Hypermobility Spectrum Disorders
Your doctor has found that you have
hypermobile joints. The ligaments, tendons,
and other structures that support your joints
can stretch more than usual. Most, but not
all, people inherit this characteristic from a
parent. Sometimes people with
hypermobility are referred to as “double-
jointed”. They do not really have extra
joints, just very flexible joints.
Hypermobility may affect many joints. You
may be able to:
ξ Bend your spine forward and
backward more than usual
ξ Bend your fingers or toes backward
or sideways more than usual
ξ Bend your knees or elbows
ξ Move your legs in unusual ways or
easily do “splits”
Not everyone has the same amount, severity,
or location of hypermobile joints. Doctors
classify people with hypermobile joints into
Hypermobility Spectrum Disorders (HSD).
People with HSDs tend to experience joint
pain, joint injuries such as sprains, or
“clumsiness” because of loose ligaments.
The types of HSD include:
ξ Generalized (G-HSD): Many
ξ Peripheral (P-HSD): Hypermobile
at hands and feet, but not elsewhere.
ξ Localized (L-HSD): Hypermobile at
a single joint or group of joints.
ξ Historical (H-HSD): Older people
who are not hypermobile now, but
were when they were younger. They
can still have joint pain and other
(The Ehlers-Danlos Syndromes [EDS] are
a separate set of inherited conditions that
look like G-HSD, but include a number of
other problems. Your doctor will help you
figure out whether you have an HSD or
People with HSDs may experience some of
these other conditions.
ξ Joint “popping” or “cracking”
ξ Flat feet
ξ Frequent ankle sprains
ξ Back pain
ξ Widespread aching pain or
ξ Problems with healing (thin scars) or
ξ Easy bruising
ξ Varicose veins
ξ Low blood pressure, dizziness when
Whether or not you have pain, it is
important to take good care of your body if
you have a HSD. There is no cure for
HSDs, so taking the proper steps now may
reduce your chances of having pain,
arthritis, or other problems later in life.
HSDs sometimes go along with more
serious health conditions. Talk to your
doctor or nurse to make sure these other
problems have been checked for and ruled
out. There may be tests to check your eyes,
blood vessels, and heart to make sure all are
People with HSDs can get help from a good
exercise program and expert advice, most
often from a physical or occupational
therapist. Exercises that increase strength
can help you to support your joints and
reduce extra motion. This may help protect
the joints from harm. Light aerobic exercise
may be helpful in keeping a healthy level of
Most people with HSDs do not need a lot of
stretching, because their joints and muscles
are more flexible than normal. Stretch only
those muscles that are very tight, cramping,
or have been specified by your therapist or
other experts. Good posture is very
important in HSDs, and you will be taught
ways to help you with this.
Braces and Splints
If a hypermobile joint is getting painful or
has arthritis, splints or braces may help to
reduce pain, improve function, and prevent
extra motion. Tools used may include:
ξ Elbow or knee supports to prevent
ξ Arch supports in the shoes to support
flat feet and decrease stress on the
ankles and knees
ξ Ankle supports
ξ Finger joint splints
ξ Spine supports
Your health care provider should guide you
in your choice of splints or braces.
Treating Fatigue and Lightheadedness
Patients with low blood pressure,
lightheadedness when standing up, or fast
heartbeat may feel better if they wear
support stockings, drink plenty of fluids, and
add salt to their diet. Talk to your health
care provider about whether you should try
Most patients with HSDs live productive
and happy lives. Some limits on activity can
help reduce the risk of pain or being injured.
These limits vary from person to person.
Talk to your health care provider to learn
which ones apply to you.
Doing such things as lifting, carrying, or
other motions over and over can cause harm
or pain. They are safer if you maintain good
posture, exercise, use splints or braces where
needed, and take rest breaks where needed.
HSDs may cause an increased risk of back
pain or other problems in the later months of
pregnancy. To prevent this, pregnant
women with HSDs or those who plan to
become pregnant should consult with their
health care providers.
Medicines and Supplements
If medicines for pain are needed, your
doctor can help you find the best choices.
Some people have tried over-the-counter
products to reduce their joint pain.
Glucosamine and chondroitin is not harmful,
but has not been proven to work for HSDs.
Herbal “joint health” products are not
proven and could be harmful. Check with
your doctor before you start to use any over-
Treatments Applied to the Skin
Some people get short-term relief from
ointments, gels or creams, or by putting heat
or ice on painful areas. Your health care
provider can advise you on the best
Areas of muscle “knotting” and pain (trigger
points) can sometimes be helped by special
injections. (For more details, please see
Health Facts for You #5934 “Trigger Point
Injection”). Bursitis or tendon pain may
also be helped by injections. Your doctor
will help you decide whether these are right
As with all chronic pain problems, pain from
HSDs can be treated using relaxation,
meditation, massage, and other non-drug
methods. Talk with your health care
provider to see if any of these are right for
People with HSDs can lead full lives. If you
take good care of your body and follow the
advice of your health care team, you should
be able to manage your JHS well, instead of
letting it manage you.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 3/2017 University of Wisconsin Hospitals
and Clinics Authority. Revised 3/2017. All rights reserved. Produced by the Department of Nursing. HF#6412.