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Hypermobility syndrome

Hypermobility syndrome (HMS), Hypermobility Spectrum Disorder (HSD), or joint hypermobility syndrome (JHS) is a heritable connective tissue disorder[3] that affects the joints and ligaments in a person's body. It comes in different degrees of severity, the least being similar to double-jointedness, but if it is progressively more serious it can create more problems for someone. These can include the inability to walk properly or for long distances, and pain in affected areas. In some cases, people with HMS are subjected to hypersensitive nerves and a weaker immune system. It also can have an effect on exhaustion levels and some cases cause depressive episodes.

Hypermobility syndrome
SymptomsJoint hypermobility, muscloskeletal pain, fatigue[1]
CausesGenetic[2]

It is a genetic disorder. It is similar to other connective tissue disorders such as Ehlers–Danlos syndrome.

ClassificationEdit

There is a lack of distinction in the clinical presentation of JHS and Ehlers-Danlos syndrome, hypermobility type (EDS-HT) and they may be the same condition.[4][5] Newer classifications either replace both terms with hypermobile EDS (hEDS)[6] or, where individuals do not meet diagnostic criteria for other syndromes, a diagnosis of hypermobility spectrum disorder (HSD) is proposed.[7]

JHS is not to be confused with double-jointedness, where a person can bend their limbs in positions others find impossible.[clarification needed]

Signs and symptomsEdit

Some common symptoms of hypermobility syndrome include:

  • Joint pain around the affected area;
  • Exhaustion (typically when affected area is the legs);
  • Swelling around the joint when joint is being exerted;
  • Depression;
  • Weaker immune system;
  • Sensitive skin around the affected area;
  • Varying pain levels around the affected area;
  • Muscle spasms

Other symptoms can appear and not everyone affected experiences the same symptoms.

DiagnosisEdit

Being diagnosed with hypermobility syndrome can be a difficult task. There is a lack of wide understanding of the condition and it can be considered a zebra condition. As Hypermobility Syndrome can be easily mistaken for being double-jointed or categorized as nothing more than perhaps an achy body from lack of exercise, medical professionals may diagnose those affected incorrectly and not adequately investigate the symptoms. Due to these circumstances many sufferers can live not knowing they have it. As a result those affected without a proper diagnosis can easily injure themselves and not take proper care to ensure they go about working safely.

The Beighton Score can be used to determine generalized joint hypermobility (GJH) related to hypermobility syndrome.[8]

In comparison to the diagnostic criteria of hypermobile Ehlers-Danlos syndrome, the criteria for hypermobile spectrum disorder is less strict. However, this criteria is differentiated from criteria of other EDS types and therefore its less-strict criteria is only comparable to the criteria of hEDS. As suffers of HSD suffer from a considerable amount of discomfort, it is important to focus on the treatment, not the labels. [9]

TreatmentEdit

Treating hypermobility syndrome can be difficult. The condition has no direct cure, but its symptoms can be treated. Physiotherapy, particularly exercise, is the main treatment for the condition, although there is only limited evidence for its effectiveness.[10]

Treatments for pain include:

  • Bandaging the affected area;
  • Placing an ice pack on the affected area;
  • Taking over the counter pain killers such as paracetamol or ibuprofen.

PrevalenceEdit

Prevalence of the condition is unknown, but can be high in those attending musculoskeletal services.[5][11]

ReferencesEdit

  1. ^ "What Is HSD?". The Ehlers-Danlos Society. The Ehlers-Danlos Society. Retrieved 30 May 2018.
  2. ^ Hakim, Alan. "Hypermobility Disorders- An Update for Clinicans". Hypermobility Syndromes Association. Retrieved 30 May 2018.
  3. ^ "Hypermobile Ehlers-Danlos syndrome | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2017-06-19.
  4. ^ B.T. Tinkle, Issues and Management of Joint Hypermobility. A Guide for the Ehlers-danlos Syndrome Hypermobility Type and the Hypermobility Syndrome, Left Paw Press, USA (2008)
  5. ^ a b Palmer et al., 2017
  6. ^ F. Malfait, C. Francomano, P. Byers, J. Belmont, B. Berglund, J. Black, L. Bloom, J.M. Bowen, A.F. Brady, N.P. Burrows, M. Castori, H. Cohen, M. Colombi, S. Demirdas, J. De Backer, A. De Paepe, S. Fournel-Gigleux, M. Frank, N. Ghali, C. Giunta, R. Grahame, A. Hakim, X. Jeunemaitre, D. Johnson, B. Juul-Kristensen, I. Kapferer-Seebacher, H. Kazkaz, T. Kosho, M.E. Lavallee, H. Levy, R. Mendoza-Londono, M. Pepin, F.M. Pope, E. Reinstein, L. Robert, M. Rohrbach, L. Sanders, G.J. Sobey, T. Van Damme, A. Vandersteen, C. van Mourik, N. Voermans, N. Wheeldon, J. Zschocke, B. Tinkle. The 2017 international classification of the Ehlers-Danlos syndromes. Am. J. Med. Genet. Part C Semin. Med. Genet., 175C (2017), pp. 8-26
  7. ^ Castori et al., 2017
  8. ^ "Assessing Joint Hypermobility". The Ehlers-Danlos Society. The Ehlers-Danlos Society. Retrieved 30 May 2018.
  9. ^ Ehlers-Danlos Society. "Hypermobile Ehlers-Danlos syndrome (hEDS) vs. Hypermobility Spectrum Disorders (HSD): What's the difference?" (PDF). Ehlers-Danlos Society. Retrieved 31 January 2019.
  10. ^ Palmer et al., 2014
  11. ^ E. Connelly, A. Hakim, S. Davenport, J. Simmonds. "A study exploring the prevalence of joint hypermobility syndrome in patients attending a musculoskeletal triage clinic." Physiother. Pract. Res., 36 (1) (2015), pp. 43-53