Hypermobility - Treating joint hypermobility

If you have joint hypermobility that doesn't cause any problems, treatment is not necessary.

However, you may need treatment and support if you have joint hypermobility syndrome (JHS), which causes a wide range of symptoms, including joint pain and digestive problems.

Some of the main treatments for JHS are outlined below.

Self care

There are some things you can do yourself that can help if you have JHS. These include:

ensuring you have a generally healthy lifestyle – including having a healthy diet and maintaining a healthy weight; this will help improve the strength of your joints and reduce the strain on them
adopting sleep hygiene measures if you have trouble sleeping – such as establishing fixed times for going to bed and waking up, trying to relax before going to bed, and maintaining a comfortable sleeping environment
staying as active as you can, but sticking to "low-impact" exercises, such as swimming or cycling to reduce strain on your joints
wearing comfortable and supportive footwear to support your ankles
applying heat – such as a hot water bottle or heat-rub cream – to soothe sore joints
if you have an injury from over-stretching, it helps to rest the joint and elevate it (for example, by propping it up on some pillows); you can also apply ice wrapped in a damp towel to the injured area – read more about treating sprains

You may also find it useful to contact a support group. Both the Hypermobility Syndromes Association and Ehlers-Danlos Support UK have a network of local support groups where you can meet other people with JHS and Ehlers-Danlos syndrome (EDS).

Physiotherapy and exercise

Physiotherapy may help people with hypermobile joints in a number of ways. For example, it may help to:

reduce pain
improve muscle strength and fitness
improve posture
improve your sense of your body’s position and movement (proprioception)
correct the movement of individual joints

It's helpful to have a physiotherapist with knowledge of JHS, as some physiotherapy treatments can make symptoms worse.

A wide range of physiotherapy techniques can be used. You may be advised to follow an exercise programme that includes strength and balance training, special stretching techniques and advice about pacing.

Pacing involves balancing periods of activity with periods of rest. It means not overdoing it or pushing yourself beyond your limits, because if you do it could slow your long-term progress.

Occupational therapy

Occupational therapy aims to help you overcome difficulties in your everyday life caused by having JHS.

This may involve teaching you alternative ways of carrying out a certain task. For example, an occupational therapist can give you advice about reducing the strain on your joints while using a computer or getting dressed.

Equipment may also be provided to make certain tasks easier. For example, special grips can make holding a pen easier and help improve handwriting.

An occupational therapist can also suggest ways to adapt your home to make moving around easier. For example, if using stairs is a problem, fitting special grab rails may be recommended.

Podiatry

For some people with JHS, flat feet can be a problem. If someone has flat feet, that person has no arch in the inner part of their feet, which can put a strain on nearby muscles and ligaments (tissue that connects bones together at a joint).

If you have problems with your feet, a podiatrist (a foot specialist) can recommend treatments such as special insoles to support your feet.

Painkillers

Medication can be used to manage the pain associated with JHS.

Painkillers available over the counter from pharmacies, such as paracetamol, can sometimes help. Your GP can also prescribe a medicine that contains both paracetamol and codeine, which is a stronger type of painkiller. Liquid paracetamol (such as Calpol) may be helpful for children with JHS.

Alternatively, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help in some cases.

Painkillers and NSAIDs are also available as gels or sprays that can be applied directly onto painful joints.

Make sure you check the patient information leaflet that comes with your medicine before taking any over-the-counter medication, to make sure it is suitable for you.

Some people with JHS may find pain medication is not effective for them. There have been reports of local anaesthetic used during surgical procedures not having an effect on people with JHS. If you are having a procedure that requires anaesthesia, such as dental treatment, you may want to discuss the issue with your doctor or dentist beforehand.

Pain management

If painkillers are not effective in reducing your pain, you may benefit from being referred to a pain specialist at a pain clinic. Staff at the clinic will be able to provide further advice and treatment.

For example, some people with JHS benefit from a pain management programme that incorporates a type of psychological therapy called cognitive behavioural therapy (CBT) when painkillers are not working.

Pain specialists can also provide stronger painkillers or medication used to specifically treat nerve (neuropathic) pain.

Read more about NHS help for people with pain.

Treating specific problems

If you have any related conditions, these will often be treated in the same way as people without JHS.

For more information about the specific treatments for some of the problems associated with JHS, see: