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- Were you particularly good at gymnastics or ballet when you were younger due to your suppleness?
- Have you ever had any 'double-joints'?
- Did you have problems with your joints in your teens, way before you were 'supposed to'? (ie. I had a disc prolapse at 16, my sister dislocated her knee twice before 18, my friend had Osgood Schlatter's in her knee at about 14)
- Have you had any joint problems (feet,ankles,knees,hips,back,shoulders,neck,elbows, wrists) which seemed to take forever to heal, or never have?
- Are you unreasonably tired after seeming to do very little?
- Do your joints ache a lot, especially at 'that time of the month'?
- Are you considered 'clumsy' and crash into things/burn yourself/cut yourself more often than seems reasonable?
- Do you twist or 'go over on' your ankle more often than you like?
- Do you suffer Irritable Bowel Syndrome?
Do you have panic attacks, or phobias, or suffer depression or OCD or PTSD?
- Have you ever suffered at the dentist or in hospital because the local anaesthetic seems not to work properly?
- Have you had an unreasonable amount of gynae problems, incl premature labour or haemorraging in labour?
- Do other members of your family suffer from any of the things mentioned above?
If you can answer 'yes' to any of those questions, you should probably read on...! (I'll put the proper diagnostic criteria at the end, as it's rather long!)
Ok, so, what is Hypermobility Syndrome?
Here's what HMSA say
"Connective tissue proteins such as collagen give the body its intrinsic toughness. When they are differently formed, the results are mainly felt in the "moving parts" - the joints, muscles, tendons, ligaments - which are laxer and more fragile than is the case for most people. The result is joint laxity with hypermobility and with it comes vulnerability to the effects of injury. The Hypermobility Syndrome is said to exist when symptoms are produced, a state of affairs that may affect only a minority of hypermobile people."
So, basically, your collagen structure is different, which makes you more stretchy and your joints a bit slack ("double-jointed"). However, you can be this bendy or slack, and NOT suffer any pain or problems, in which case you are 'hypermobile'. If you start to suffer from pain or problems, this is Hypermobility Syndrome.
But, it seems like there's a lot more to it than that. It seems to be possible to have no symptoms at all in the joints, but still to suffer from other problems listed above. At the moment, research is not prolific, and a lot of the links are being made anecdotally, but they seem to happen far too regularly in the already diagnosed HMS sufferer to be coincidental.
The related illnesses/problems already linked with HMS, and backed by research are;
Postural Orthostatic Tachycardia Syndrome (POTS)
Chronic pain/Fybromyalgia
Problems in labour
Local anaesthetic resistance
Longer healing times, and more pronounced scarring of the skin.
Increased tendency to 'Phobic states' incl. PTSD, OCD, Agaraphobia etc.
Repetetive Strain Injury
Early-onset Osteoarthritis
Proprioception & Kinaesthesia disfunction - this is your brain's automatic awareness of where your body is in space especially your extremities like hands and feet. In people with HMS this is often not functioning correctly and can lead to bumps & bangs as well as more serious things like cutting fingers during food prep and burning yourself on the iron/oven.
Anecdotally (or unproven) related illnesses/problems include;
Irritable Bowel Syndrome
PMT
Migraine
Carpal Tunnel Syndrome
Chronic Fatigue Syndrome/ME
Restless legs
This isn't an exhaustive list, but as you can see, there's quite a lot to take in!
If you feel that any of this might apply to you, I would encourage you to go and have a look at The Hypermobility Syndrome Association - Home where you will find loads of information, and a really great forum where the members are happy to answer questions (although they aren't medical people and can only give the benefit of their personal experience) and are generally nice to newbies!
After you've done a bit of research, you should raise the matter with your GP, who should be able to refer you to a suitable clinic/rheumatologist/hypermobility-trained physio in your area. There is no 'cure' for HMS, but an awareness of what is causing your problems often helps you to feel less helpless, and also affects the type of physio you may be given as traditional physio can often make the problem worse.
OFFICIAL DIAGNOSIS CRITERIA
(Pictures can be found at The Hypermobility Syndrome Association - Home)
Beighton Score
Score one point if you can bend and place you hands flat on the floor without bending your knees
Score one point for each elbow that will bend backwards.
Score one point for each knee that will bend backwards.
Score one point for each thumb that will bend downwards to touch the forearm.
Score one point for each hand when you can bend the little finger back beyond 90°.
REVISED DIAGNOSTIC CRITERIA FOR THE BENIGN JOINT HYPERMOBILITY SYNDROME (BJHS)
Major Criteria
· A Beighton score of 4/9 or greater (either currently or historically)
· Arthralgia for longer than 3 months in 4 or more joints
Minor Criteria
· A Beighton score (See above) of 1, 2 or 3/9 (0, 1, 2 or 3 if aged 50+)
· Arthralgia (Pain) (>3 months) in one to three joints, or back pain (>3 months), spondylosis, spondylolysis/spondylolisthesis.
· Dislocation/subluxation in more than one joint, or in one joint on more than one occasion.
· Soft tissue rheumatism. (inflammation of soft-tissue i.e. tendons) >3 lesions (e.g. epicondylitis, tenosynovitis, bursitis).
· Marfanoid habitus (ratio of body to leg length) (tall, slim, span/height ratio >1.03, upper: lower segment ratio less than 0.89, arachnodactily [positive Steinberg/wrist signs].
· Abnormal skin: striae, hyper-extensibility, thin skin, papyraceous scarring.
· Eye signs: drooping eyelids or myopia or antimongoloid slant.
· Varicose veins or hernia or uterine/rectal prolapse.
The BJHS is diagnosed in the presence two major criteria, or one major and two minor criteria, or four minor criteria. Two minor criteria will suffice where there is an unequivocally affected first-degree relative.
