Hypermobility Spectrum Disorders (HSD)

Hypermobility spectrum disorders (HSD) are connective tissue disorders that cause joint hypermobility, instability, injury, and pain. Other problems such as fatigue, headaches, gastrointestinal issues, and autonomic dysfunction are often seen as part of HSD.

Joint hypermobility means that a person’s joints have a greater range of motion than is expected or normal. Joint hypermobility alone is not always a problem – about 20% of adults have joint hypermobility.
The problem occurs when hypermobile joints are unstable or place too much strain on other parts of the body. Joint instability occurs when the bones of a joint aren’t held in place securely. This can lead to joint subluxations, dislocations, sprains, and other injuries.

There are four types of HSD based on the type of joint hypermobility present:

  • Generalized HSD (G-HSD): HSD in which joint hypermobility occurs throughout the body
  • Peripheral HSD (P-HSD): HSD in which joint hypermobility is limited to the hands and feet
  • Localized HSD (L-HSD): HSD in which joint hypermobility occurs in a single joint or group of joints in the same area
  • Historical HSD (H-HSD): HSD in which there is history of generalized joint hypermobility, but without current evidence of generalized joint hypermobility on exam

The four types of hypermobility spectrum disorder are often collectively referred to as HSD.

We do not currently know the true prevalence of HSD. It is believed to be a common condition, but, unfortunately, HSD is often missed and not diagnosed.

The cause(s) of HSD have not been identified. Currently, we do not know if HSD is a genetic disorder. We do know that joint hypermobility tends to run in families, but not everyone with joint hypermobility has a type of HSD. More research is needed to better understand the cause(s) of HSD.

Joint hypermobility is seen in all types of HSD and may be associated with:

  • Joint instability
  • Injuries
  • Pain

HSD is diagnosed by medical history and physical examination. In the process, doctors must find that joint hypermobility is causing problems and must rule out other conditions that can cause the same symptoms. HSD is diagnosed when a person has symptomatic joint hypermobility that cannot be explained by other conditions.

HSD is managed by addressing the symptoms a person is experiencing. HSD can cause a variety of symptoms in many different areas of the body, so people with HSD may require multiple providers in different specialties to manage their care. Key aspects of care include physical therapy and pain management. Everyone with HSD is different, so each person should work with their care team to develop a care plan that meets their individual needs.

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