Correlation between Generalized Joint Hypermobility and Chronic Musculoskeletal Pain in College Students

AbstractObjectivesA significant proportion of adolescents with chronic musculoskeletal pain (CMP) experience difficulties in physical functioning, mood and social functioning, contributing to diminished quality of life. Generalized joint hypermobility (GJH) is a risk factor for developing CMP with a striking 35-48% of patients with CMP reporting GJH. In case GJH occurs with one or more musculoskeletal manifestations such as chronic pain, trauma, disturbed proprioception and joint instability, it is referred to as generalized hypermobility spectrum disorder (G-HSD). Similar characteristics have been reported in children and adolescents with the hypermobile Ehlers-Danlos Syndrome (hEDS). In the management of CMP, a biopsychosocial approach is recommended as several studies have confirmed the impact of psychosocial factors in the development and maintenance of CMP. The fear-avoidance model (FAM) is a cognitive-behavioural framework that describes the role of pain-related fear as a determinant of CMP-related disability.ContentPubmed was used to identify existing relevant literature focussing on chronic musculoskeletal pain, generalized joint hypermobility, pain-related fear and disability. Relevant articles were cross-referenced to identify articles possibly missed during the primary screening. In this paper the current state of scientific evidence is presented for each individual component of the FAM in hypermobile adolescents with and without CMP. Based on this overview, the FAM is proposed explaining a possible underlying mechanism in the relations between GJH, pain-related fear and disability.Summary and outlookIt is assumed that GJH seems to make you more vulnerable for injury and experiencing more frequent musculoskeletal pain. But in addition, a vulnerability for heightened pain-related fear is proposed as an underlying mechanism explaining the relationship between GJH and disability. Further scientific confirmation of this applied FAM is warranted to further unravel the underlying mechanism.In explaining disability in individuals with G-HSD/hEDS, it is important to focus on both the physical components related to joint hypermobility, in tandem with the psychological components such as pain-related fear, catastrophizing thoughts and generalized anxiety.

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Are chronic musculoskeletal pain and generalized joint hypermobility disabling contributors to physical functioning?

European Journal of Physical and Rehabilitation Medicine ◽

10.23736/s1973-9087.21.06455-8 ◽

2021 ◽

Vol 57 (5) ◽

Author(s):

Thijs VAN MEULENBROEK ◽

Ivan P. HUIJNEN ◽

Raoul H. ENGELBERT ◽

Jeanine A. VERBUNT

Keyword(s):

Musculoskeletal Pain ◽

Physical Functioning ◽

Joint Hypermobility ◽

Chronic Musculoskeletal Pain ◽

Generalized Joint Hypermobility

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Prevalence of generalized joint hypermobility, musculoskeletal injuries, and chronic musculoskeletal pain among American university students

PeerJ ◽

10.7717/peerj.7625 ◽

2019 ◽

Vol 7 ◽

pp. e7625 ◽

Cited By ~ 8

Author(s):

Peter R. Reuter ◽

Kaylee R. Fichthorn

Keyword(s):

Chronic Pain ◽

Musculoskeletal Pain ◽

Gulf Coast ◽

Joint Hypermobility ◽

Musculoskeletal Injuries ◽

Chronic Musculoskeletal Pain ◽

Beighton Score ◽

Aged Population ◽

Generalized Joint Hypermobility ◽

Florida Gulf Coast

The objective of this study was to investigate the prevalence of generalized joint hypermobility (GJH) in a university-aged population, whether young adults (aged 18–25 years) with GJH are prone to sustain more musculoskeletal injuries, and are more likely to suffer from chronic musculoskeletal pain. The study used an interactive survey to gather data; GJH was assessed using a cut-off Beighton score of ≥5 in accordance with the 2017 International Classification of EDS criteria. The analyzed sample consisted of 482 female and 172 male participants from Florida Gulf Coast University (USA). The prevalence of GJH in a university-aged population can be estimated at 12.5%. Women did not have higher rates of GJH than men. However, female participants showed significantly higher rates of hypermobility of the spine as well as the right knee and elbow joints. The Beighton scores did not differ by ethnicity/race. Female participants had a lower rate of self-reported injuries than male participants, although this difference was not significant. There was no difference in the proportion of all participants classified within different categories (0; 1–4; 5–9) of Beighton scores and whether or not they reported having been injured. Male and female participants reported chronic pain of joints and neck or back at the same rates across the Beighton score categories. Female participants, however, reported higher pain intensity for chronic neck and back pain. This study increases knowledge about a correlation between GJH, musculoskeletal injuries, and chronic pain of joints, neck, and back in a university-aged population.

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