Hypermobility Spectrum Disorder

Question 1

What is hypermobility?

Answer 1

A pain syndrome in people with joints that move beyond normal limits.

It is commonly called “double-jointed”.

Question 2

What is hypermobility due to?

Answer 2

Laxity of ligaments, capsules and tendons.

It is thought that the origin of pain is from microtrauma.

Question 3

Aeitiology of hypermobility spectrum disorder.

Answer 3

Affects 10% of population

ONly few are symptomatic

Often familial such as HSD, Marfan Syndrome and EDS.

More common in women and asian people

Usually presents in childhood or young adulthood.

Question 4

Complications of hypermobility spectrum disorder.

Answer 4

Recurrent subluxations or dislocations.

Question 5

Symptoms and signs of HSD.

Answer 5

Pain around joints, worse after activity, but pain may generalise and fatigue is prominent too.

Soft tissue rheumatism like epicondylitis

Abnormal skin - papyraceous scars, hyperextensible, thin, striae.

Marfanoid habitus

Arachnodactyly

Drooping eyelids and myopia

Hernias and uterine/rectal prolapses.

Question 6

Treatment of HSD.

Answer 6

Improve pain and reduce disability.

Question 7

Non-drug therapy of HSD.

Answer 7

Focus is on strengthening exercises to reduce joint subluxation.

Work on posture and balance

Splinting and surgical interventions might be needed.

Advice on pacing and goal setting

Specialist pain management

Paracetamol

Question 8

Diagnostic criteria for HSD.

Answer 8

The Beighton score.

Question 9

Explain the Beighton score.

Answer 9

4 or more.