The DOI matches its Crossref record; 52 of the 53 references it cites were found in a registry or an index.
Joint Hypermobility Syndrome: Recognizing a Commonly Overlooked Cause of Chronic Pain
Abstract
Joint hypermobility syndrome, also known as benign hypermobility syndrome, is a connective tissue disease characterized by joint instability, chronic pain, and minor skin changes. It shares many clinical features of Ehlers-Danlos syndrome, Hypermobility Type; enough so that many authorities consider them as one disease process. Approximately 3% of the general population is believed to have joint hypermobility syndrome, but despite this high prevalence, due to lack of awareness, heterogeneity of clinical presentation, and reliance on physical examination for diagnosis, it is largely overlooked by primary care physicians as well as by specialists. This leads to delayed or missed opportunities for diagnosis, and inappropriate interventions that frustrate both providers and patients. We review the literature regarding the pathophysiology, diagnosis, treatment options, and prognosis of joint hypermobility syndrome, and advocate for primary care physicians to consider it in the differential diagnosis of patients with chronic pain.
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In the citing paper
“Common musculoskeletal pain in both HSD and hEDS can lead to disability, driven by pain-related fear and anxiety.9,12”
From Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review (2025) · cites this paper as [12]
In the citing paper
“Previously described in BJHS, higher rates of anxiety and depression may be due to pain-related fear and fear avoidance, but studies are scarce to clarify this relationship.[8,35,36]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Cross-sectional studies suggest that chronic trauma reduces the pain threshold,[8] and hyperalgesia may serve as a compensatory mechanism to minimize joint instability.[34]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“This likely leads to soft tissue injury manifesting as localized joint arthralgias (nociceptive pain) and in some, over time, diffuse musculoskeletal pain (central sensitization).[2,8,24,25]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Extra-articular manifestations are common.”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Prevalence of the BJHS was about 3%-4% of the general population, affecting 3.3% of women and 0.6% of men.[8,13]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Overt synovitis is unusual, but some patients may have small effusions as a consequence of meniscal or cartilaginous irritation.”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Generalized hyperalgesia is common and believed to be mediated by central sensitization.”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Fear of provoking pain and sustaining injury potentially leads to decreased levels of physical activity, hastening deconditioning and exercise intolerance.[8,33]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“Reported sensitivity and specificity for the 5PQ is 84% and 85% respectively.[8,10]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“The lack of clinician familiarity and experience with the disorders, a highly variable clinical presentation, and absence of a confirmatory test, lead to continued under recognition of these disorders.[8]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“With a prevalence approaching 4% of the general populations, underdiagnosis has been common.[8]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [8]
In the citing paper
“The main complaint of individuals with symptomatic GJH is chronic musculoskeletal pain (MSP) that may affect their daily activities, leading to a decreased quality of life (Kumar & Lenert, 2017; Morris et al., 2017; Leone et al., 2009; Hakim, Malfait & Paepe, 2010; Scheper et al., 2013; Chustecka, 2004; Grahame, 2000b; Simonsen et al., 2012; Nikolajsen et al., 2013).”
From Prevalence of generalized joint hypermobility, musculoskeletal injuries, and chronic musculoskeletal pain among American university students (2019) · cites this paper as Kumar & Lenert, 2017
Citations
Cites
(2000) · PubMed · Cited by 738
Dysautonomia in the joint hypermobility syndrome
Gazit, Y., Nahir, A. M., Grahame, R., & Jacob, G. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00235-3 · Cited by 390
(2007) · PubMed · Cited by 356
Hakim, A., & Grahame, R. (2003) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2003.tb10455.x · Cited by 312
Hakim, A., & Grahame, R. (2003) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2003.08.001 · Cited by 289
Hypermobility and the hypermobility syndrome
Simmonds, J. V., & Keer, R. J. (2007) · Manual Therapy · doi:10.1016/j.math.2007.05.001 · Cited by 265
Rombaut, L., Malfait, F., Cools, A., De Paepe, A., & Calders, P. (2010) · Disability and Rehabilitation · doi:10.3109/09638280903514739 · Cited by 236
Quality of Life in Patients With Postural Tachycardia Syndrome
Benrud-Larson, L. M., Dewar, M. S., Sandroni, P., Rummans, T. A., Haythornthwaite, J. A., & Low, P. A. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.6.531 · Cited by 217
Generalized Joint Hypermobility and Risk of Lower Limb Joint Injury During Sport
Pacey, V., Nicholson, L. L., Adams, R. D., Munn, J., & Munns, C. F. (2010) · The American Journal of Sports Medicine · doi:10.1177/0363546510364838 · Cited by 193
zarate, N., farmer, A. D., grahame, R., mohammed, S. D., knowles, C. H., scott, S. M., & aziz, Q. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2009.01421.x · Cited by 178
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Reuter, P. R., & Fichthorn, K. R. (2019) · PeerJ · doi:10.7717/peerj.7625 · Cited by 110
Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children
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Bragée, B., Michos, A., Drum, B., Fahlgren, M., Szulkin, R., & Bertilson, B. C. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00828 · Cited by 63
“Joint hypermobility was overrepresented in our study as 49% of the participants with ME/CFS had a Beighton score >4 compared to 3% in the general population (6).”
