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Hypermobility Syndrome

Posted by wendyn on 12/14/00 at 23:17 (034982)

Last night when I did a search on costochondritis I found something related on HMS (hypermobility syndrome). I printed it out and it didn't print well, and I'm not even sure of the link (I will search for it on the weekend) but I thought some of you may find this interesting. I've been told I have too much mobility in parts of my feet and lower back - and I'm wondering if there could be some big connection.

Highlights from this article - or what I printed of it..

Been given relatively little attention in literature - because diagnositc criteria are often not well defined. Patients with HMS lack lab findings that could identifiy it unlike many other rheumatologic or orthopedic conditions. Also it lacks a definitive pharmacological surgical treatment, physicians perceive little benefit in diagnoses.

Patients often have complaints that are diffuse, chronic inconsistent with observed pathology. May not get a diagnosis or are misdiagnosed - may lead to unnecessary or inappropriate procedures or management.

Presentation:
Patients may have complaints that have lasted 15 days to 45 years (avg 6.5 yrs) onset at age 3 to 70 yers. Patents go to doctors with a wide range of traumatic or non traumatic complaints. They lack the positive lab findings found in rheumatologic disorders and often the raidologic changes, inflmmation, swelling and decreased mobility typical of orthopedic pathology. Often have poor response to anti-inflamms.

Incrased incidence of nerve compression disorders.

Sorry - kid coming to the computer to finish homework (way too late at night for him - he procrastinates!) I will finish this tomorrow night - a lot of symptoms you may find interesting!

Re: Hypermobility Syndrome

Kim B. on 12/14/00 at 23:25 (034983)

Wendyn, Tell me more, I my knees (and a few other joints) are double-jointed or 'Hypermobile'

Kim B.

Re: Hypermobility Syndrome

Julie F on 12/15/00 at 03:40 (034993)

Wendy, I think there could be a connection. People with hypermobile joints (the ones who can do all those hairpin forward bends and make themselves into pretzels with a smile on their face in yoga class) need to be terribly careful NOT to use their full range of movement. The function of ligaments is to allow movement of the joints within a certain, safe range. If the ligaments are too loose (i.e. hypermobility) they allow too much movement, which can lead to all sorts of problems and damage.

Cartilage cushions joints and prevents bone/bone contact, so I think it makes sense to assume that if a joint is moved beyond its 'safe' range, the cartilage can suffer, i.e. become inflamed, i.e. costochondritis. This is speculation on my part, or maybe lateral thinking - I don't _know_. But I would like to know more. Can you lead me to the website you found the information on?

Excess movement due to hypermobility doesn't usually cause pain at the time (this is why hypermobile people need to be so careful) - the problems tend to appear later, often much later in life. Former ballet dancers often end up with severe back problems. In your case, going just a bit too far in shoulder stand could have moved the joints between your ribs and sternum just that bit too far. This is a guess. (As your doctor said, you may not have 'done anything'.)

(NB for pregnant women: the increased secretion of progesterone, which loosens the ligaments of the pelvic floor in preparation for birth, loosens all the other ligaments too, so pregnant women need to be careful not to overstretch - not just during pregnancy, but for at least six months afterwards, to give the ligaments a chance to return to their normal pre-pregnancy state. Once they are overstretched, they never go back.)

Julie

Re: Hypermobility Syndrome

wendyn on 12/15/00 at 08:28 (035013)

All right - increased nerve compression disorders. Excessive numbness and tingling in multiple limbs in about 60% of the patents. Thoracic outlet symptoms...More common in patients with chondromalacia patellae.

Correlation between TMD and HMS.

More likely (69%) to have anxiety disorders may also be due to the perception of joint instability and frequent pain and injury without understandable antecedent.

More prevelent amount females than males. In children with fibromyalgia the prevalance may be as high as 81%.

There is some testing that can be done to determine a degree of mobility to confirm diagnosis. Involves stretching certain body parts past a certain degree.

There was more - that didn't print I will try to find it later....but it's possible that for some of us it could be a possible link. I'm one of thoese people with repetitive injuries in a bunch of joints. I am also one of those pretzel people Julie referred to.

Anyone interested may just want to do some of their own research on the web on this - and see if they come up with anything important.

Re: Hypermobility Syndrome

Dr. Biehler on 12/15/00 at 09:24 (035016)

I would like to mention that a biomechanical exam is used to determine the range of motion that the joints are going through. It is well know that people with hyper mobile joints are much more inclined to have foot problems. It is also been linked to the cause of bunions in teenagers.It also allows the foot to over pronate which can cause excessive strain on the plantar fascia. Dr.B.

Re: Hypermobility Syndrome - info, Wendy

Julie on 12/16/00 at 00:38 (035068)

Wendy, you might have come across this in your searches, but in case you didn't, it seemed to me a neat, complete description of your cc, which I hope is all gone now.

I like the prognosis bit at the end. But it does say to avoid activities that cause trauma or stress to the rib cage, so take care.

COSTOCHONDRITIS

(Tietze's Syndrome)

What is It?
* Painful inflammation (swelling) of the cartilage of the ribs (attaching ribs to sternum).
* Commonly affects the 3rd or 4th ribs.
* Age of onset before 40.
* Both sexes are affected equally.
* May mimic cardiac pain.

Causes
Cause of the inflammation is often unknown.
Signs and Symptoms
1. Pain in the chest wall, usually sharp in nature, especially on pressure.
2. Pain may occur in more than one location and may radiate into the arm.
3. Pain worsens with movement.
4. Tightness in chest.
5. Affected area is sensitive to the touch.

