Hypermobility and musculoskeletal pain in children: a systematic review
Abstract
OBJECTIVE: To examine the evidence of an association between hypermobility and musculoskeletal pain in children. METHODS: A systematic review of the literature was performed using the databases PubMed, EMBASE, NHS Evidence, and Medline. Inclusion criteria were observational studies investigating hypermobility and musculoskeletal pain in children. Exclusion criteria were studies conducted on specialist groups (i.e. dancers) or hospital referrals. Pooled odds ratios (ORs) were calculated using random effects models and heterogeneity was tested using χ(2)-tests. Study quality was assessed using the Newcastle-Ottawa Scale for case-control studies. RESULTS: Of the 80 studies identified, 15 met the inclusion criteria and were included in the review. Of these, 13 were included in the statistical analyses. Analysing the data showed that the heterogeneity was too high to allow for interpretation of the meta-analysis (I(2) = 72%). Heterogeneity was much lower when the studies were divided into European (I(2) = 8%) and Afro-Asian subgroups (I(2) = 65%). Sensitivity analysis based on data from studies reporting from European and Afro-Asian regions showed no association in the European studies [OR 1.00, 95% confidence interval (CI) 0.79-1.26] but a marked relationship between hypermobility and joint pain in the Afro-Asian group (OR 2.01, 95% CI 1.45-2.77). Meta-regression showed a highly significant difference between subgroups in both meta-analyses (p < 0.001). CONCLUSION: There seems to be no association between hypermobility and joint pain in Europeans. There does seem to be an association in Afro-Asians; however, there was a high heterogeneity. It is unclear whether this is due to differences in ethnicity, nourishment, climate or study design.
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A systematic review of GJH and MSP in children did not show an association in Caucasian populations and only a potential association in African and Asian populations.
“Yet, a systematic review of GJH and MSP in children did not show an association in Caucasian populations and only a potential association in African and Asian populations (McCluskey et al., 2012).”
From Prevalence of generalized joint hypermobility, musculoskeletal injuries, and chronic musculoskeletal pain among American university students (2019) · cites this paper as McCluskey et al., 2012
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- Authors
- McCluskey, G., O'Kane, E., Hann, D., Weekes, J., & Rooney, M.
- Affiliations
- Queen's University Belfast (GB)
- Corresponding author
- Rooney, M
- Venue
- Scandinavian Journal of Rheumatology
- Publisher
- Informa UK Limited
- Published
- 2012-05-28
- Volume
- 41
- Issue
- 5
- Pages
- 329-338
- ISSN
- 0300-9742 (ISSN-L)
- 1502-7732
- OpenAlex
- W2061276541
- Cited by
- 28
- References
- 42
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- joint hypermobility, musculoskeletal pain, children, joint pain, ethnicity, regional variation, hypermobility spectrum disorders, pediatric rheumatology
- MeSH terms
- Child, Humans, Joint Instability, Musculoskeletal Pain
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