BackgroundMethodDiagnosis and Management of Hypermobility Spectrum Disorders in Primary Care
Atwell, K., Michael, W., Dubey, J., James, S., Martonffy, A., Anderson, S., Rudin, N., & Schrager, S. (2021) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2021.04.200374 · Cited by 52
“A more recent UK symptom-based survey estimated prevalence of HSDs in a general population at 3%.(10)”
BackgroundInfluentialKim, S., Choi, C., Kim, S., Lee, S.-K., Lee, W., Kim, T., & Jung, M. (2018) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-018-4881-y · Cited by 49
Physical therapy treatment of hypermobile Ehlers–Danlos syndrome: A systematic review
Reychler, G., Backer, M. D., Piraux, E., Poncin, W., & Caty, G. D. (2021) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.62393 · Cited by 50
Hypermobility spectrum disorders: A review
Carroll, M. B. (2023) · Rheumatology and Immunology Research · doi:10.2478/rir-2023-0010 · Cited by 45
“Previously described in BJHS, higher rates of anxiety and depression may be due to pain-related fear and fear avoidance, but studies are scarce to clarify this relationship.[8,35,36] Even less is understood about the autonomic dysfunction patients may experience potentially due to connective tissue abnormalities.”
BackgroundInfluentialDonaghy, B., Moore, D., & Green, J. (2023) · Child Care in Practice · doi:10.1080/13575279.2022.2149471 · Cited by 43
“JHS characterisation involves symptomatic hypermobility (soft tissue injury, frequent dislocations andmusculoskeletal pain due to joint hyperextensibility) and similar symptoms to EDS (Kumar & Lenert, 2017; Ross & Grahame, 2011).”
BackgroundThe biopsychosocial impact of hypermobility spectrum disorders in adults: a scoping review
Clark, N., Johnson, M., Rangan, A., Kottam, L., & Swainston, K. (2023) · Rheumatology International · doi:10.1007/s00296-023-05298-2 · Cited by 34
Reychler, G., Liistro, G., Pierard, G., Hermanns‐Lê, T., & Manicourt, D. H. (2018) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.61016 · Cited by 31
“Because of lack of awareness, heterogeneity of clinical presentation, and reliance on physical examination for diagnosis, hEDS in patients was often overlooked, misdiagnosed, and mistreated (Grahame, 2013; Kumar & Lenert, 2017).”
BackgroundAngwin, C., Ghali, N., Baker, D., Brady, A. F., Pope, F. M., Vandersteen, A., Wagner, B. E., Ferguson, D. J. P., & van Dijk, F. S. (2019) · British Journal of Dermatology · doi:10.1111/bjd.18165 · Cited by 29
Nikolenko, V. N., Oganesyan, M. V., Vovkogon, A. D., Cao, Y., Churganova, A. A., Золотарева, М. А., Ачкасов, Е. Е., Sankova, M. V., Rizaeva, N. A., & Sinelnikov, M. Y. (2020) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-020-03698-0 · Cited by 26
Maya, T. R., Fettig, V. M., Mehta, L., Gelb, B. D., & Kontorovich, A. (2021) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.62446 · Cited by 30
“Hypermobility disorders are strikingly common but rarely diagnosed (Kumar & Lenert, 2017).”