Risk Factors
* Trauma, such as a blow to the chest.
* Unusual physical activity.
* Upper respiratory infection.

Prevention
Avoidance of activities that may strain or cause trauma to the rib cage.

Diagnosis and Treatment

General Measures
* Rest.
* Ice packs applied to the affected area.
* Avoidance of sudden movements that will intensify the pain.

Medication
* Mild pain medications, such as aspirin, acetaminophen or ibuprofen may help relieve discomfort.
* Stronger pain medicines and non-steroidal anti-inflammatories may be prescribed..
* Steroid injections may be prescribed for some patients.

Activity
As tolerated.
Diet
No special diet.

Possible Complications
None likely.

Prognosis
Complete healing. The disorder is benign and the course is usually of a short duration.

Re: Hypermobility Syndrome

Kim B. on 12/14/00 at 23:25 (034983)

Wendyn, Tell me more, I my knees (and a few other joints) are double-jointed or 'Hypermobile'

Kim B.

Re: Hypermobility Syndrome

Julie F on 12/15/00 at 03:40 (034993)

Wendy, I think there could be a connection. People with hypermobile joints (the ones who can do all those hairpin forward bends and make themselves into pretzels with a smile on their face in yoga class) need to be terribly careful NOT to use their full range of movement. The function of ligaments is to allow movement of the joints within a certain, safe range. If the ligaments are too loose (i.e. hypermobility) they allow too much movement, which can lead to all sorts of problems and damage.

Cartilage cushions joints and prevents bone/bone contact, so I think it makes sense to assume that if a joint is moved beyond its 'safe' range, the cartilage can suffer, i.e. become inflamed, i.e. costochondritis. This is speculation on my part, or maybe lateral thinking - I don't _know_. But I would like to know more. Can you lead me to the website you found the information on?

Excess movement due to hypermobility doesn't usually cause pain at the time (this is why hypermobile people need to be so careful) - the problems tend to appear later, often much later in life. Former ballet dancers often end up with severe back problems. In your case, going just a bit too far in shoulder stand could have moved the joints between your ribs and sternum just that bit too far. This is a guess. (As your doctor said, you may not have 'done anything'.)

(NB for pregnant women: the increased secretion of progesterone, which loosens the ligaments of the pelvic floor in preparation for birth, loosens all the other ligaments too, so pregnant women need to be careful not to overstretch - not just during pregnancy, but for at least six months afterwards, to give the ligaments a chance to return to their normal pre-pregnancy state. Once they are overstretched, they never go back.)

Julie

Re: Hypermobility Syndrome

wendyn on 12/15/00 at 08:28 (035013)

All right - increased nerve compression disorders. Excessive numbness and tingling in multiple limbs in about 60% of the patents. Thoracic outlet symptoms...More common in patients with chondromalacia patellae.

Correlation between TMD and HMS.

More likely (69%) to have anxiety disorders may also be due to the perception of joint instability and frequent pain and injury without understandable antecedent.

More prevelent amount females than males. In children with fibromyalgia the prevalance may be as high as 81%.

There is some testing that can be done to determine a degree of mobility to confirm diagnosis. Involves stretching certain body parts past a certain degree.

There was more - that didn't print I will try to find it later....but it's possible that for some of us it could be a possible link. I'm one of thoese people with repetitive injuries in a bunch of joints. I am also one of those pretzel people Julie referred to.

Anyone interested may just want to do some of their own research on the web on this - and see if they come up with anything important.

Re: Hypermobility Syndrome

Dr. Biehler on 12/15/00 at 09:24 (035016)

I would like to mention that a biomechanical exam is used to determine the range of motion that the joints are going through. It is well know that people with hyper mobile joints are much more inclined to have foot problems. It is also been linked to the cause of bunions in teenagers.It also allows the foot to over pronate which can cause excessive strain on the plantar fascia. Dr.B.

Re: Hypermobility Syndrome - info, Wendy

Julie on 12/16/00 at 00:38 (035068)

Wendy, you might have come across this in your searches, but in case you didn't, it seemed to me a neat, complete description of your cc, which I hope is all gone now.

I like the prognosis bit at the end. But it does say to avoid activities that cause trauma or stress to the rib cage, so take care.

COSTOCHONDRITIS

(Tietze's Syndrome)

What is It?
* Painful inflammation (swelling) of the cartilage of the ribs (attaching ribs to sternum).
* Commonly affects the 3rd or 4th ribs.
* Age of onset before 40.
* Both sexes are affected equally.
* May mimic cardiac pain.

Causes
Cause of the inflammation is often unknown.
Signs and Symptoms
1. Pain in the chest wall, usually sharp in nature, especially on pressure.
2. Pain may occur in more than one location and may radiate into the arm.
3. Pain worsens with movement.
4. Tightness in chest.
5. Affected area is sensitive to the touch.

Risk Factors
* Trauma, such as a blow to the chest.
* Unusual physical activity.
* Upper respiratory infection.

Prevention
Avoidance of activities that may strain or cause trauma to the rib cage.

Diagnosis and Treatment

General Measures
* Rest.
* Ice packs applied to the affected area.
* Avoidance of sudden movements that will intensify the pain.

Medication
* Mild pain medications, such as aspirin, acetaminophen or ibuprofen may help relieve discomfort.
* Stronger pain medicines and non-steroidal anti-inflammatories may be prescribed..
* Steroid injections may be prescribed for some patients.

Activity
As tolerated.
Diet
No special diet.

Possible Complications
None likely.

Prognosis
Complete healing. The disorder is benign and the course is usually of a short duration.