Joint hypermobility is defined as “an abnormally increased mobility of small and large joints beyond the limits of their physiological movement.” Joint hypermobility is common among young females and is seen in about 5 per cent of the healthy adult population.
When musculoskeletal signs arise in hypermobile individuals in the absence of any other chronic rheumatological disease, this is called “hypermobility syndrome.” Joint hypermobility is also a characteristic of a neurological condition called Ehlers-Danlos syndrome (EDS), which is characterized by weakening of the body’s connective tissue.
Similarity of symptoms
Could there be a possible link between fibromyalgia and joint hypermobility? Or do these two syndromes actually resemble one another and overlap? They certainly share the same symptoms of wide-spread musculoskeletal pain and rigidity, but does the liaison end there, or do they share a similar underlying disease process?
The jury is still out in the medical community but research teams around the world are finding out. Joint hypermobility is most prevalent among young women, and its prevalence may vary among populations. For example, about 5 percent of the Caucasian population is believed to be affected as compared to a frequency of 38 percent of Middle East women.
How to confirm the diagnosis
If you have fibromyalgia, I want you to go back to your childhood. Were your joints extremely flexible or do you have double joints? Did your fingers curve backwards when you straightened them? Can you bend your thumb so you can touch your forearm? When your legs or arms were fully extended, did they look like they were bending slightly backwards?
If one or more of these questions can be answered ” yes, “you may have (or have) a joint hypermobility syndrome. One can diagnose joint hypermobility by asking an individual to perform a series of hyperextensive movements.
For example, by leaning forward without bending their knees or placing the palm of their hand on the table and extending their fifth finger backwards by 90 degrees, if a person can perform a certain number of these abnormal movement ranges then they are diagnosed with hypermobile joints.
Another condition is known as ‘proprioceptive deficiency,’ when people do not ‘think’ when they are in space visually, which may make them less steady and vulnerable to slipping, and unstable or awkward. Some people with the syndrome of joint hypermobility (possibly up to half) are more sensitive to pain than the rest of the population, and have pain across their bodies at a number of sites. Other symptoms may include low blood pressure when standing up, fainting and lightheadedness, tachycardia (fast heart rate), anxiety , panic attacks, fatigue, and heat intolerance.
In addition to having hypermobile joints, people with joint hypermobility syndrome may also have skin that is thinner and more fragile than the skin of other people, and they may be more likely to bruise. Young people with a joint hypermobility syndrome may develop stretch marks during periods of rapid growth on their skin.
Association between fibromyalgia and joint hypermobility
The link between fibromyalgia and joint hypermobility is not entirely understood. Joint hypermobility in patients can cause widespread arthralgia due to abuse or overuse of hypermobil joints. Data from this specific study have indicated:
• Typical fibromyalgia symptoms were found mainly in patients who meet the ACR criterion.
• Some patients who exhibit fibromyalgia symptoms clinically but do not meet the ACR criteria may actually have fibromyalgia misdiagnosed as joint hypermobility.
In 1967 joint hypermobility was first featured in the literature of rheumatology. Joint hypermobility is now more well understood and widely recognized. To learn even more about the interaction between joint hypermobility and fibromyalgia, however, further investigation and research is still required.
One of the hypotheses behind the syndrome of fibromyalgia is that constant pain induces discomfort from hypersensitization and this contributes to syndrome of fibromyalgia. People with syndrome of joint hypermobility may be vulnerable to frequent strains and dislocations because their joints are more easily overextended-this could be the trigger for chronic pain and therefore fibromyalgia syndrome.
Similarities between these two syndromes
In the field of research how do these two syndromes compare? Present reviews of the study have provided contradictory findings. Researchers from Córdoba, Spain, Acasuso-Diaz and Collantes-Estevez conclude that the two diseases are related and that mobile joints may play an significant role in the root cause of fibromyalgia.
Their 1998 study compared 66 women with fibromyalgia to 70 women who had been diagnosed with other rheumatic conditions. Statistical analysis revealed a significant difference between these two groups, with 27% of women with hypermobile joints having fibromyalgia compared to only 11.4% of women with other rheumatic disorders.
Hypermobility can be a symptom, once in a while, of a rarer and more serious disorder called Ehlers-Danlos syndrome. Ehlers-Danlos syndrome (EDS) is a group of genetic disorders which weaken the connective tissue. Six different types of EDS exist, and the severity can range from mild to life-threatening.
Treatment of hypermobile joints
There is no cure for the condition of joint hypermobility but exercise will strengthen the muscles surrounding the joints and joints themselves, making them more flexible. It is also important to care properly for any injuries, to prevent chronic pain from developing.
From all the research it seems clear that joint hypermobility in certain individuals is related to widespread musculoskeletal discomfort. The research studies, however, conflict over whether there is a direct link to fibromyalgia. Joint hypermobility could be mimicable and misdiagnosed as fibromyalgia, underlining the importance of the ARC criteria.
Nevertheless, rheumatologists tend to differ in their opinion as to whether strict adherence to ARC criteria is beneficial, but given the obvious overlap in symptoms some criteria need to be in place to avoid misdiagnosis.
- Joint Hypermobility and Primary Fibromyalgia: A Clinical Enigma, Journal of Rheumatology, July 2000 (27:1774-6)
- Joint Hypermobility and Fibromyalgia By Carol Eustice via Verywell Health