BackgroundHill, J. R., Eekhoff, J. D., Brophy, R. H., & Lake, S. P. (2020) · Journal of Orthopaedic Research · doi:10.1002/jor.24695 · Cited by 24
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Feldman, E. C. H., Hivick, D. P., Slepian, P. M., Tran, S. T., Chopra, P., & Greenley, R. N. (2020) · Children · doi:10.3390/children7090146 · Cited by 24
“, Malfait classification) and on the presence of arthralgia (though, a “minor” rather than a “major” diagnostic criterion for hEDS) [19,20].”
BackgroundBrittain, M. G., Flanagan, S., Foreman, L., & Teran-Wodzinski, P. C. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2216028 · Cited by 23
“However, the lack of consensus in physical therapy interventions on hypermobility-related conditions challenges clinicians [26].”
BackgroundUpdate in the Treatment of Chronic Pain within Pediatric Patients
Rabin, J. P., Brown, M., & Alexander, S. (2017) · Current problems in pediatric and adolescent health care · doi:10.1016/j.cppeds.2017.06.006 · Cited by 23
Sacroiliac Joint Hypermobility Biomechanics and What it Means for Health Care Providers and Patients
Enix, D. E., & Mayer, J. M. (2019) · PM&R · doi:10.1002/pmrj.12176 · Cited by 22
Teran-Wodzinski, P. C., & Kumar, A. (2023) · Rheumatology International · doi:10.1007/s00296-023-05378-3 · Cited by 22
Ali, A. A., Andrzejowski, P., Kanakaris, N. K., & Giannoudis, P. V. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9123992 · Cited by 21
“Theories have suggested that altered biomechanical loading and kinematics secondary to JH and instability can overload and injure joints, as repetitive microtrauma to its supporting structures can cause soft tissue injuries and arthralgias [59].”
BackgroundHypermobile Disorders and Their Effects on the Hip Joint
Clapp, I. M., Paul, K. M., Beck, E. C., & Nho, S. J. (2021) · Frontiers in Surgery · doi:10.3389/fsurg.2021.596971 · Cited by 18
“In order to meet the diagnosis, patients must meet the criteria listed in Table 2 (29, 46).”
BackgroundCsecs, J. L. L., Dowell, N. G., Savage, G. K., Iodice, V., Mathias, C. J., Critchley, H., & Eccles, J. (2021) · American Journal of Medical Genetics Part C Seminars in Medical Genetics · doi:10.1002/ajmg.c.31957 · Cited by 18
“…& Aziz, 2017), bladder dysfunction (De Wandele et al., 2014), hyperhidrosis (excessive sweating indicating sudomotor dysregulation) (Castori, 2012; De Wandele et al., 2014) and secretomotor symptoms (including dry mouth or dry eyes) (Kumar & Lenert, 2017; Wang, Fealey, Gehrking, & Low, 2008).”
BackgroundKulesa-Mrowiecka, M., Piech, J., & Gaździk, T. S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173808 · Cited by 21
“However, over time, due to lack of or incorrectly performed activities, overloads of locomotive organ structures may occur, which are manifested in the spine, peripheral joints and muscle pain [11].”
BackgroundJoint Hypermobility among Female Patients Presenting with Chronic Myofascial Pelvic Pain
Hastings, J., Forster, J. E., & Witzeman, K. A. (2019) · PM&R · doi:10.1002/pmrj.12131 · Cited by 16
“2% of women with chronic myofascial pelvic pain is higher than current estimates of approximately 3% to 20% for JHS in the general population.(23) In our patient population, the presence of G-HSDwas associatedwith a higher likelihood of comorbid dyspareunia, low back pain, hip pain, SUI, and IBS, but not provoked vest…”
BackgroundAn acquired or heritable connective tissue disorder? A review of hypermobile Ehlers Danlos Syndrome
Martin, A. (2019) · European Journal of Medical Genetics · doi:10.1016/j.ejmg.2019.103672 · Cited by 19
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Wang, Z., Wilson, C. M., Ge, Y., Nemes, J., LaValle, C. R., Boutté, A. M., Carr, W. S., Kamimori, G. H., & Haghighi, F. G. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.01010 · Cited by 17
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Mills, D. S., Coutts, F. M., & McPeake, K. J. (2023) · Veterinary Clinics of North America Small Animal Practice · doi:10.1016/j.cvsm.2023.08.007 · Cited by 14
Ribeiro, J. A. D. S., Gomes, G., Aldred, A., Desuó, I. C., & Giacomini, L. A. (2024) · The Yale Journal of Biology and Medicine · doi:10.59249/wgrs1619 · Cited by 17
“Additional - ly, questionnaires contribute to standardizing the diagno - sis of hypermobile joints, a key point for the diagnostic hypothesis [85].”
