Joint Hypermobility Syndrome (JHS) is a connective tissue disorder characterized by an unusually large range of motion in the joints. While some individuals may enjoy enhanced flexibility without adverse effects, those with JHS may experience a range of uncomfortable and debilitating symptoms. Often misunderstood or misdiagnosed, this condition requires careful management to ensure a good quality of life. This article explores the symptoms, risks, and evidence-based best practices for managing JHS.
What Is Joint Hypermobility Syndrome?
Joint Hypermobility Syndrome, also known as hypermobile Ehlers-Danlos Syndrome (hEDS) in some cases, occurs when the tissues that hold joints together—ligaments and tendons—are more elastic than normal. This leads to increased flexibility, but also joint instability. JHS is considered a systemic condition because it can affect not just joints but also skin, blood vessels, and internal organs due to the underlying connective tissue abnormalities.
Hypermobility is relatively common, especially in children and adolescents, and is often benign. However, when it is associated with pain, dislocations, fatigue, and other systemic symptoms, it crosses into the territory of Joint Hypermobility Syndrome. Unlike isolated joint hypermobility, JHS can significantly impair function and quality of life.
The condition tends to be hereditary, meaning it often runs in families. While it affects people of all races and genders, it is more commonly diagnosed in women and those with a family history of hypermobility.
Common Symptoms of Joint Hypermobility Syndrome
Symptoms of JHS can vary widely in severity and presentation. Some people may experience mild discomfort, while others deal with chronic pains and systemic issues that affect their daily lives. The most commonly reported symptoms include:
- Joint pain and instability: Achy joints are the most frequently cited complaint. Pain may worsen after physical activity or toward the end of the day. Joints may also dislocate or subluxate (partially dislocate) easily.
- Muscle fatigue and weakness: Because the joints are unstable, surrounding muscles often work harder to provide stability, leading to fatigue and occasional muscle strain.
- Frequent injuries: People with JHS are more susceptible to sprains, strains, and overuse injuries due to lax connective tissues.
- Soft, stretchy skin: Skin may feel unusually soft and may bruise easily.
- Digestive issues: Symptoms like bloating, constipation, and acid reflux can occur, as connective tissues in the digestive tract may also be affected.
- Autonomic dysfunction: Conditions like Postural Orthostatic Tachycardia Syndrome (POTS) often co-occur, causing symptoms like dizziness, palpitations, and fainting upon standing.
Associated Risks and Complications
Living with JHS can pose a variety of long-term health challenges. While the condition itself is not life-threatening, its complications can significantly impact a person’s well-being. Here are some of the key risks:
- Chronic pain: Persistent joint and muscle pain can interfere with sleep, work, and daily activities, sometimes leading to secondary conditions like depression or anxiety.
- Dislocations and joint degeneration: Repeated subluxations or dislocations can lead to early-onset osteoarthritis.
- Reduced mobility: Chronic instability and pain may eventually lead to a sedentary lifestyle, muscle deconditioning, and worsening of symptoms.
- Mental health strain: The constant physical discomfort and unpredictability of symptoms can lead to stress, depression, and feelings of isolation.
- Compromised proprioception: Many people with JHS have difficulty sensing the position of their joints in space, increasing the risk of falls and injuries.
Diagnosis: Challenges and Tools
Diagnosing Joint Hypermobility Syndrome can be challenging due to its broad symptom profile and overlap with other conditions. It is often mistaken for fibromyalgia, chronic fatigue syndrome, or even psychosomatic disorders, especially in the early stages.
The Beighton score is the most widely used screening tool to assess joint hypermobility. It includes tests such as touching the floor with palms flat while keeping knees straight or bending the thumb to touch the forearm. A score of 5 or higher out of 9 suggests generalized joint hypermobility.
However, a diagnosis of JHS also requires the presence of musculoskeletal symptoms such as joint pain or instability. The Brighton criteria or the more recent 2017 Ehlers-Danlos Syndromes (EDS) classification may also be used to determine if the hypermobility is part of a more systemic condition like hEDS.
Because there are no specific blood or imaging tests for JHS, diagnosis is largely clinical and may require input from multiple specialists such as rheumatologists, geneticists, and physiotherapists.
Best Practices for Management and Treatment
Although there is no cure for Joint Hypermobility Syndrome, a multidisciplinary approach can significantly reduce symptoms and improve function. Management often involves the following strategies:
- Joint stabilization
- Muscle strengthening
- Proprioceptive training
- Low-impact cardiovascular fitness
Swimming and Pilates are particularly beneficial, as they enhance core strength without stressing the joints.
- Topical pain relief creams
- TENS (transcutaneous electrical nerve stimulation) units
- Heat and cold therapy
- Mind-body techniques like mindfulness or cognitive-behavioral therapy (CBT)
- Avoiding prolonged standing or repetitive motions
- Using joint supports like braces or kinesiology tape
- Adopting ergonomic workstations
- Wearing supportive footwear
Living Well with Joint Hypermobility Syndrome
While Joint Hypermobility Syndrome presents a range of challenges, many individuals lead active, fulfilling lives with the right support and self-care strategies. Early diagnosis and a proactive, individualized treatment plan can make a profound difference. It’s essential for both patients and healthcare providers to recognize the legitimacy and complexity of this condition to foster better outcomes
