Joint Hypermobility Syndrome

Joint hypermobility syndrome (JHS) is a condition characterized by joints that are excessively flexible, often beyond the normal range of motion. This can lead to various symptoms and complications, including joint pain, instability, and increased risk of injury.

Causes and Risk Factors

The exact cause of JHS is not fully understood, but it is believed to be related to genetic factors, as well as abnormalities in the structure and function of connective tissue. Connective tissue provides support and stability to joints, and in individuals with JHS, this tissue may be weaker or more elastic than normal.

Risk factors for developing JHS include:

• Family history: Having a family member with JHS or other conditions that affect connective tissue, such as Ehlers-Danlos syndrome
• Genetic predisposition: Certain genetic mutations can increase the risk of developing JHS
• Gender: Women are more likely to develop JHS than men
• Age: JHS can occur at any age, but symptoms often begin in childhood or adolescence

Symptoms

The symptoms of JHS can vary widely from person to person, but common complaints include:

• Joint pain and stiffness, particularly after exercise or activity
• Joint instability, which can lead to dislocations or subluxations (partial dislocations)
• Muscle weakness and fatigue
• Poor proprioception (awareness of body position and movement)
• Increased risk of injury, particularly to joints and muscles
• Gastrointestinal symptoms, such as constipation or abdominal pain, in some individuals

Diagnosis

The diagnosis of JHS is typically made based on a combination of clinical evaluation, medical history, and physical examination. The Beighton criteria are often used to assess joint hypermobility, which include:

• Passive dorsiflexion of the fifth finger beyond 90 degrees
• Passive apposition of the thumb to the forearm
• Hyperextension of the elbow beyond 10 degrees
• Hyperextension of the knee beyond 10 degrees
• Forward flexion of the trunk, with the knees straight, so that the palms of the hands can be placed on the ground

A score of 4 or more out of 9 indicates joint hypermobility. Additional tests, such as imaging studies (e.g., X-rays, MRI) or blood tests, may be ordered to rule out other conditions that can cause similar symptoms.

Treatment and Management

Treatment for JHS typically focuses on managing symptoms, improving joint stability, and preventing injuries. This may include:

• Physical therapy: To improve joint stability, strength, and proprioception
• Exercise modification: Avoiding high-impact activities or exercises that exacerbate symptoms
• Pain management: Using medications, such as analgesics or anti-inflammatory agents, to control pain
• Bracing or orthotics: To provide additional support and stability for joints
• Lifestyle modifications: Maintaining a healthy weight, avoiding heavy lifting or bending, and taking regular breaks to rest and stretch

Complications and Associated Conditions

JHS can increase the risk of various complications and associated conditions, including:

• Osteoarthritis: Due to repetitive joint stress and instability
• Tendinopathy: Inflammation or degeneration of tendons
• Ligament sprains: Tears or strains to ligaments, which can lead to chronic instability
• Fibromyalgia: A condition characterized by widespread muscle pain and fatigue
• Gastrointestinal disorders: Such as irritable bowel syndrome (IBS) or constipation