Joint hypermobility

Causes of joint hypermobility

Joint hypermobility is often hereditary (runs in families). One of the main causes is thought to be linked to changes in a type of protein called collagen.

Collagen is found throughout the body. For example, its found in:

• skin
• ligaments (the tough bands of connective tissue that link 2 bones together at a joint)

If collagen is more stretchy and lax than it should be then the ligaments, tendons and muscles around the joints allow a greater range of movement. This means they also sometimes cannot keep the joints stable.

There is no genetic test currently available for hEDS or HSD. It’s likely that more than one gene is involved. There are genetic tests for rarer forms of EDS.

More information is available on the Ehlers-Danlos Support UK website.

আপনার শরীরের জোড়াগুলো স্বাভাবিকের চেয়ে বেশি নমনীয় (জয়েন্ট হাইপারমোবিলিটি) কিনা সেই সন্দেহ হলে আপনার চিকিৎসক বা স্বাস্থ্যকর্মী আপনার বেইটন স্কোর দেখে নিতে পারেন। নির্দিষ্ট কয়েকটি জোড়া কতটা দূর পর্যন্ত নড়াচড়া করতে পারে, তা দ্রুত বুঝে নেওয়ার একটি উপায় এটি।

তবে এই স্কোর একা রোগনির্ণয় নিশ্চিত করতে পারে না, কারণ সব জোড়া দেখতে হয় এবং সঙ্গে রোগীর উপসর্গগুলোও বিবেচনায় নিতে হয়। বেইটন স্কোরে সব জোড়া ধরা পড়ে না, যেমন কাঁধ ও কোমরের জোড়া এর বাইরে থেকে যায়।

জোড়ার ব্যথার কারণ হতে পারে এমন অন্য রোগ, যেমন রিউমাটয়েড আর্থ্রাইটিস, বাদ দেওয়ার জন্য আপনার চিকিৎসক রক্ত পরীক্ষা ও এক্স-রে করতেও বলতে পারেন।

বেইটন স্কোর

বেইটন স্কোরে মোট 5টি পরীক্ষা থাকে, আর সেগুলোর ফলাফল মিলিয়ে সর্বোচ্চ 9 পয়েন্ট হয়।

স্কোরটি এভাবে হিসাব করা হয়:

• পা সোজা রেখে দাঁড়িয়ে হাতের তালু মাটিতে সমানভাবে রাখতে পারলে 1 পয়েন্ট
• কোনো কনুই পেছন দিকে বেঁকে গেলে প্রতিটির জন্য 1 পয়েন্ট
• কোনো হাঁটু পেছন দিকে বেঁকে গেলে প্রতিটির জন্য 1 পয়েন্ট
• বুড়ো আঙুল পেছন দিকে বাঁকালে সেটি বাহুর সঙ্গে লেগে গেলে প্রতিটির জন্য 1 পয়েন্ট
• কড়ে আঙুল পেছন দিকে 90 ডিগ্রির বেশি বেঁকে গেলে প্রতিটির জন্য 1 পয়েন্ট

বেইটন স্কোর 4 বা তার বেশি হলে বোঝা যায়, জয়েন্ট হাইপারমোবিলিটি থাকার সম্ভাবনা রয়েছে।

hEDS বা HSD আছে এমন কারও শরীরজুড়ে সংযোগকারী টিস্যুর দুর্বলতার সঙ্গে জড়িত আরও কয়েকটি উপসর্গও দেখা দিতে পারে।

If your joint hypermobility isn't causing any problems, you won't need any treatment for it.

However, treatment and support may be needed if you have hEDS or HSD. These conditions can cause many different symptoms, including joint pain and digestive problems.

Things you can do

There are several things you can try yourself if you're experiencing symptoms. These include:

• eating a healthy diet and keeping to a healthy weight, which can help improve your joint strength and reduce the strain on them
• keeping to a good sleep routine (sleep hygiene)
• staying as active as you can, but sticking to low-impact exercises such as swimming, cycling, pilates or tai chi to reduce strain on your joints
• wearing comfortable, supportive footwear to support your ankles
• using heat or ice, which can be a helpful way to ease pain

Our information on soft tissue injury can help your recovery if you've injured your muscles, tendons, joints or ligaments.

When doing exercises aimed at improving flexibility, such as yoga, take care not to over-stretch hypermobile areas.

Do get in touch with your healthcare professional if you're struggling with any of your symptoms.

Support groups are also available for people with hEDS or HSD, including:

• Hypermobility Syndromes Association
• Ehlers-Danlos Support UK

Physiotherapy and exercise

Physiotherapy can help people with hypermobile joints in several ways. For example, it may help to:

• reduce pain
• improve muscle strength and fitness
• improve posture
• improve your sense of your body's position and movement (proprioception)
• correct the movement of individual joints

It helps to see a physiotherapist who understands hEDS or HSD, since some physiotherapy treatments can actually make symptoms worse.

Many different physiotherapy techniques can be used. You may be advised to follow an exercise programme that includes:

• strength and balance training
• special stretching techniques
• advice about pacing

Pacing means balancing periods of activity with periods of rest, so you avoid overdoing it or pushing yourself past your limits. Pushing too hard can slow your progress in the long run.

Occupational therapy

Occupational therapy aims to help you manage everyday difficulties caused by hEDS or HSD.

This may involve learning alternative ways to carry out certain tasks. For example, an occupational therapist can advise you on:

• reducing the strain on your joints while using a computer
• getting dressed
• adapting your home to make moving around easier, such as when using stairs is difficult

You may also be able to get equipment that makes certain tasks easier. Special grips, for instance, can make holding a pen easier and improve your handwriting.

Podiatry

Flat feet can be an issue for some people with hEDS or HSD. This means there's no arch on the inner part of the foot, which can put strain on nearby muscles and ligaments (the tissue connecting bones at a joint).

A podiatrist (a foot specialist) can help if you're having foot problems. They can recommend footwear for indoor and outdoor use that supports the foot arches and eases pain in the feet, knees, hips and back, along with insoles if needed.

Painkillers

Medication can help manage the pain that comes with hEDS or HSD.

Over-the-counter painkillers such as paracetamol can sometimes help. Your doctor may also prescribe a medicine combining paracetamol with codeine, a stronger painkiller. Liquid paracetamol (such as Calpol) may suit children with hEDS or HSD.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may also help in some cases. Painkillers and NSAIDs are available as gels or sprays too, which can be applied directly to painful joints.

Always read the patient information leaflet that comes with any over-the-counter medicine, to make sure it's suitable for you before taking it.

For some people with hEDS or HSD, pain medication doesn't work well. Some have also found that local anaesthetic has little effect on them. If you're due to have a procedure that needs local anaesthetic, it's worth discussing this with your doctor or dentist beforehand.

Pain management

If painkillers aren't easing your pain enough, you may be referred to a pain specialist at a pain clinic, where staff can offer further advice and treatment.

Some people with hEDS or HSD, for example, benefit from cognitive behavioural therapy (CBT), a pain management approach that can help when painkillers aren't working.

Pain specialists may also prescribe stronger medication for nerve (neuropathic) pain. These should only be continued if they're clearly helping. This kind of long-lasting pain is often called chronic pain.