than just being very flexible. It can have wide spanning effects on pain, function and quality of life. Not every person with hypermobility will experience the same symptoms or have the same condition. There are two main categories for hypermobility; hypermobility spectrum disorders (HSD) and hypermobile Ehlers Danlos Syndrome (hEDS). There are different subtypes of HSD depending on how widespread the hypermobility is, its severity and the presence of additional symptoms.
Symptoms with hypermobility
There are a variety of symptoms that someone might experience;
- Musculoskeletal symptoms: joint instability, injuries, poor proprioception
- Gastrointestinal issues
- Dysautonomia
- Cardiovascular issues
- Skin concerns
- Chronic pain: pain is often multifactorial and difficult to see on imaging due to sensitisation, neuropathic and psychosocial components
Diagnosing Hypermobility
Hypermobility conditions are often underdiagnosed or misdiagnosed, often leading to a delay in appropriate management. Traditional diagnostic criteria is important and still used, but often insufficient, missing extra-articular symptoms such as gastrointestinal or cardiovascular complaints.
Management of Hypermobility
Management often includes a multidisciplinary, multifaceted approach. Osteopathy can help with pain and movement restrictions as well as exercise prescription. Exercise and strengthening is important, especially in muscles around the joints, to improve joint support, as well as working on proprioception and motor control. Pharmacological management may also be required to aid in the management of pain, and other extra-articular symptoms experienced.
Osteopathy and Hypermobility
Osteopaths can play a strong role in helping those with a hypermobility condition.
They can assist with assessment and diagnosis support. This can be achieved through a thorough history; including symptoms beyond joint pain, a physical assessment and being equipped with the knowledge when to refer for further support, such as for those with suspected hEDS.
They can aid with manual therapy to gently mobilise joints, without overstretching, address compensatory overuse or tension patterns and work on proprioception and nervous system involvement.
Osteopaths can also help with exercise prescription and activity modification in a guided gradual progression to monitor flare up and help reduce the risk of injury. Additionally, they can help with pain management through pacing and load strategies, education and liaising with other practitioners as necessary.
Blackburn Allied Health Group
If you suspect you have hypermobility or persistent joint pain, get in touch with our team at Blackburn Allied Health Group to see how they can help you take control of your pain and get to the root cause of your problems.
For more information visit:
- https://pubmed.ncbi.nlm.nih.gov/37637226/ Hypermobility Spectrum Disorders: A Review
- https://pubmed.ncbi.nlm.nih.gov/38947102/ Chronic Pain and Joint Hypermobility: A Brief Diagnostic Review for Clinicians and the Potential Application of Infrared Thermography in Screening Hypermobile Inflamed Joints
