Medicines for Joint hypermobility syndrome

What it is

Joint hypermobility means that some or all of a person’s joints have an unusually large range of movement — they are very flexible, or "double-jointed". Joint hypermobility on its own is common, particularly in children and young people, and is often harmless — many people with flexible joints have no problems at all, and flexibility can even be an advantage (for example in dancing or gymnastics). Joint hypermobility syndrome (now often considered part of "hypermobility spectrum disorders") is the term used when hypermobility is associated with symptoms, particularly pain and other problems, that affect a person’s life. The symptoms can include: joint pain and stiffness (especially after activity); joints that are prone to being injured, dislocating, or partially dislocating (subluxing); tiredness (fatigue); poor coordination or clumsiness; and, in some people, other symptoms — as hypermobility can be associated with a range of features, sometimes including digestive symptoms, dizziness on standing, and others, and it can be linked with conditions such as certain connective tissue disorders. The joints and surrounding tissues (ligaments) are more lax, which can make them less stable and more prone to strain and injury. Joint hypermobility syndrome is usually not a serious or damaging condition in the sense of causing joint destruction, but the symptoms — particularly pain and injuries — can be troublesome and affect daily life and activities. The good news is that it can usually be managed well, primarily through exercise and physiotherapy to strengthen the muscles around the joints and improve their stability and control, along with managing pain and protecting the joints. It is worth being assessed if hypermobility is causing pain or other problems, both to confirm the diagnosis and to access support, and (in some cases) to consider whether there is an associated condition. The key messages are that joint hypermobility is common and often harmless, that when it causes pain and other problems it is called joint hypermobility syndrome, and that it can usually be managed well with exercise, physiotherapy, and self-care.

How it is treated

Joint hypermobility syndrome is usually managed with exercise and physiotherapy to strengthen and stabilise the joints, along with managing pain and protecting the joints; most people can manage their symptoms well. The mainstay of management is exercise and physiotherapy: because the joints and ligaments are more lax and less stable, strengthening the muscles around the joints (and improving their control, coordination, and stability) helps support the joints, reduce pain and the risk of injury, and improve function — a physiotherapist can advise on and guide a suitable, graded exercise programme, which is central to treatment. Staying active and maintaining good general fitness, while pacing activity and avoiding overdoing things or movements that strain the joints, helps. Managing pain is also important: simple measures and pain relief (as advised) help with joint pain, and approaches for managing longer-term or widespread pain may be used where relevant. Protecting the joints — for example good posture and technique, avoiding hyperextending (over-straightening) joints, and using supports for particular joints where helpful — can reduce strain and injuries. Managing any injuries (such as sprains or dislocations) appropriately, and building strength to reduce recurrence, are part of care. Because joint hypermobility can be associated with other symptoms and, in some people, with underlying conditions (such as certain connective tissue disorders), assessment can help confirm the diagnosis, identify any associated features or conditions that may need specific attention, and access appropriate support; this may involve a doctor and, where relevant, specialists. Support for associated symptoms (such as fatigue, or other features) is provided as needed. Education and self-management — understanding the condition, and learning how to exercise, protect the joints, pace activity, and manage symptoms — are valuable, and support and information are available. The reassuring messages are that joint hypermobility is common and often harmless, that joint hypermobility syndrome (when it causes symptoms) is usually not a joint-destroying condition and can be managed well, and that exercise and physiotherapy to strengthen and stabilise the joints, along with managing pain and protecting the joints, help most people manage their symptoms and stay active — so it is worth being assessed and supported if hypermobility is causing problems.