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Hypermobility: Causes, Symptoms and Treatment

Hypermobility refers to an excessive range of movement in one or more joints beyond what is considered normal. It can be congenital or acquired and may be associated with pain and joint instability.

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Things worth knowing about "Hypermobility"

Hypermobility refers to an excessive range of movement in one or more joints beyond what is considered normal. It can be congenital or acquired and may be associated with pain and joint instability.

What is Hypermobility?

Hypermobility is the ability of joints to move beyond their normal range of motion. It can affect individual joints or the entire musculoskeletal system. The condition is often caused by increased laxity of ligaments, tendons, and connective tissue. Hypermobility is not always pathological – for some people it is a benign physical trait, while for others it can lead to significant discomfort and health issues.

Causes

The causes of hypermobility are varied and include:

Genetic predisposition: An inherited weakness of connective tissue is a common underlying factor and often runs in families.
Connective tissue disorders: Conditions such as Ehlers-Danlos syndrome and Marfan syndrome are strongly associated with hypermobility.
Hypermobility Spectrum Disorder (HSD): A distinct diagnosis where hypermobility causes symptoms without an identifiable underlying connective tissue disorder.
Training and occupation: Intensive stretching practices, as seen in dancers and gymnasts, can increase joint flexibility over time.

Symptoms

Hypermobility does not always cause symptoms. When symptoms do occur, they may include:

Joint and muscle pain, often worsened after physical activity
Recurrent joint injuries such as sprains or dislocations
Morning stiffness in joints and muscles
Fatigue and general exhaustion
A feeling of instability or looseness in affected joints
In severe cases: chronic pain significantly affecting quality of life

Diagnosis

Hypermobility is typically diagnosed through a clinical examination. The Beighton Score is a widely used tool that assesses the flexibility of five joint regions on a 9-point scale. A score of 5 or above generally indicates generalised hypermobility.

If an underlying condition is suspected, further investigations may include:

Genetic testing to identify specific mutations
Imaging studies (X-ray, MRI) to assess joint and tissue changes
Blood tests to exclude other potential causes

Treatment

There is currently no cure for hypermobility itself, but treatment focuses on managing symptoms and improving joint stability:

Physiotherapy: Targeted muscle-strengthening exercises stabilise affected joints, reduce pain frequency, and lower the risk of injury.
Pain management: Anti-inflammatory medications (e.g., ibuprofen) or other analgesics may be used as needed.
Orthopedic aids: Braces, splints, or compression garments can provide additional joint support.
Patient education: Learning protective movement strategies and avoiding overexertion is an important part of self-management.
Psychological support: For those with chronic pain, psychological therapy can improve overall well-being and coping strategies.

Hypermobility in Children

Increased joint flexibility is more common in children than in adults and is often age-related. Many children outgrow hypermobility over time. However, parents should be attentive to signs such as frequent joint pain after physical activity or repeated injuries and consult a healthcare professional if concerned.

References

Hakim, A. et al. - Hypermobility, fibromyalgia and chronic pain. Churchill Livingstone Elsevier, 2010.
Castori, M. et al. - A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics Part C, 175(1), 2017.
Malfait, F. et al. - The 2017 international classification of the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C, 175(1), 2017.

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