Hypermobility Syndromes
Hypermobility refers to joints that move beyond the typical range of motion. This can occur for many reasons, from natural flexibility or training in activities like ballet and gymnastics, to connective tissue conditions such as Ehlers-Danlos Syndrome (EDS) or Hypermobility Spectrum Disorders (HSD). While some people experience hypermobility without symptoms, others may face challenges such as joint pain, instability, frequent sprains or dislocations, and difficulty healing after injuries or surgery. Hypermobility is also often linked to other conditions including dysautonomia (such as POTS), migraines, gastrointestinal problems, and chronic pain syndromes. At Lavender Spectrum Health, we recognize the wide impact hypermobility can have on daily life, and we are committed to providing compassionate, comprehensive care tailored to each individual’s needs.
Hypermobility syndromes can cause a range of symptoms that affect quality of life, daily functioning, and the ability to work. The Ehlers-Danlos Syndromes (EDS) are one group of conditions within the broader category of hypermobility syndromes. This means that all forms of EDS involve joint hypermobility, but not everyone with joint hypermobility has EDS. Some people are flexible because of their body type, physical training, or other connective-tissue conditions not classified as EDS. In other words: EDS is always a hypermobility syndrome, but hypermobility alone does not always mean EDS.
At Lavender Spectrum Health, we can do a hypermobility evaluation using the Beighton Scale. If this evaluation is positive, we can diagnose hypermobility syndrome. If you have hypermobility syndrome, there are many different things we can do to support you. We have limited options for referral for evaluation for hypermobile Ehlers Danlos Syndrome, many of which do not take insurance or have a wait list greater than one year.
Chronic Pain Treatment
We understand that hypermobility syndromes cause chronic pain due to repeated joint injury from normal everyday activities. Our providers will work with you to explore treatments for your pain including:
Referring you to physical therapists specialized in hypermobility syndrome
Discussing options for joint braces and ordering these if appropriate
Discussing options for mobility equipment and referring you for evaluation for a wheelchair, electric wheelchair, or other mobility aids
Discussing other accommodations such as disabled parking placard
Prescribing non-opioid medications for chronic pain if appropriate for you and safe
Work Accommodations & FMLA
We understand these symptoms may impact your ability to work. We are happy to discuss options to make your life more supportive including FMLA/intermittent leave, disability accommodations, and other supports and complete paperwork on a case by case basis after reviewing all the information including your job description. Please see our disability policy for more specifics.
Screening for Common Comorbidities
Many conditions occur commonly with hypermobility syndromes. We can help identify conditions that may be impacting you. While we cannot diagnose all of these, we can help with referrals where appropriate.
Care Coordination
We know the other people on your team may not understand how hypermobility affects your other conditions. We are happy to discuss treatment options your other specialists recommend to determine if there are any complications or contraindications your other healthcare team members may not be aware of. We have also made a handout below to give to providers to help them understand the impact of hypermobility on other conditions.
Handout on Hypermobility for Providers & Patient Advocacy
Hello, Provider! I have been diagnosed with hypermobility syndrome. Here are some things you may want to be aware of even if you are not the one treating my connective tissue disorder:
Surgical/ Procedure complications
Orthopedic procedures on soft tissue like tendons, ligaments, muscles, bursa may be less effective than expected, can cause damage even with gentle technique, and problems may be more likely to recur
Skin and soft tissues may not hold stitches well, and scars may stretch or widen over time
Poor wound healing, infection, and scarring are more likely
Steroid injections carry a higher risk of infection, tendon rupture, poor wound healing, and worsening joint instability
Eye surgeries or procedures are more likely to fail or problems to recur
Joint or spinal stabilizing procedures are more likely to fail and problems more likely to recur including recurrent subluxation/dislocation, infection, poor wound healing
Gastrointestinal surgeries are more likely to have poor tissue healing, spontaneous perforation, and bleeding.
Hernia or uterine/rectal prolapse surgeries are more likely to have complications or fail
Medication complications/ side effects
Estrogen can worsen joint hypermobility leading to joint damage, consider alternatives for contraception, treatment for menopause
Fluoroquinolone antibiotics are more likely to cause tendon rupture and other problems
Local anaesthetics may not work at all, may wear off sooner, or I may need more medicine to become numb
Comorbidities
The following comorbidities are more likely in people with hypermobility and EDS, please consider these:
Autism/ADHD
Pelvic organ prolapse
Mast cell activation syndrome
Dysautonomia/ POTS
Migraine
Gastroparesis
Endometriosis
Neuropathy
Fibromyalgia
Craniocervical instability
Chiari malformation
Sleep apnea
Autoimmune connective tissue disorders like lupus, rheumatoid arthritis, ankylosing spondylitis
Thoracic outlet syndrome
References:
The Ehlers-Danlos Syndromes.
Malfait F, Castori M, Francomano CA, et al. Nature Reviews. Disease Primers. 2020;6(1):64. doi:10.1038/s41572-020-0194-9.Ehlers-Danlos syndrome.
National Library of Medicine (MedlinePlus)Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders.
Yew KS, Kamps-Schmitt KA, Borge R. American Family Physician. 2021;103(8):481-492.Hypermobile Ehlers-Danlos Syndrome.
Hakim A GeneReviews® [Internet]. Updated 2024 Feb 22.Extracutaneous Features and Complications of the Ehlers-Danlos Syndromes: A Systematic Review.
Doolan BJ, Lavallee ME, Hausser I, et al. Frontiers in Medicine. 2023;10:1053466. doi:10.3389/fmed.2023.1053466.Recognizing and Effectively Managing Hypermobility-Related Conditions.
Russek LN, Stott P, Simmonds J. Physical Therapy. 2019;99(9):1189-1200. doi:10.1093/ptj/pzz078.Masterclass: Hypermobility and Hypermobility Related Disorders.
Simmonds JV. Musculoskeletal Science & Practice. 2022;57:102465. doi:10.1016/j.msksp.2021.102465.Orthopaedic Manifestations in Hypermobile Ehlers-Danlos Syndrome.
Eichinger JK, Byrd RL, Bailey EP, et al. The Journal of Bone and Joint Surgery. American Volume. 2025;:00004623-990000000-01511. doi:10.2106/JBJS.24.01106.Orthopedic Considerations and Surgical Outcomes in Ehlers-Danlos Syndromes.
Yonko EA, LoTurco HM, Carter EM, Raggio CL. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics. 2021;187(4):458-465. doi:10.1002/ajmg.c.31958.
Hypermobility_ Patient Handout to Providers (2).pdfGeneral Hypermobility Resources
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