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
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Dysautonomia in the joint hypermobility syndrome
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1 of the 53 references couldn’t be matched to a known paper.
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Items 101–150 of 150
Tuna, F., Özdemir, H., Kabayel, D. D., & Doğanlar, Z. B. (2018) · The European Research Journal · doi:10.18621/eurj.411056 · Cited by 1
“While management suggestions include considering 25-hydroxyvitamin D (25[OH]D) deficiency, there is no enough data on levels of 25(OH)D in EDS groups as well as GJH [8-11].”
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“…association between pain sensation and GJH is clearly reported in the literature, yet GJH remains commonly overlooked as a cause for chronic pain and GJH is often totally disregarded as a factor within pain sensitivity in dancers and gymnasts because it is seen as an asset (Kumar and Lenert 2017).”
BackgroundOverview of Pediatric Rheumatology
Benham, H., & Wright, T. B. (2020) · Physician Assistant Clinics · doi:10.1016/j.cpha.2020.09.004 · Cited by 1
Rheumatische Syndrome bei verschiedenen nichtrheumatischen Erkrankungen
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Bone, Cartilage, and Soft Tissue Disorders
Moutsopoulos, H. Μ., & Zampeli, E. (2020) · Springer eBooks · doi:10.1007/978-3-030-56670-8_12 · Cited by 1
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ELZAYAT, A., & El-Gamal, A. (2022) · Benha Medical Journal · doi:10.21608/bmfj.2022.123656.1551
Bone, Cartilage, and Soft Tissue Disorders
Moutsopoulos, H. Μ., Zampeli, E., & Vlachoyiannopoulos, P. G. (2018) · Springer eBooks · doi:10.1007/978-3-319-71604-6_12
Uvais, N. A., & Sreeraj, V. S. (2019) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_491_18
“An increased prevalence of psychological disturbances, such as anxiety, depression, agoraphobia, panic disorder, and attention deficit hyperkinetic disorder (ADHD) has been found in patients with BJHS.([1,3]) Here, we describe a young male with BJHS comorbid with bipolar affective disorder (BPAD).”
BackgroundInfluentialIs joint hypermobility related to preterm birth?
Turan, Ö. D., Sabancı, S., Özdemir, E., Atakul, T., & Turan, Y. (2020) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2020.1754393
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The Prevalence of Joint Hypermobility among High School and University Students
Kashif, M., Albalwi, A. A., Fatima, N., & Fatima, N. (2020) · Physikalische Medizin Rehabilitationsmedizin Kurortmedizin · doi:10.1055/a-1213-7005
“repetitive microtrauma) are also responsible for converting JH into JHS and making it more devastating condition that affect individual lifestyle [1].”
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Ganu, S. S., & Tadge, A. B. (2021) · International Journal of Science and Healthcare Research · doi:10.52403/ijshr.20210708 · Cited by 2
“[17] The vast majority of cases appear not to be linked to any identifiable mutation, although pedigree studies have shown a weak autosomal dominant inheritance pattern with variable penetrance.”
BackgroundA Systematic Approach to the Bleeding Patient
Cunningham, J., & Kessler, C. M. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-46202-0.00002-9 · Cited by 1
Nishanth, S., & Saravanamuttu, U. (2022) · Cureus · doi:10.7759/cureus.26148
“They are susceptible to developing significant musculoskeletal injuries [3].”
BackgroundInfluentialJoint Mobility among Patients with Trochanteric Bursitis in Erbil-Iraq
Aref, S. F., Al-Rawi, Z. S., & Jalal, A. (2022) · Indian Journal of Public Health Research & Development · doi:10.37506/ijphrd.v14i1.18863
Clinical Examination of the Foot and Ankle
Rajopadhye, K. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-815449-6.00013-5
Joint Hypermobility Syndrome: A Narrative Review
de Oliveira, J. L., Nogueira, I. A., Nogueira, C. T., Lopes, S. V. P., Teles, G. S., Rocha, R. S. D. C., Morais, P. I., Carvalho, A. B. C., Pereira, P. H. D. S., & Alencar, D. J. P. (2023) · American Journal of Internal Medicine · doi:10.11648/j.ajim.20231103.12
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BackgroundInfluentialSupporting morphometric determinants as a basis for the physical culture safety
Sankova, M. V., Nikolenko, V. N., & Александрович, Г. Л. (2023) · Morphology · doi:10.17816/morph.472062
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Doski, J. O. (2024) · Kufa Medical Journal · doi:10.36330/kmj.v20i1.14725
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Kasap, Z., & Sarı, B. (2024) · Cerasus journal of medicine. · doi:10.70058/cjm.1536334
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Physician Perspectives Surrounding Hypermobile Ehlers-Danlos Syndrome
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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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