Hypermobility

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**Hypermobility**
*Classification & external resources*
ICD-10	M 35.7
ICD-9	728.5
OMIM	147900
DiseasesDB	31101

Hypermobility (also called double-jointedness, hypermobility syndrome or hyperlaxity) describes joints that stretch farther than is normal. For example, some hypermobile people can bend their thumbs backwards to their wrists, or bend their knee joints backwards.

1 Causes
2 Hypermobility syndrome
3 Treatments
4 See also
5 References
6 External links

[edit] Causes

Hypermobility generally results from one or more of the following:

abnormally-shaped ends of one or more bones at a joint
weak or stretched ligaments
abnormal joint proprioception (an impaired ability to determine where in space parts of the body are, and how stretched a joint is)

The condition tends to run in families, suggesting that there may be a genetic basis for at least some forms of hypermobility. There is considerable variation in joint hypermobility between ethnic communities.

Some people have hypermobility with no other symptoms or medical conditions. However, people with hypermobility syndrome (hypermobility together with other symptoms) may experience many difficulties. For example, their joints may be easily injured, and they may develop problems from muscle overuse (as muscles must work harder to compensate for the excessive suppleness of the joint). Hypermobility may also be symptomatic of a serious medical condition, such as Marfan syndrome.

[edit] Hypermobility syndrome

Hypermobility syndrome (known by a variety of other names, including Benign Joint Hypermobility Syndrome) is generally considered to comprise hypermobility together with other symptoms, such as myalgia and arthralgia, and extra-articular features such as skin hyperextensibility and varicose veins. The current diagnostic criteria for hypermobility syndrome are the Brighton criteria, which incorporate the Beighton score[1]. Hypermobility syndrome is considered by many doctors expert in hypermobility (e.g. Professor Rodney Grahame) to be equivalent to the Hypermobile Type of Ehlers-Danlos Syndrome.

People with hypermobility syndrome may develop other conditions caused by their lax connective tissues. These conditions include Gastroesophageal Reflux Disease (GERD), Irritable Bowel Syndrome (IBS), varicose veins, flat feet, scoliosis, sprains, tendonitis, and bursitis. People with hypermobility syndrome may be at increased risk of early-onset osteoarthritis, and there is evidence linking hypermobility syndrome to anxiety and depression.[2][3]

[edit] Treatments

[edit] Medication

Medications frequently used to reduce pain and inflammation caused by hypermobility include analgesics, anti-inflammatory drugs, and tricyclic antidepressants. Some people with hypermobility may benefit from other medications such as steroid injections or gabapentin, a drug originally used for treating epilepsy.

[edit] Physical therapy

Regular exercise and physical therapy or hydrotherapy can reduce symptoms of hypermobility, because strong muscles help to stabilise joints. These treatments can also help by stretching tight, overused muscles and ensuring that the person can use their full, hypermobile range of motion. Low-impact exercise such as swimming or Pilates is usually recommended for hypermobile people as it is less likely to cause injury than high-impact exercise or contact sports.

[edit] Lifestyle modification

For many people with hypermobility, lifestyle changes decrease the severity of symptoms. For example, if writing is very painful, people may be able to reduce their pain by typing. It can be important for people with hypermobility to know their physical limits and avoid injury, for example, by avoiding over-stretching their joints.

Moist hot packs can relieve the pain of aching joints and muscles. For some patients, ice packs also help to relieve pain.

People with HMS are encouraged to use their over-flexible joints to their full range, but not beyond as it may cause injury - just as it would for those without the condition.

Treatments include planned exercise specifically to strengthen the muscles around the joints and allow them to compensate for the joints' excessive suppleness.

Bracing to support weak joints may be helpful, but caution must be used not to weaken the joints further.