The Hypermobility Spectrum
Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are a continuum of conditions characterised by joint hypermobility (excessive range of movement), pain, and systemic symptoms. They are more common than previously recognised and are thought to affect 1 in 500 people, though many remain undiagnosed. The conditions predominantly affect women and often run in families.
Ehlers-Danlos Syndrome (hEDS)
hEDS is the most common type of Ehlers-Danlos syndrome, a group of inherited connective tissue disorders. In hEDS, the connective tissue that gives joints their structure is more elastic than normal, leading to widespread hypermobility, joint instability, and a range of systemic features. Diagnosis requires meeting specific clinical criteria including evidence of generalised hypermobility, symptoms of joint instability and pain, and systemic features.
Associated Conditions
HSD and hEDS are frequently associated with:
- Postural tachycardia syndrome (POTS) — dizziness and rapid heart rate on standing
- Mast cell activation syndrome (MCAS) — allergic-type reactions
- Irritable bowel syndrome (IBS) and gut dysmotility
- Anxiety and depression
- Fatigue — often severe
- Chronic pain
Management
There is no cure but symptoms can be managed effectively. Key approaches include physiotherapy (the most important treatment), pain management, cardiovascular support for POTS, pacing strategies for fatigue, occupational therapy, and psychological support. Referral to a specialist centre with experience in hypermobility disorders is beneficial for complex cases.