BackgroundFragkos, K. C., Keetarut, K., Cox, A., Eady, J., Emmanuel, A. V., & Zarate-Lopez, N. (2019) · Gastroenterology Research · doi:10.14740/gr1133 · Cited by 11
“JHS is defined as musculoskeletal symptoms in a hypermobile individual in the absence of systemic rheumatological disease, and its prevalence is around 3% of the population [18, 19].”
BackgroundSchöffl, V., von Schroeder, H., Liße, J., El‐Sheikh, Y., Küpper, T., Klinder, A., & Lutter, C. (2023) · The American Journal of Sports Medicine · doi:10.1177/03635465231199671 · Cited by 11
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Akkaya, K. U., Burak, M., Erturan, S., Yıldız, R., Yıldız, A., & Elbasan, B. (2022) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2022.102642 · Cited by 14
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Starling, C. T., Nguyen, Q. D., Butler, I. J., Numan, M. T., & Hebert, A. A. (2021) · International Journal of Women’s Dermatology · doi:10.1016/j.ijwd.2021.03.003 · Cited by 11
Signs and Symptoms in Congenital Myopathies
Gonorazky, H. D., Dowling, J. J., Volpatti, J. R., & Vajsar, J. (2019) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2019.01.002 · Cited by 10
Wang, T. J., Stecco, A., Hakim, A. J., & Schleip, R. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26125587 · Cited by 14
Nikolenko, V. N., Oganesyan, M. V., Vovkogon, A. D., Sankova, M. V., & Rizaeva, N. A. (2019) · Human Sport Medicine · doi:10.14529/hsm190313 · Cited by 9
Eseonu, K., Payne, K., Ward, S. P., Fakouri, B., & Panchmatia, J. R. (2021) · The International Journal of Spine Surgery · doi:10.14444/8067 · Cited by 9
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BackgroundSong, J. Z., Luong, D., Feldman, E. C. H., Tran, S., Perrier, L., Eubanks, K., Bayley, M., Kastner, M., Slepian, M., & Munce, S. E. P. (2023) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-023-02799-y · Cited by 9
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BackgroundDesai, M. J., Brestle, M. D., & Jonely, H. (2024) · Pain Practice · doi:10.1111/papr.13411 · Cited by 8
Maarj, M., Coda, A., Tofts, L., Williams, C., Santos, D., & Pacey, V. (2021) · BMC Pediatrics · doi:10.1186/s12887-021-03009-z · Cited by 10
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“5,6 This may in fl uence the reporting of AEs because women are more likely to report AEs, compared to men, across the bio-medical literature.”
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BackgroundLong COVID and hypermobility spectrum disorders have shared pathophysiology
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Fuster, E., Mirmosayyeb, O., & Blitshteyn, S. (2025) · Rheumatology Advances in Practice · doi:10.1093/rap/rkaf023 · Cited by 5
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BackgroundSankova, M. V., Nikolenko, V. N., Oganesyan, M. V., Vovkogon, A. D., Gadzhiakhmedova, A. N., Zharikova, T. S., & Zharikov, Y. O. (2023) · World Journal of Orthopedics · doi:10.5312/wjo.v14.i3.146 · Cited by 7
Yokoe, T., Tajima, T., Yamaguchi, N., Morita, Y., & Chosa, E. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11071759 · Cited by 5
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MethodBebeshko, V., Bruslova, K. M., Volodina, T., Lyashenko, L. O., Tsvetkova, N., Trychlіb, I. V., Chernysh, T. O., Boyarskyi, V. G., Gonchar, L. O., & Kavardakova, N. V. (2019) · Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology · doi:10.33145/2304-8336-2019-24-322-334 · Cited by 4
Chen, H., Zeng, X., Xie, Z., Ma, L., Zhong, G., Li, L., Huang, W., & Zhang, Y. (2022) · Journal of orthopaedic surgery · doi:10.1177/10225536221125951 · Cited by 5
Bornhöft, L., Arvidsson, D., Bergenheim, A., Börjesson, M., Fridolfsson, J., Hellgren, M. I., Nordeman, L., & Larsson, M. E. H. (2024) · BMC Public Health · doi:10.1186/s12889-024-18017-8 · Cited by 4
Kozyra, M., Kostyun, R. O., & Strecker, S. E. (2024) · Medicine · doi:10.1097/md.0000000000039212 · Cited by 6
“In addition, variables related to each patient’s demo-graphics (sex [male, female], age [10–14, 15–19, 20–24 years of age], region of the country (Northeast, South, Midwest, West), and insurance status (Cash, Commercial, Government, Medicaid, or Medicare) were collected.”
