Hypermobility Syndrome: Symptoms, & Effective Treatments

What is Hypermobility Syndrome?

Hypermobility syndrome (HMS) is a connective tissue disorder where joints move beyond their normal range of motion, making them extremely flexible. Commonly affected joints include the elbows, wrists, fingers, and knees. HMS often runs in families and is caused by weakened connective tissues, especially ligaments, which normally stabilize joints. Hypermobility is also seen in conditions like Down syndrome and Marfan syndrome. The most prevalent form is Ehlers-Danlos syndrome (EDS), affecting about 1 in every 100 to 200 people².

Causes of Hypermobility

Genetics is a major factor in hypermobility syndrome¹. Faulty collagen genes lead to loose connective tissue and hypermobile joints. If hypermobility runs in your family, you are more likely to develop it. Other causes include:

• Aging: Collagen production decreases with age, weakening ligaments and increasing joint mobility.
• Joint or bone abnormalities: Shallow joint sockets or abnormal muscle tone can allow extra movement.
• Flat feet: Collapsed arches can increase joint laxity in the feet.

For more on the genetics and causes, see Grahame, 1999.

Symptoms of Hypermobility Syndrome

• Pain and stiffness: Dull or severe joint pain, especially after activity. Back pain is also common.
• Clicking joints: Crackling or clicking, often with discomfort, especially in knees, shoulders, elbows, or neck.
• Joint dislocation: Shoulders and fingers are most commonly affected. Severe cases may require surgery.
• Fatigue: Persistent tiredness, even after rest.

Types of Hypermobility Syndrome

Classical Type

Characterized by significant joint hypermobility, stretchy and fragile skin, and frequent joint dislocations. Inherited as an autosomal dominant trait.

Hypermobility Type

The most common form, also known as hypermobile Ehlers-Danlos syndrome (hEDS)². Main symptoms are joint hypermobility and frequent dislocations. Benign joint hypermobility syndrome (BJHS) is also common and may be associated with hernias and other connective tissue problems³.

Vascular (VEDS) Type

Involves fragile arteries and organs, with a risk of sudden rupture. Inherited in a dominant pattern.

Kyphoscoliosis Type

Characterized by abnormal spinal curvature (scoliosis), fragile eyes, and joint hypermobility⁴.

Arthrochalsia Type

Marked by severe joint laxity and frequent dislocations, often in people of short stature⁵.

Treatment Options for Hypermobility

Treatment is tailored to each individual and focuses on managing symptoms and improving quality of life⁶:

• Pain management: Over-the-counter pain relievers like ibuprofen can help reduce pain and inflammation.
• Physical therapy: Exercises to strengthen muscles and improve joint stability. Physiotherapy is especially helpful for postural issues.
• Occupational therapy: Helps with daily activities and joint protection.
• Surgery: Reserved for severe cases, especially in vascular EDS, where tissue fragility is a concern.

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat Hypermobility.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with Hypermobility.
As prolotherapy is helping to treat the root cause of Hypermobility, it is deemed to be a permanent fix, preventing the symptoms from returning.

Prevention and Exercises

While hypermobility is often inherited, symptoms can be managed and injuries prevented:

• Avoid high-impact sports and activities that strain joints.
• Use ergonomic furniture and protective gear to prevent injuries.
• Practice isometric and low-impact exercises (like planks and swimming) to build muscle strength and joint stability.
• Protect your skin and joints from trauma.

Regular exercise and physical therapy can help reduce pain and improve function for people with hypermobility.

Frequently Asked Questions

What is the difference between hypermobility and Ehlers-Danlos syndrome?

Hypermobility refers to joints that move beyond the normal range. Ehlers-Danlos syndrome (EDS) is a group of genetic disorders that often include hypermobility as a symptom, along with skin and tissue fragility.

Can hypermobility be cured?

There is no cure for genetic hypermobility, but symptoms can be managed with exercise, therapy, and treatments like prolotherapy.

Is hypermobility dangerous?

Most cases are not dangerous, but severe forms (like vascular EDS) can be life-threatening. Joint injuries and chronic pain are common risks.

What exercises are best for hypermobility?

Low-impact, isometric exercises (such as planks, swimming, and Pilates) are best. Avoid high-impact or contact sports.

How is hypermobility diagnosed?

Diagnosis is based on physical examination, family history, and sometimes genetic testing.

Conclusion

Hypermobility syndrome is a common connective tissue disorder that can cause pain, fatigue, and joint instability. Early diagnosis, tailored exercise, and advanced treatments like prolotherapy can help manage symptoms and improve quality of life. For more information on related conditions, see our article on hyperlordosis causes and symptoms.

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Author Bio

Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating Hypermobility, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Hypermobility and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
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References

1. Grahame, R. (1999). Joint hypermobility and genetic collagen disorders: are they related? Archives of Disease in Childhood, 80(2), 188–191. https://doi.org/10.1136/adc.80.2.188
2. Tinkle, B., Castori, M., Berglund, B., Cohen, H., Grahame, R., Kazkaz, H., & Levy, H. (2017). Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 48–69. https://doi.org/10.1002/ajmg.c.31538
3. Fikree, A., Aziz, Q., & Grahame, R. (2013). Joint Hypermobility Syndrome. Rheumatic Disease Clinics of North America, 39(2), 419–430. https://doi.org/10.1016/j.rdc.2013.03.003
4. Colombi, M., Dordoni, C., Chiarelli, N., & Ritelli, M. (2015). Differential diagnosis and diagnostic flow chart of joint hypermobility syndrome/ehlers-danlos syndrome hypermobility type compared to other heritable connective tissue disorders. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 169(1), 6–22. https://doi.org/10.1002/ajmg.c.31429
5. Carter, C., & Wilkinson, J. (1964). Persistent joint laxity and congenital dislocation of the hip. The Journal of Bone and Joint Surgery. British Volume, 46-B(1), 40–45. https://doi.org/10.1302/0301-620x.46b1.40
6. Engelbert, R. H. H., Juul-Kristensen, B., Pacey, V., de Wandele, I., Smeenk, S., Woinarosky, N., Sabo, S., Scheper, M. C., Russek, L., & Simmonds, J. V. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 175(1), 158–167. https://doi.org/10.1002/ajmg.c.31545