For many with joint hypermobility syndrome (JHS), the condition comes with no negative symptoms; they are simply more flexible than the average person. But for some people, the condition can lead to chronic musculoskeletal pain.
People with JHS may experience muscle, joint and ligament pain. Collagen weakness is believed to be involved in the condition, causing ligaments and joint capsules to be weak. Ligaments may be more susceptible to sprains (tears), and joints may be more susceptible to dislocation. Finally, muscles may be overworked and strained from trying to support the loose joints.
For people with pain related to JHS, pain-killers don’t have a very good track record. That, combined with the risks of prolonged NSAID or opioid medication use, makes it important to find safer, more effective ways to manage pain when it is present.
As with many chronic pain disorders, patients with JHS often experience psychological symptoms as well, such as depression and anxiety. A wealth of research has been done into cognitive behavioral therapy (CBT) and attests to the general reliability of this method for coping with psychological problems connected to chronic pain. Cognitive behavioral therapy is a method of talk therapy in which the patient becomes aware of harmful thought patterns that may be perpetuating both psychological and physical symptoms, then works to replace them with more constructive patterns.
While a lot of research has been done into CBT for chronic pain generally, there was a lack of research into its potential use for patients with hypermobility-related pain. A group of researchers sought to change this, and the results of their study were published in the February, 2014 issue of Clinical Rheumatology.
The researchers note that patients with JHS often feel like they can’t relate to other chronic pain patients in group CBT sessions, which leads some patients with hypermobility to drop out of the program. The researchers designed a CBT program specifically for patients with JHS. They put 87 patients in a 6-week program that combined physical therapy with CBT and measured outcomes for pain, depression, catastrophizing, frustration, physical function, anxiety and self-efficacy at baseline as well as one and five months after the program.
The researchers found notable improvements in all measures at one month post-program. Though results were less significant at five months for all measures, with pain intensity regressing completely to baseline levels, notable improvements over baseline were still present. This may suggest that physical therapy programming should be continued or revisited by patients with JHS, or that a second round of cognitive behavioral therapy may sometimes be in order.
See the study at link.springer.com. (Click the “Look Inside” button to access the first two pages.)
This study was small, and more research is needed to nail down a reliable pain management approach for patients with joint hypermobility syndrome. But the study does suggest that a multidisciplinary approach, incorporating a psychotherapeutic element specifically designed for people with hypermobility, may be a good choice.