BackgroundRiley, S. P., Grimes, J. K., Calandra, K., Foster, K., Peet, M., & Walsh, M. T. (2020) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2020.07.008 · Cited by 4
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“EDS shares many of the clinical features of joint hypermobility syndrome and is considered by some as one disease process [21].”
BackgroundClark, N., Johnson, M., Rangan, A., Swainston, K., & Kottam, L. (2024) · Systematic Reviews · doi:10.1186/s13643-024-02452-0 · Cited by 5
“Conditions associated with joint hypermobility include hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndrome (EDS) [3, 4], with prevalence varying from 0.2% in Wales [5] to 3% in the UK [6].”
BackgroundInfluentialAlexander, M. (2022) · doi:10.1101/2022.04.25.22274226 · Cited by 4
“Failure to recognise GJH leads to poor patient outcomes (Kumar and Lenert, 2017).”
BackgroundJoint hypermobility determined by the Beighton score in university students
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Sankova, M. V., & Nikolenko, V. N. (2022) · Russian Journal of Pain · doi:10.17116/pain20222001127 · Cited by 3
The association between keratoconus and systemic manifestations of connective tissue hyperlaxity
Safir, M., Satanovsky, A., Hecht, I., Heller, D. E., Lifshitz, A. E., & Pras, E. (2023) · Contact Lens and Anterior Eye · doi:10.1016/j.clae.2023.101892 · Cited by 3
Boucher, L., Nestler, B., Groepper, D., Quillin, J. M., Deyle, D. R., & Halverson, C. M. E. (2025) · Genetics in Medicine Open · doi:10.1016/j.gimo.2024.101960 · Cited by 4
“13 There is signi fi cant symptom overlap between the different subtypes of EDS.”
Bashaireh, K. M., Yabroudi, M. A., Nawasreh, Z. H., Al-Zyoud, S. M., Bashir, N. B., Aleshawi, A. J., & Allouh, M. Z. (2020) · The Knee · doi:10.1016/j.knee.2020.05.003 · Cited by 3
Prevalence of hypermobility in primary school children: a Saudi experience
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Cohen, A., Sela, M. C., Ran, L. Z., Rushinek, H., Talisman, S., & Casap, N. (2023) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2023.04.006 · Cited by 3
Do Plantar Pressure and Loading Patterns Vary with Joint Hypermobility in Young Females?
Torğutalp, Ş. Ş., Babayeva, N., Özkan, Ö., YILMAZ, S., Dönmez, G., & Korkusuz, F. (2020) · Journal of the American Podiatric Medical Association · doi:10.7547/18-146 · Cited by 3
“Musculoskeletal problems related with JH are commonly seen in weight-bearing joints like knees and ankles.(9) JH is an underlying risk factor that leads to lower extremity injuries by influencing postural balance and alignment.”
BackgroundSchwartzkopf-Phifer, K., Leach, S., Whetstone, K., Brown, K., & Matsel, K. (2021) · International Journal of Sports Physical Therapy · doi:10.26603/001c.28055 · Cited by 4
Hand Joint Hypermobility among Dental Students—A Cross-Sectional Study
Sangalli, L., Alabsy, M., Lingle, D., Khazaal, N., West-Pelak, E., & Mitchell, J. C. (2023) · Applied Sciences · doi:10.3390/app13127158 · Cited by 2
“This corroborated the findings of other investigations that have revealed strength and pro-prioception deficits in patients with hypermobility [15,42,43].”
