Joint Hypermobility Syndrome

Overview

Joint hypermobility syndrome is a condition where joints move more than usual and this causes symptoms such as pain, stiffness, tiredness, or repeated injuries. It is sometimes called hypermobility spectrum disorder. Being very flexible is not the same as having the syndrome; the diagnosis is about symptoms, not flexibility alone.

Joint hypermobility is common, especially in children and young people. The syndrome, where flexibility causes symptoms, is less common but is still seen often in general practice.

It can affect anyone. It is more often noticed in children, teenagers, and women, and it often runs in families. People of all ages can have symptoms.

Symptoms

Common symptoms

• Joint pain that comes and goes, often in knees, hips, fingers, shoulders, or back
• Stiffness, especially after rest or in the morning
• Joints that click, clunk, or feel loose
• Tiredness or low energy
• Frequent sprains or soft tissue injuries
• Poor balance or a feeling that joints may give way
• Muscle pain or tenderness
• Symptoms that flare up after activity or when tired

Symptoms in children

• Being very flexible compared with other children
• Frequent falls, trips, or clumsiness
• Trouble with handwriting, sports, or activities that need steady joints
• Tiredness or avoiding physical activity because of pain
• Growing pains or leg pain that comes and goes
• Symptoms may affect school, play, or sleep

Symptoms in older adults

• Joint pain and stiffness that may change over time
• More sprains, strains, or fall-related injuries
• Tiredness or reduced stamina
• Symptoms may overlap with other joint conditions, so assessment is important
• Strength and balance exercises can help reduce injury risk

Causes

Main causes

• Joint hypermobility syndrome is usually linked to variations in the genes that affect connective tissue, the body's supporting tissue.
• It often runs in families.
• It is not caused by poor fitness or by stretching alone, although fitness and activity can affect symptoms.

Risk factors

• A family history of flexible joints or hypermobility
• Being female
• Being a child or teenager, when flexibility is often at its highest
• Low muscle strength or poor balance
• Repetitive strain or frequent injuries
• Other conditions that affect connective tissue

When to see a doctor

See a doctor urgently if:

• A hot, red, swollen joint with fever
• A joint that looks deformed or cannot be moved after an injury
• New numbness, weakness, or coldness in a limb
• Severe pain or swelling that is getting worse quickly
• Repeated dislocations or a joint that gives way often

Book a routine appointment if:

• Joint pain or stiffness that lasts more than a few weeks
• Tiredness or pain that affects school, work, sleep, or daily life
• Frequent sprains, falls, or injuries
• Joint symptoms in a child that affect play or activity
• You are worried about flexibility or a family history of hypermobility

Diagnosis

There is no single test for joint hypermobility syndrome. A GP or specialist asks about your symptoms and medical history, examines your joints and movement, and checks for other conditions. They may use a movement scoring system such as the Beighton score and may refer you to a physiotherapist or rheumatologist.

Tests that may be done

• A physical examination of your joints and movement
• A movement score, such as the Beighton score
• Questions about pain, tiredness, injuries, and family history
• Blood tests to help rule out other causes of joint pain
• X-rays or scans if there has been an injury or if another joint problem is suspected
• Other checks if a different connective tissue condition is suspected

What to expect at your appointment

Your appointment may include questions about your symptoms and a gentle movement exam. Diagnosis can take time because other causes need to be considered. It can help to keep a note of your symptoms, triggers, and questions before your visit.

Treatment

There is no cure for joint hypermobility syndrome, but most people can manage symptoms well. The main aims are to strengthen the muscles around your joints, improve balance and posture, reduce pain, and help you stay active safely.

Self-care at home

• Ask a physiotherapist about gentle strength and balance exercises
• Warm up before activity and build up slowly
• Pace yourself and avoid switching between overactivity and long rest
• Use good posture and supportive footwear
• Try low-impact activity such as walking, swimming, or cycling
• Use heat or cold packs if they help you, wrapped safely
• Keep a symptom diary to spot patterns and triggers
• Ask about aids or equipment if daily tasks are hard

Medical treatments

Treatment is tailored to your symptoms. A GP or physiotherapist may offer advice, exercises, referral to occupational therapy, podiatry, or a pain clinic. Pain relief may be discussed for some people, but no single medicine suits everyone; ask your clinician or pharmacist for advice. The focus is usually on exercise, pacing, and self-management rather than medicines alone.

When is surgery considered?

Surgery is not a usual treatment for joint hypermobility syndrome. It may be considered for a specific joint problem, such as severe joint damage or repeated dislocation, after specialist assessment.

Living with this condition

Living with joint hypermobility syndrome often means planning activity and rest, keeping muscles strong, and protecting joints from repeated strain. Symptoms can change from day to day, so it helps to have flexible routines and to ask for support when needed.

Lifestyle tips

• Build regular, gentle strength and balance exercises into your week
• Break activity into short sessions rather than doing too much at once
• Get enough sleep and rest after busy days
• Keep to a healthy weight if this is relevant for your joints
• Set up your desk, workspace, or school bag to reduce strain
• Avoid repeated extreme stretching or showing off flexible moves
• Use aids such as insoles, braces, or supports only with advice

Diet and exercise

A balanced diet helps general health and energy. There is no special diet that treats joint hypermobility syndrome. Exercise is important: gentle strength work, swimming, cycling, walking, and balance exercises can help. Start slowly and seek advice from a physiotherapist if you are unsure.

Mental health and emotional wellbeing

Ongoing pain, tiredness, and uncertainty can affect mood, sleep, relationships, and confidence. It is okay to ask for help. If you feel in crisis or have thoughts of harming yourself, contact your local emergency number or a local crisis support service straight away.

Prevention

You cannot prevent inherited hypermobility, but you can reduce pain and injury by keeping muscles strong, pacing activity, using good posture, and getting advice early if symptoms start.

Vaccines

There is no vaccine for joint hypermobility syndrome.

Screening programmes

There is no routine screening for joint hypermobility syndrome. If you have a family history and symptoms, talk to your GP about assessment.

Complications

If left untreated

• Ongoing joint pain and stiffness
• Tiredness that affects daily life
• Repeated sprains, strains, or joint dislocations
• Falls or reduced confidence in movement
• Less physical activity, which can weaken muscles further
• Low mood or anxiety related to long-term symptoms
• Difficulties at school, work, or with daily tasks

Long-term outlook

The outlook is often positive. Many people improve with physiotherapy, strength exercises, pacing, and self-management. Symptoms can flare and settle over time, and most people can still live full, active lives with the right support.

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