Common Clues Suggesting Joint Hypermobility Syndrome
In children and adolescents*
- Coincidental congenital dislocation of the hip
- Late walking with bottom shuffling instead of crawling
- Recurrent ankle sprains
- Poor ball catching and handwriting skills
- Tiring easily compared with peers
- So called growing pains or chronic widespread pain
- Joint dislocations
- Non-inflammatory joint or spinal pain
- Joint dislocations
- Multiple soft tissue (including sporting) injuries
- Increase in pain or progressive intensification of pain that is largely unresponsive to analgesics
- Progressive loss of mobility owing to pain or kinesiophobia (pain avoidance through movement avoidance)
- Premature osteoarthritis
- Autonomic dysfunction, such as orthostatic intolerance (dizziness or faintness) or postural tachycardia syndrome (in this form of dysautonomia, in 60˚ upright tilt the blood pressure remains constant while the pulse rate rises by a minimum of 30 beats/min)
- Functional gastrointestinal disorders (sluggish bowel, bloating, rectal evacuatory dysfunction)
- Laxity in other supporting tissues – for example, hernias, varicose veins, or uterine or rectal prolapsed
Based on observations, expert opinion, and case series.
*Ross J, et al. Joint hypermobility syndrome. BMJ. 2011;342:c7167
Examples of Joint Hypermobility & Dislocation due to Ehlers-Danlos Syndrome (EDS)
Kristle Lowell, World Champion in double mini-trampoline, demonstrates joint dislocation at will. She uses Prolotherapy when joint instability interferes with her athletic training and competition.
Systematic Manifestations of Ehler-Danlos Syndrome, Hypermobility Type
Joint Instability can affect all organ systems of the body.
1. Primarily joint instability, as well as fibromyalgia, myofscial pain and complex regional pain syndromes. 2. Comprising xerophthalmia, xerostomia, vaginal dryness, and abnormal sweating. 3. Asthma, atopy, gluten sensitivity, inflammatory bowel disease, and recurrent cystitis are all possible manifestations of an underlying immune system dysregulation. Modified from: Castori M. Ehlers-danlos syndrome, hypermobility type: an underdiagnosed hereditary connective tissue disorder with mucocutaneous, articular, and systemic manifestations. ISRN Dermatol. 2012;2012:751768. Figure 6.
Prolotherapy Treatment for EDS & Hypermobility
For patients suffering from full body pain, loose joints, and chronic subluxations, Prolotherapy is the ideal treatment. It strengthens and tightens the ligament junctions by triggering the body’s own healing cascade specifically at the site of the injected tissue. This can be applied to many joints during a treatment session in our office, making it an effective way to address extensive body pain. Strong ligaments allow the joints to properly glide through their normal range of motion without constantly subluxing and causing body pain and triggering autonomic nervous system symptoms. The exciting aspect of Prolotherapy for chronic conditions like EDS and hypermobility is that each treatment builds upon itself. The tissue remodeling phase continues into the months after the last Prolotherapy session, lending itself to successful long-term pain relief and joint stability after the treatment series. Read more in detail about our approach to treating EDS
Our Research on the use of Prolotherapy for EDS & Hypermobility
Joint Hypermobility Syndrome (JHS) and Ehlers-Danlos Syndrome are both heritable disorders of connective tissue (HDCT) characterized by joint laxity and hypermobility. The conditions are both genetic disorders of collagen synthesis, where the adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. Both conditions have as their hallmark generalized hypermobility which can affect almost every bodily system. The hypermobility can be documented by the Brighton criteria which involves the objective measurement of the hyperextensibility of various joints. While the major presenting complaint of JHS and EDS is arthralgia in multiple joints, if the hypermobility is left unchecked, joint dislocations and degeneration may prevail. While traditional medical treatments, including education and lifestyle advice, behavior modification, physiotherapy, taping and bracing, exercise prescription, functional rehabilitation and pain medications offer some symptomatic control, they do little in regard to curbing the progressive debilitating nature of the diseases. The excessive joint mobility, with its subsequent joint degeneration and multiple joint dislocations, can then lead the individual to seek out surgical intervention, which has suboptimal results in the hypermobile patient population versus the normal population. As such, some patients with JHS and EHS are seeking alternative treatments for their pain including Prolotherapy.
