Joint Hypermobility Syndrome

Joints move beyond the normal range with joint hypermobility syndrome.

Joint hypermobility syndrome is a condition that features joints that move beyond the normal range expected for a particular joint. Joint hypermobility syndrome is considered a benign condition. It is estimated that 10%-15% of normal children have hypermobile joints or joints that can move beyond the normal range of motion. Hypermobile joints are sometimes referred to as "loose joints," and those affected are referred to as being "double jointed."

Hypermobile joints tend to be inherited in specific genes passed on by parents to their children. It is felt that these certain genes predispose to the development of hypermobile joints. As a result, there is a tendency for the condition to run in families (familial). Genes that are responsible for the production of collagen, an important protein that helps to glue tissues together, are suspected of playing a role.

Joint hypermobility is also a feature of a rare, inherited, more significant medical condition called Ehlers-Danlos syndrome (EDS), which is characterized by weakness of the connective tissues of the body. Joint hypermobility is commonly seen in people with Down syndrome and in people with Marfan syndrome.

Because the joints are capable of excessive motion in people with joint hypermobility syndrome, they are susceptible to injury. Symptoms of joint hypermobility syndrome include pain in the knees, fingers, hips, and elbows. There is a higher incidence of joint dislocation and sprains of involved joints. Scoliosis (curvature of the spine) occurs more frequently in people with hypermobile joints and can lead to back pain. Joint hypermobility tends to decrease with aging as we become naturally less flexible.

Signs of the syndrome include:

• Ability to place the palms of the hands on the floor with the knees fully extended
• Hyperextension of the knee or elbow beyond 10 degrees
• Ability to touch the thumb to the forearm

Joint hypermobility syndrome is diagnosed by examining affected joints and noting that they move easily beyond the normal range expected. For example, the middle of the fingers may bend backward more than usual. There is no blood test for hypermobility syndrome.

Doctors who treat hypermobility syndrome include general-medicine doctors, family medicine doctors, and internists, as well as rheumatologists, orthopedists, and physical-medicine physicians.

Often, joint hypermobility causes no symptoms and requires no treatment. Many individuals with joint hypermobility syndrome improve in adulthood. Treatments are customized for each individual based on their particular manifestations.

• Joint pain can be relieved by medications for pain or inflammation.
• Proper physical fitness exercises should be designed to avoid injury to the joints.
• Home remedies include home exercises and acetaminophen (Tylenol), as needed.
• Sometimes physical therapy can help with the rehabilitation of injured areas and can be especially helpful to prevent re-injury.

Frequently, there are no long-term consequences of joint hypermobility syndrome. However, hypermobile joints can lead to joint pain. Over time, joint hypermobility can lead to degenerative cartilage and arthritis. Certain hypermobile joints can be at risk for injury, such as sprained ligaments.

Because joint hypermobility syndrome is inherited, it is not preventable. Nevertheless, when joint hypermobility syndrome causes symptoms, prevention of injury and pain is possible by avoiding trauma and with appropriate treatments.