Abdominal and pelvic pain can have a variety of causes. Joint hypermobility syndrome can often be an undetected and underdiagnosed comorbidity in chronic pelvic pain conditions (I.e. like endometriosis). Joint hypermobility syndrome, or benign hypermobility syndrome, is a connective tissue disorder and considered a milder variant of Ehlers-Danlos Syndrome. This syndrome is characterized by chronic musculoskeletal pain as a consequence of joint hyperextensibility. Patients with this syndrome are commonly afflicted by pain in their pelvis, fingers, hips, knees, and elbows. A physician and/or physical therapist evaluates using special tests such as the Nine Point Beighton Score as a diagnostic tool to determine whether hypermobility is present.
Patients with joint hypermobility syndrome may display signs of fatigue, headaches, anxiety, orthostatic hypotension, and many experience abdominal and genitourinary difficulties at high rates. According to a 2013 study, about 3% of people have some form of this syndrome. People usually characterize the pain as being a dull, constant sensation. The pain, which usually occurs later in the day, can be heightened by repetitive use of the joint, or prolonged physical activity.
Most patients with joint hypermobility syndrome also suffer from impaired autonomic reflexes, called dysautonomia. The autonomic nervous system is responsible for regulating things like internal body temperature, breathing patterns, heart rate, arousal, and excretion. According to studies, people with dysautonomia seem to have higher than average muscle tone. Nevertheless, they have less sympathetic reactivity to stimuli. There are different types of dysautonomia, and some can lead to things like constipation, early satiety, bloating, nausea, and vomiting. Chronic constipation can have an impact on how the bladder functions and result in pelvic floor muscle dysfunction. Some may feel pain that originates in the bladder, in any part of the pelvis, or the lower back.
The vast majority of patients with joint hypermobility syndrome also experience abdominopelvic pain. Dysautonomia and laxity in the collagen of the gastrointestinal tract and pelvic organs may serve as the underlying cause of the pain. Patients with joint hypermobility syndrome seem to have reduced pain thresholds, which may further heighten pain sensations.
Studies indicate that abdominal laxity may cause pelvic organ prolapse, known by its acronym POP. In fact, women with pelvic organ prolapse have been reported to have a very high rate of joint hypermobility (as much as 54 percent). And that’s important because women with joint hypermobility syndrome are more likely to suffer from polycystic ovaries, endometrial cysts, endometrial hypertrophy, and endometriosis. Women with POP usually have pelvic floor muscle weakness, which can be alleviated with physical therapy to the pelvic floor. To put it simply, joint hypermobility syndrome can be an ignored cause of chronic pelvic pain.
We treat chronic pelvic pain issues and know that there are a variety of ways to manage it, along with other, similar, conditions resulting from joint hypermobility syndrome. Physical therapy’s approach to treating joint hypermobility syndrome is to deal with muscle inhibition, atrophy, and the reduced joint control. Physical therapy also educates the patient to keep their movements within normal joint range, which over time can help to stabilize the joint.
There are also adjunct techniques patients can perform on their own once taught by the physical therapist. Neuromuscular taping techniques and bracing may prevent injuries and make it easier to walk. Patients can also be instructed in core stabilization and other strengthening programs targeting the periarticular musculature. This helps stabilize joints.
Before strenuous activity, patients are advised to perform stretches that isolate tight muscles without stressing the joints. These stretches, especially over time, can improve a patient’s balance and body control. We devise stretching and exercise regiments that are tailored to each patient, so get in touch with us to schedule an appointment with one of our expert therapists.