ResultChen, K., Yang, Y., Zhu, D., Zhu, Y. M., Lyu, F., Jiang, J., Xia, X., & Zheng, C. (2023) · Muscle & Nerve · doi:10.1002/mus.27959 · Cited by 2
Moy, L. N., Lenert, A., & Lenert, P. S. (2025) · Biomedicines · doi:10.3390/biomedicines13092134 · Cited by 2
“Previous studies have identified JHS/hEDS as a cause of chronic pain, and given extensive clinical similarities, JHS/hEDS may even be classifiable as part of the fibromyalgia spectrum [5,6,8].”
Self-citationLarsen, K., & Chien, G. C. C. (2019) · Anaesthesia Pain & Intensive Care · doi:10.35975/apic.v23i2.1055 · Cited by 2
Jeong, H., Tarima, S. S., Nguyen, A., Qashqai, A., Muriello, M. J., Basel, D., & Slavens, B. A. (2024) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2024.112151 · Cited by 2
Aukštuolytė-Bačienė, E., Daunoravičienė, A., Tamulionytė, V., Berškienė, K., Narbutaitė, J., Razón, S., & Slapšinskaitė, A. (2024) · Healthcare · doi:10.3390/healthcare12111065 · Cited by 2
“In recent years, GJH and joint hypermobility syndrome (JHS) have started to gain attention as potential sources of pain and injury among college students [4,7].”
BackgroundHershkovich, O., Gordon, B., Derazne, E., Tzur, D., Afek, A. B., & Lotan, R. (2024) · JAAOS Global Research and Reviews · doi:10.5435/jaaosglobal-d-24-00047 · Cited by 2
Braun, J. (2025) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-024-01603-x · Cited by 2
Reuter, P. R., & Brady, M. (2023) · Journal of Orthopedics and Orthopedic Surgery · doi:10.29245/2767-5130/2023/3.1185 · Cited by 1
The Relationship Between Beighton Score and Walking Age in Children
Kurniawati, L., Wardhani, I. L., Rochmah, N., & Sulistiawati, S. (2021) · Journal Of The Indonesian Medical Association · doi:10.47830/jinma-vol.71.1-2021-355 · Cited by 3
The Effect of Hypermobility on Pain and Quality of Life in Young Adults
Karaman, Ç. A., ZEREN, E., MARAL, F., Parlak, M., Kirazlı, Ö., BORACI, H., Zeren, M., & Arifoğlu, Y. (2022) · Bezmialem Science · doi:10.14235/bas.galenos.2022.55707 · Cited by 2
“Musculoskeletal pains are observed more frequently in weightbearing joints, such as knees and ankles due to biomechanical loading, impaired proprioception, decreased muscle strength and endurance (40,41).”
BackgroundKepenek-Varol, B., Şırayder, U., SANDAL, M., & Tuncer, D. (2023) · Journal of Health Sciences and Medicine · doi:10.32322/jhsm.1221090 · Cited by 2
Hope for Hypermobility: Part 2—An Integrative Approach to Treating Symptomatic Joint Hypermobility
Daylor, V., Gensemer, C., Norris, R. A., & Bluestein, L. S. (2023) · Topics in Pain Management · doi:10.1097/01.tpm.0000933968.28098.59 · Cited by 2
Drabik, M., Byś, A., & Gawda, P. (2020) · Medycyna Ogólna i Nauki o Zdrowiu · doi:10.26444/monz/122300 · Cited by 2
Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review
van Die-de Vries, J. E., Rameckers, E., Calders, P., Engelbert, R. H., Ramaekers, S. P., Goossens, M. E., & Verbunt, J. A. (2025) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2025.100467 · Cited by 1
“9,12 16-18 Misinterpreted pain signals can lead to fear and avoidance of activities that might worsen pain.”
Lipari, M. L., & Laxson, S. E. (2023) · Cureus · doi:10.7759/cureus.42397 · Cited by 1
Stickler syndrome: associated musculoskeletal manifestations and first population-based incidence
Rehm, A., Newton, A. C., Ashby, E., Novak, P. L., Thahir, A., Clegg, R., Butt, J., Hatzantoni, K., Ngu, A. W. T., Kobezda, T., et al. (2025) · Journal of Pediatric Orthopaedics B · doi:10.1097/bpb.0000000000001180 · Cited by 1
“The studies by Stickler et al. [2] [35].”
