The term “joint hypermobility” refers to a broad spectrum of disorders characterized by the ability to extend some or all of the joints beyond normal physiological limits. Patients present with ligament laxity (relaxation of the tissues that hold the joint together) and weakening of the muscles. Furthermore, they undergo recurrent dislocations. So, In this article, we will give you a complete guide about hypermobility spectrum disorder.
The joints most affected by hypermobility are the knee, shoulder, elbow, wrist, and finger joints. However, the joint mobility in human beings changes with age: it is higher after birth and gradually decreases over the course of life. Furthermore, the range of joint motion is greater in females than in males.
Hypermobility spectrum disorder
In most cases, this manifestation is not related to other pathologies ( benign hypermobility ). Greater joint mobility, in fact, can be constitutional and depend on a particular bone and muscle structure, the lack of proprioceptive sensation (impaired ability to perceive the extension of the joints), and family history.
In addition to increased mobility, some patients also complain of mild onesmyalgia , intermittent joint swelling and a typical fibromyalgia syndrome. Joint laxity can coexist with postural disorders, such as scoliosis and flat foot valgus.
Sometimes, hypermobility is due to a systemic disease, such as Down syndrome, osteogenesis imperfect, and cleidocranial dysostosis (a rare genetic abnormality of bone development). Although the syndrome of Ehler-Danlos and Marfan syndrome are severe disorders characterized by such symptoms. However, a major one joint mobility can also be acquired in some sports disciplines through specific training techniques that allow overcoming the physiological limits, as in the case of ballet dancers, gymnasts, contortionists, or those who practice martial arts.
In general, joint hypermobility is quantified in clinical screening using a scoring system: the Beighton scale. One point is assigned for each of the following (note: two points are assigned if they are bilateral): extensibility of the elbow and knee joint greater than 10 degrees, ability to extend the fifth metacarpophalangeal joint up to 90 degrees, and ability to oppose the thumb to the forearm. To this score, the last element must be added, that is the ability to rest the palms of the hands on the floor while keeping the knees extended. About 12-20% of people with rheumatological diseases get a Beighton score between 5 and 9 (the maximum score is 10).
1. Hypermobility spectrum disorder: Syndrome
Syndrome of hypermobility (or excessive mobility) of the joints is a condition of the connective tissue. That explains its increased elasticity and manifests itself in a combination of several states of the musculoskeletal system to a large symptom complex affecting different systems of our body. Simply put, if a child simultaneously has, for example, excessive mobility in the knee joints, mobile flat feet, idiopathic scoliosis, fatigue pain in the legs after a short walk, increased anxiety.
At the moment, programs for an integrated approach to this problem already exist in the world, more and more conferences are being created on the numerous concomitant conditions of one of the three main diagnoses of patients with excessive joint mobility ( Ehlers-Danlos syndrome, joint hypermobility syndrome, a spectrum of hypermobility disorders ) and that is characteristic that a large number of specialists show interest in this condition: geneticists, orthopedists, rheumatologists, neurologists, gastroenterologists, cardiologists, endocrinologists, gynecologists, ophthalmologists, physiotherapists.
The main idea at the moment is that it is necessary to treat and observe the patient so as not to cause the system of a vicious circle of diseases, and this is also the main step towards practical recovery or improving their quality of life. Orthopedics has been holding a consultation of children with joint hypermobility syndrome.
The consultation consists of an orthopedist, a psychologist, and a rehabilitation therapist. Which makes it possible to understand the cause of pain. Which can be the cause of both dysfunctions of the musculoskeletal system and a combination of psychological and social problems. However, the purpose of the council is not only to diagnose but also to offer the most appropriate strengthening rehabilitation. So, leading to muscle balance, minimizing and preventing discomfort in the musculoskeletal system.
2. Hypermobility spectrum disorder: Syndrome Second Part
Every day at work in the clinic, I and some of my colleagues have to deal with a mass of cases of undiagnosed hypermobility syndrome. On the other hand, the patients themselves feel dissatisfied after consultations with doctors of various specialties, since the doctor does not realize the great influence of this syndrome on the patient’s life.
If we find the answer to the question “why”, then the doors open up for us to deal with the effective management of these patients. When we hold a consultation on joint hypermobility syndrome at the end, we want to achieve three goals:
- First, to explain what joint hypermobility syndrome is, both for children and for parents.
- Secondly, to provide an opportunity to speak out about the treatment that patients are already receiving.
- Third, suggest options that can improve your quality of life.
Thanks to such an integrated approach, which has no analogs in Russia and the near abroad, patients get to know themselves better, begin to understand the true causes of chronic pain, and parents save the child from unnecessary, psychologically harmful frequent consultations of various specialists and unjustified treatment.
“We give children the joy of movement” – this is the phrase we meet with our patients at the Turner Institute in Pushkin. Turner on Lakhtinskaya Street in St. Petersburg!
3. Hypermobility spectrum disorder: Treatment
Vertebral hypermobility occurs in people of any age. Without timely treatment, the disease can cause serious complications, for example, neurological disorders. At the clinic of Dr. Length, we practice an integrated approach to therapy, which allows you to achieve complete recovery.
4. Congenital and acquired forms of spinal hypermobility
The spine consists of individual bony vertebrae, between which the intervertebral discs are located. They are strengthened by a complex ligamentous apparatus: two longitudinal and short transverse ligaments. The facet, facet, and uncovertebral joints are located between the vertebrae. So, this whole complex ensures the stability of the spinal column, starting from the birth of the child.
