Hypermobility (joints)

Hypermobility
Synonyms	hyperlaxity, benign joints hypermobility syndrome (BJHS), hypermobility syndrome (HMS)
Pronounce
Field	Rheumatology
Symptoms
Complications
Onset
Duration
Types
Causes
Risks
Diagnosis
Differential diagnosis
Prevention
Treatment
Medication
Prognosis
Frequency
Deaths

Hypermobility is a physiological condition characterized by the ability of joints to move beyond the standard range of motion, commonly referred to as double-jointedness. It can present itself in various ways, such as the ability to bend thumbs backwards to touch the wrist, knee joint hyperextension, or the ability to place a leg behind the head among other extraordinary movements. It may affect a single joint or multiple joints throughout the body.

Epidemiology

It's a common phenomenon, with an estimated occurrence in about 10% to 25% of the general population<ref name="pop_stat">.[2] Most individuals with hypermobility do not experience symptoms<ref name="asymptomatic">[3], but a subset may develop associated conditions related to joint instability, referred to as hypermobility syndrome<ref name="syndrome">[4].

Association with Other Syndromes

In the past, there was an overlap between hypermobility syndrome and Ehlers–Danlos syndrome (EDS) hypermobile type, also known as EDS Type 3. The diagnostic criteria and treatments for these conditions are similar, leading to the suggestion by many experts that they should be regarded as a single condition until further research provides differentiation<ref name="overlap">[5][6]. As of now, no genetic test can definitively identify either condition.

In 2016, the diagnostic criteria for EDS Type 3 was tightened with an aim to better isolate the group of patients for genetic study, as EDS Type 3 is the only variant of EDS that lacks a diagnostic DNA test. At the same time, hypermobility syndrome was redefined to exclude conditions that meet the diagnostic criteria for EDS Type 3 and other collagen disorders like Marfan syndrome and Osteogenesis Imperfecta, and renamed as Hypermobility Spectrum Disorder (HSD).

Signs and Symptoms

Joint Issues

People with hypermobility syndrome may experience various issues related to their unstable joints. These can range from joint instability leading to frequent sprains, tendinitis, and bursitis, to more severe conditions like subluxations or dislocations, particularly in the shoulder<ref name="joint_issues">[7]. Other symptoms can include:

• Joint pain
• Premature osteoarthritis
• Knee pain
• Fatigue following minimal exercise
• Back pain, including prolapsed discs or spondylolisthesis
• Joints making clicking sounds
• Increased susceptibility to whiplash

Associated Conditions

In addition to these issues, several conditions have been linked with hypermobility. This includes fibromyalgia, mitral valve prolapse, and anxiety disorders, including panic disorder<ref name="associated_conditions">[2]. Other conditions often associated with hypermobility syndrome include:

• Temporomandibular joint dysfunction (TMJ)
• Increased risk of nerve compression disorders, such as carpal tunnel syndrome
• Finger locking
• Inadequate response to anesthesia or pain medication
• "Growing pains" in children, usually experienced in the late afternoon or at night

Diagnosis and Treatment

The diagnosis of hypermobility is usually based on physical examination and patient history, with the Beighton score being commonly used as a quantitative measure. Treatment typically involves physical therapy, medication for symptom management, and lifestyle modifications.

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