Joint Hypermobility and Fibromyalgiaby Karen Lee Richards Patient Advocate
Fibromyalgia is rarely the only diagnosis a person has. Usually someone with fibromyalgia also has one or more comorbid or overlapping conditions, such as ME/CFS, irritable bowel syndrome, restless legs syndrome, Migraines, allergies, etc. One possible comorbid condition we don't talk about frequently is joint hypermobility syndrome (also called benign hypermobility syndrome).
If you have fibromyalgia, I'd like you to think back to your childhood. Were your joints extremely flexible or were you double jointed? When you straightened your fingers, did they curve backward? Could you bend your thumb to touch your forearm? When you fully extended your legs or arms, did they look like they were bending slightly backward? If you can answer "yesâ� to one or more of these questions, you may have (or have had) joint hypermobility syndrome.
Joint hypermobility is the ability of a joint to move beyond it's normal range of motion. Usually more apparent in childhood, the flexibility tends to decrease with age. Hypermobility is something you're born with. For most people, it's not a big problem and requires no treatment. However, for some, hypermobility can lead to joint pain and may result in sprains, dislocations and osteoarthritis.
The Hypermobility-Fibromyalgia Connection
Although we don't really know why, hypermobility and fibromyalgia seem to occur together more often than would be expected by chance. A 1993 study published in the Annals of the Rheumatic Diseases tested the hypothesis that joint hypermobility may play a part in the pathogenesis of pain in fibromyalgia.
Researchers studied 338 children between the ages of nine and 15. They found that:
13% had joint hypermobility
6% had fibromyalgia
81% of those with fibromyalgia had joint hypermobility
40% of those with joint hypermobility had fibromyalgia
The investigators concluded, "This study suggests that there is a strong association between joint hypermobility and fibromyalgia in schoolchildren. It is possible that joint hypermobility may play a part in the pathogenesis of pain in fibromyalgia. More studies are needed to establish the clinical significance of this observation."
Once in a while, hypermobility may be a symptom of a rarer and more serious disorder called Ehlers-Danlos syndrome. Ehlers-Danlos syndrome (EDS) is a group of inherited disorders that weaken connective tissues. There are six different types of EDS and the seriousness can range from mild to life-threatening.
Symptoms of EDS include:
Fragile, small blood vessels
Abnormal scar formation and wound healing
Soft, velvety, stretchy skin that bruises easily
My Personal Experience...
My fingers have always been double-jointed - something I inherited from my dad. Until a couple of years ago, though, I never connected that with fibromyalgia. Thinking back, I do remember spraining my ankle several times as a child, which may or may not have had anything to do with hypermobility.
Other than my double-jointed fingers, the first time I had a hint that I might be hypermobile was during a doctor visit about 15 years ago. The doctor who finally diagnosed my fibromyalgia was moving my wrists and ankles around and said, "Do you even have any ligaments in there?" At the time, I thought that perhaps the fibromyalgia had caused my ligaments to be weak. Now, however, I suspect it's the other way around; the hypermobility may have made me more susceptible to fibromyalgia.
It's Your Turn...
I'd like to hear about your personal experiences with hypermobility and fibromyalgia. If you have FM, are your joints also hypermobile? If so, has the hypermobility ever caused you pain? What do you think about the possibility that hypermobility could be a risk factor for FM?
Gedalia A, et al. "Joint hypermobility and fibromyalgia in schoolchildren." Ann Rheum Dis. 1993 July; 52(7): 494-496.
Laskowski, Edward R. "Joint hypermobility: What causes 'loose joints'?" Mayo Clinic. August 20, 2011.