Increased mobility of the vertebrae can be congenital or acquired. In the first case, it is associated with defects in the intrauterine development of these structures, which leads to symptoms of hypermobility. They are detected in a child at the moment when he begins to hold his head upright and sit down. Acquired forms of pathology occur in children and adults. As a rule, they develop against the background of several risk factors that cause hypermobility spectrum disorder.
5. The reasons for the development of violations
The majority of patients have hypermobility of the cervical spine. Moreover, the causes of pathology in children and adults are different. In childhood, the disease occurs with the following factors:
- Malformations of ligaments, tendons, or cartilaginous intervertebral discs.
- Weakness of the back and neck muscles.
- Also, Changes in the natural curves of the spine.
- Premature training of the child in heavy movements – sitting and standing. An unformed musculoskeletal system can lead to hypermobility spectrum disorder.
- Trauma during childbirth.
The main cause of vertebral hypermobility in adulthood is osteochondrosis. Degenerative-dystrophic processes in the intervertebral discs lead to the fact that the vertical axis of the spine deviates, and the tendon-ligamentous apparatus experiences excessive stress. Additional risk factors include a sedentary lifestyle, traumatic injuries of the neck and lower back, chronic myositis, postural curvature, spinal surgery, and other factors. When diagnosing disease, it is important to identify all risk factors. So, this is necessary for the appointment of effective therapy and the prevention of exacerbations.
6. Hypermobility spectrum disorder: Symptoms of pathology
Spinal hypermobility can occur in the cervical and thoracic regions. Both conditions differ from each other in symptomatology.
Changes in the cervical vertebrae
Hypermobility is asymptomatic for a long time. It is important to distinguish it from the normal joint sound that occurs in healthy people. In order to identify a pathological symptom, a person is asked to sit with a straight back on a chair, and then bend the neck forward, reaching with the chin to the sternum. In a healthy person, a click does not occur. With hypermobility spectrum disorder, a characteristic sound is heard, and muscle tension and discomfort are noted in the neck region.
- Dizziness arising from a sharp change in body position, turning the head or neck.
- Headache, accompanied by an increase in muscle tone in the cervical segment.
- Rapid mental fatigue.
- Daytime sleepiness, accompanied by general weakness.
- Changes in blood pressure levels.
- Deterioration of vision and hearing.
- Vestibular disorders.
So, if these symptoms appear, you should immediately seek medical attention. Effective therapy is possible only at the initial stages of the disease. However, even with advanced forms of the disease, the doctor will prescribe a treatment that can improve the patient’s condition.
7. Hypermobility spectrum disorder: lumbar vertebrae
Pathology is often found in people who are intensively involved in sports or heavy physical labor. At the heart of hypermobility spectrum disorders osteochondrosis, which progresses in the absence of therapy. With a heavy and sharp load, sudden body movements, the vertebral body can move in relation to the surrounding tissues. In this case, a person develops severe pain syndrome.
Symptoms for hypermobility in the lumbar spine include:
- Disturbances of sensitivity on the skin of the legs and in the perineum.
- Partial decrease in muscle strength (paresis) or their complete absence (paralysis).
- Dysfunction of the bladder, intestines, and other abdominal organs.
- Also, These symptoms increase gradually, leading to a decrease in the quality of life and disability of a person.
8. Hypermobility spectrum disorder: Complications of the disease
Spinal hypermobility requires early treatment. Without timely therapy, the disease tends to constantly progress and develop complications. So, the main negative consequences of pathology include:
- Radicular syndromes associated with pinching of the roots of the spinal nerves between the bodies of adjacent vertebrae.
- Narrowing of the spinal canal with the development of severe neurological deficit.
- Osteoarthritis in facet, facet, uncovertebral joints with deformities.
- Destruction of the articulation of the iliac bones, sacrum.
- Curvature, degenerative changes in the pelvis.
- Spinal deformities with poor posture.
These conditions lead to a significant decrease in the quality of life, as well as worsen the professional and social adaptation of a person.
How to eliminate hypermobility?
The main goal of treatment is to eliminate the existing symptoms and causes of increased mobility. Treatment is based on osteopathy and manual therapy. However, these are unique techniques that are based on a complex perception of the patient’s body as a whole. During the examination, the osteopath examines the condition of the patient’s musculoskeletal system and detects areas with altered tone. With its normalization, there is a complete disappearance of symptoms. Moreover, In this case, the areas with violations may be located far from the spinal column.
Doctor Length’s clinic uses di-Tazine therapy. This is a unique approach to the elimination of diseases of the osteoarticular system. Di-Tazintherapy includes three methods:
- Manual influence on the musculoskeletal system.
- Photodynamic treatment, which allows to locally improve the blood supply to damaged tissues, accelerates their recovery.
- Medicinal electrophoresis with anti-inflammatory and analgesic agents.
Outside the acute period of the disease, patients have prescribed physiotherapy exercises, massage, and physiotherapy. Also, These methods make it possible to accelerate the rehabilitation of a person, to prevent motor complications in the future.
Why is it worth being treated in the clinic of Doctor Length?
Our doctors have a positive experience in the treatment of spinal hypermobility. It is related to several points:
- An integrated approach to the patient’s disease and health.
- Individual prescription of treatment.
- You can make an appointment with our doctors by phone and using an application on our website.