Your doctor has found that you have hypermobile joints. The ligaments, tendons, and other structures that support your joints stretch more than normal. Most people inherit this feature from a parent. People with hypermobility are sometimes referred to as “double-jointed.” They do not have extra joints, just very flexible ones.
Hypermobility may affect many joints. You may be able to:
Bend your spine forward and backward more than usual.
Bend your fingers or toes backward or sideways more than usual.
Bend your knees or elbows backwards.
Move your legs in unusual ways or easily do “splits.”
Not everyone has the same amount, severity, or location of hypermobile joints. Doctors classify people with hypermobile joints into hypermobility spectrum disorders (HSD). People with HSD tend to have joint pain, joint injuries (sprains) or “clumsiness” due to loose ligaments.
The types of HSD include:
Ehlers-Danlos Syndromes (EDS): A group of different conditions causing hypermobile joints. Your doctor will help you figure out whether you have an EDS or one of the other HSDs. See Health Facts for You #8098, “Ehlers-Danlos Syndromes,” to find out more.
Generalized (G-HSD): Many hypermobile joints. Very similar to hypermobile-type EDS.
Peripheral (P-HSD): Hypermobile at hands and feet only.
Localized (L-HSD): Hypermobile at a single joint or group of joints.
Historical (H-HSD): Older people who are not hypermobile now but were when they were younger. They can still have joint pain and other problems.
People with HSD may have some of these other conditions:
Joint “popping” or “cracking”
Flat feet
Frequent ankle sprains
Back or neck pain
Widespread aching pain or
fibromyalgiaOsteoarthritis
Problems with healing (thin scars) or fragile skin
Easy bruising
Varicose veins
Low blood pressure, dizziness when standing up
Fatigue
Flushing, rashes, hives
Diarrhea, constipation, abdominal pain, or irritable bowel syndrome
Whether or not you have pain, you need to take good care of your body. There is no cure for HSD. Take the proper steps now. This will reduce your chances of having pain, arthritis, or other problems later in life.
Diagnosis
HSD sometimes go along with more serious health problems. Talk to your doctor to make sure these other problems have been checked for and ruled out. There are tests to check your eyes, blood vessels, and heart to make sure all are working well.
Exercise
A physical or occupational therapist can help you find a good exercise program and give you advice. Strength training helps support your joints and reduce extra motion. This may help protect the joints from harm. Light aerobic exercise may be helpful in keeping a healthy level of fitness.
Most people with HSD do not need a lot of stretching; their joints and muscles are more flexible than normal. Stretch only those muscles that are very tight, cramping, or muscles that your therapist has told you to stretch. Good posture is very important, and you will be taught ways to help with this.
Braces and Splints
If a joint is getting painful or has arthritis, splints or braces may help reduce pain, improve function, and prevent extra motion.
Tools used may include:
Elbow or knee supports to prevent abnormal bending.
Arch supports in the shoes to support flat feet.
Ankle supports.
Finger joint splints.
Spine supports.
Your health care provider will help you in your choice of splints or braces.
Fatigue and Faintness
People with low blood pressure, faintness when standing up, or fast heartbeat may feel better if they wear support stockings, drink plenty of fluids, and add salt to theirdiet. Talk to your doctor about these options.
Activity
Some limits on activity can help reduce the risk of pain or injury. These limits vary from person to person. Talk to your health care provider to learn which ones apply to you.
Lifting, carrying, or other motions can cause harm or pain. They are safer if you maintain good posture, exercise, use splints or braces where needed, and take rest breaks.
HSD may increase risk of back pain or other problems in pregnancy. To prevent this, pregnant women with HSD or those who plan to become pregnant should talk with their health care providers.
Medicines and Supplements
Your doctor can help you find medicine for pain, if needed.
Some people have tried over-the-counter products to reduce their joint pain. Diclofenac 1% gel is an anti-inflammatory you can rub on painful joints. Supplements and herbal “joint health” products are not proven and could be harmful. Talk with your doctor before you use any over the counter medicine or supplement.
Skin Treatments
Some people get short-term relief from ointments, gels, creams, or by putting heat or ice on painful areas. Your doctor can advise you on the best treatments.
Injections
Areas of muscle “knotting” and pain (trigger points) can sometimes be helped by special injections. See Health Facts for You #5934 “Trigger Point Injection.” Bursitis or tendon pain may also be helped by injections. Physical therapists may use “dry needling” techniques. Your doctor will help you decide if any of these are right for you.
Mind/Body Therapies
Pain from HSD can be treated using relaxation, meditation, massage, and other non-drug methods. Mindfulness-based stress reduction (MBSR) can be very helpful. You can learn this through classes or using programs for your smartphone or computer. Talk with your doctor to see if any of these are right for you.
People with HSD can lead full lives. If you take good care of your body and follow the advice of your health care team, you should be able to manage your HSD well, instead of letting it manage you.
Good luck!
For More Information
The Ehlers-Danlos Society: www.ehlers-danlos.com.
EDS Wisconsin: www.edswi.org.
New England EDS/CTD Support Group: www.ctdnewengland.org.
Hypermobility Syndromes Association: www.hypermobility.org.
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