Gilbert, C., Bennett, K. M., Bush, A., & Brown, C. A. (2025) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-025-03607-5 · Cited by 1
“For those affected with chILD, hypermobility may be related to developmental processes because of complex care needs or connective tissue disorders [13, 20].”
Moon, J.-Y., Inhestern, L., Landskron, N., Barvencik, F., Amling, M., & Oheim, R. (2025) · JBMR Plus · doi:10.1093/jbmrpl/ziaf076 · Cited by 1
“40 Women generally report higher pain prevalence and worse QoL in most subdomains than men, consistent with previous studies, 41 which makes them an important target group for appropriate interventions.”
Hyperlaxity in Hand Surgery: A Cross-sectional Survey
Jain, N. S., Taylor, J. M., Chevalier, J. M., Liu, T. P., & Azari, K. K. (2025) · Hand · doi:10.1177/15589447251340081 · Cited by 1
Evaluation of Postural Habits and Awareness in Young Adults with Generalized Joint Hypermobility
Yıldız, R., & Yıldız, A. (2025) · Ergoterapi ve Rehabilitasyon Dergisi · doi:10.30720/ered.1543835 · Cited by 1
Orabi, Z. A., Thompson, S., van Vliet, J., Gee, K., Roy, A., & Townend, J. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14207373 · Cited by 1
“Why this common problem affecting around 3% of the population and up to 26% of adolescents is so poorly appreciated and understood remains unclear [4,5].”
Gender Differences of the ACL Insertion Sites
Malanin, D. A., Volodin, I. V., Алексеевич, С. И., & Demeshchenko, M. V. (2020) · Traumatology and Orthopedics of Russia · doi:10.21823/2311-2905-2020-26-4-80-92 · Cited by 1
Kimmick, G. G., Pienknagura, R. A., & Weinmann, S. C. (2021) · Springer eBooks · doi:10.1007/978-3-030-75377-1_6 · Cited by 1
Aranda-Sánchez, M., Huaco, M. D., & Bravo-Cucci, S. D. (2023) · Medwave · doi:10.5867/medwave.2023.01.2575 · Cited by 1
Centrally mediated abdominal pain syndrome: Causes and treatments
Gajendran, M., McCallum, R. W., & Harris, L. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-13911-6.00022-0 · Cited by 1
Kapitán, M., Pilbauerová, N., Macháč, S., Hodačová, L., Čermáková, E., & Schmidt, J. (2024) · European Journal Of Dental Education · doi:10.1111/eje.13026 · Cited by 1
Myopia and systemic manifestation of tissue hyperlaxity: A population‐based cross‐sectional study
Hecht, I., Nitzan, I., & Safir, M. (2024) · Clinical and Experimental Ophthalmology · doi:10.1111/ceo.14450 · Cited by 1
“18,30 Surgical repair of inguinal hernias stands out as the most frequently performed procedure in paediatric patients, exhibiting an overall occurrence ranging from 0.8% to 4.4%.”
InfluentialBarbosa, C., Gavinha, S., Soares, T., Reis, T., & Manso, M. C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm14010044 · Cited by 1
“Chronic musculoskeletal pain is one of the most challenging complications associated with GJH [27,28].”
Metadata
- Authors
- Kumar, B., & Lenert, P.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Kumar, Bharat
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2017-06
- Volume
- 130
- Issue
- 6
- Pages
- 640-647
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2593628444
- Cited by
- 153
- References
- 53
- Citations by year
- 2026: 9 · 2025: 22 · 2024: 21 · 2023: 29 · 2022: 12 · 2021: 18 · 2020: 19 · 2019: 15 · 2018: 7 · 2017: 1
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- joint hypermobility syndrome, Ehlers-Danlos syndrome, chronic pain, connective tissue diseases, joint instability, skin changes, differential diagnosis, primary care, delayed diagnosis, pathophysiology, treatment, prognosis
- MeSH terms
- Ehlers-Danlos Syndrome, Fatigue, Headache, Humans, Mitral Valve Prolapse, Abdominal Pain, Prevalence, Pelvic Pain, Primary Dysautonomias, Chronic Pain, Musculoskeletal Pain
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