Hypermobility, the Ehlers-Danlos syndromes and chronic pain. – PubMed – Clin Exp Rheumatol. 2017 Sep-Oct;
This is yet another scientific paper adding to the evidence of how painful EDS (and other connective tissue disorders) can be.
Chronic widespread pain is a common complaint among individuals affected by generalised joint hypermobility.
In the absence of other conditions that cause chronic pain, these individuals are usually diagnosed with joint hypermobility syndrome (JHS). JHS is a multifactorial trait with a strong genetic basis, but no specific genetic markers.
Clinical overlap of JHS is seen with heritable connective tissue disorders, particularly with the Ehlers-Danlos syndrome, hypermobile type (hEDS).
Clinical experience and a limited number of clinical studies show that chronic pain also is common in EDS patients, especially in hEDS.
The specific underlying causes and mechanisms of pain in JHS and EDS remain poorly understood.
Factors likely contributing to the generation and chronicity of pain include
- nociceptive pain, directly based on structural changes in affected joints, muscle and connective tissue;
- neuropathic pain; impaired proprioception and muscle weakness; and central sensitisation
These mechanisms are not mutually exclusive, and likely more than one mechanism may be present. Furthermore, anxiety, depression, and other variables may influence the phenotype.
Chronic pain in JHS and EDS patients often is inadequately controlled by traditional analgesics and physical therapy.
Sadly, such negligence is now encouraged, praised, and even rewarded by medical “management” forcing a misapplication of the CDC’s guidelines.
In view of the high prevalence of these underrecognised conditions, future studies addressing the nature and mediators of chronic pain are needed in order to potentially identify novel targets for therapeutic intervention and optimise treatment.