Through our case studies, we have found that Prolotherapy offers great hope for those with symptoms from generalized hypermobility because it is designed to successfully treat the ligament and tissue laxity that accompanies JHS and EDS. Some of the rationale for using Prolotherapy for patients with EDS and JHS are that it has a high safety record, is comprehensive (all or most joints can be treated at each visit), is an outpatient procedure, is cost effective (compared to surgery), pain relief is often quick, and it provides joint stabilization. Perhaps its greatest asset is the fact that this one treatment modality can handle most of the painful musculoskeletal conditions that occur in individuals with EDS and JHS. Prolotherapy could also contribute to the treatment of hypermobility disorders also by preventing the development of precocious osteoarthritis. It has long been known that individuals with JHS and EDS suffer with premature osteoarthritis in various joints and the amount of degeneration correlates with the extent of the individuals hypermobility. The combination of extreme hypermobility and repeated injury is presumed to be what leads to the early osteoarthritis. This is most likely the reason that the hypermobility type of Ehlers-Danlos Syndrome is the most debilitating form with respect to musculoskeletal function.
While the primary author has twenty years experience treating JHS and EDS musculoskeletal symptoms with Prolotherapy, future studies will need to be conducted to best document the exact role Prolotherapy has in the treatment of the musculoskeletal symptoms and hypermobility of JHS and EDS and if it can prevent future joint degeneration in these individuals. The complete results can be read here: Hauser R, Phillips H. Treatment of Joint Hypermobility Syndrome, Including Ehlers-Danlos Syndrome, with Hackett-Hemwall Prolotherapy. Journal of Prolotherapy. 2011;3(2):612-629.
Our other studies on regenerative treatment outcomes for EDS & hypermobility
- A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain
- Evidence-Based Use of Dextrose Prolotherapy for Musculoskeletal Pain: A Scientific Literature Review
- Joint Instability Treatment with Prolotherapy
Patient Success Stories using Prolotherapy for EDS & Hypermobility
AL, with a history of Ehlers-Danlos Syndrome, had multiple shoulder dislocations despite 4 reconstruction surgeries, including a labral repair. AL’s shoulder was dislocating daily before coming for Prolotherapy. Because of her severe multidirectional instability, she required 12 Prolotherapy visits over the course of 12 months to stabilize her shoulder.
Stabilization surgeries are often ineffective for patients with Ehlers-Danlos Syndrome.
Multi-joint Instability, POTS, Ehlers-Danlos Syndrome Type III
For 5 years, eighth grader Louise S managed her EDS pain with weekly chiropractic care, until chronic multi-joint dislocations became incapacitating, keeping her from her love of gymnastics, as even bumping into things would cause her joints to dislocate. Louise came to CMRS from Europe along with her mother, looking for an answer to this life altering disease. After 5 treatments of Prolotherapy, Louise was able to become proficient at aerial circus, with improved overall body, core and shoulder strength, without dislocations.
Joint instability causes bones to move excessively, because the ligaments are too loose. Traditional medicine is limited as far as helping the suffering EDS patient, but Prolotherapy treats the loose ligaments at the core of the disease, safely and effectively giving patients like Louise their lives back.
Ankle Instability from Ehlers-Danlos Syndrome
Kristle Lowell, Double-Mini Trampoline World Champion, diagnosed with EDS was experiencing severe instability from multiple ligament injuries of her left ankle and received massage, physical therapy, cortisone and NSAIDS, from which she saw no long-term relief. In order to inhibit menstruation from interfering with training, she went on birth control pills, which caused a worsening of symptoms. Kristle suffered a career threatening injury to her ankle, which made gymnastics training unbearable. She came to Caring Medical and received 2 PRP Prolotherapy treatments, and discontinued the birth control pills. Her ankle was stabilized, enabling her to compete and place second in national championships and qualify for world championships.
Cortisone, NSAIDS, PT and MT do nothing to strengthen the ligaments of an unstable joint. Prolotherapy strengthens the injured ligaments and stabilizes the joint. Estrogen in birth control pills inhibits the fibroblastic proliferation necessary for the healing of ligaments. Fibroblastic proliferation is the mode of healing by which Prolotherapy repairs.
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In 9/10 cases we meet or beat the patients expectations. Our results are long lasting and provide permanent pain relief. This is why for 25 years, patients have been traveling from all over the world to see our providers. Give us a call, or fill out the form below to get started.