What is Joint Hypermobility Syndrome?
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What Is Joint Hypermobility Syndrome?
Joint hypermobility syndrome is a medical condition in which joints move beyond the normal range because the ligaments holding them are too loose, along with chronic joint pain, frequent sprains or dislocations. [1] It is believed to be linked to genes that affect collagen. [1] It often improves with age, and treatment includes physical therapy, supportive footwear and avoiding overextension. [1]
What the research says
Hypermobile athletes have a higher risk of knee injury in contact sports. A systematic review and meta-analysis of 18 studies (from 4,841 identified) found that sport participants with generalized joint hypermobility had a significantly increased risk of knee joint injury, with a combined odds ratio of 4.69 (95% CI 1.33-16.52) in contact sports, but no increased risk of ankle injury (Pacey et al., American Journal of Sports Medicine, 2010 [2]).
The Beighton score alone is not enough to rule hypermobility in or out. A review of the nine-point Beighton score found that it mostly tests upper-limb joints and failed to identify hypermobility in joints outside its scoring system. The authors concluded it should not be used alone to exclude generalized joint hypermobility and that clinician judgment deserves more weight (Malek et al., Rheumatology International, 2021 [3]).
The names for this condition have changed. A clinical review explains that joint hypermobility syndrome and hypermobile Ehlers-Danlos syndrome (hEDS) were two undifferentiated clinical diagnoses, and that the current EDS classification combines them into the hypermobile type of EDS. Both are diagnosed clinically when no other cause is found (Tinkle et al., American Journal of Medical Genetics Part C, 2017 [4]).
Key Takeaways
Feature | Details |
Medical Term | Joint Hypermobility Syndrome |
Primary Cause | Believed to involve collagen genes (loose ligaments) [1] |
Commonly Affected | Children, adolescents, females [1] |
Key Symptom | Joint pain and extreme flexibility [1] |
Diagnosis Tools | Beighton score, 5-point questionnaire [1] |
Common Treatment | Physical therapy, muscle strengthening, orthotics [1] |
What are the core features and symptoms of joint hypermobility syndrome?
Joint hypermobility syndrome involves more than just flexible limbs; it affects the entire body's connective tissue network.
Joint and Muscle Issues
The most prominent symptom is persistent pain in the joints and muscles [1], often worsening after physical activity [4]. Because the ligaments do not provide adequate stability, the muscles must work harder to hold the joints in place, leading to chronic fatigue and stiffness. Individuals are also more prone to frequent sprains, strains, and full dislocations. [1]
Systemic Symptoms
Beyond the joints, the condition can affect other systems:
Digestive Health: There is a known link between hypermobility and gastrointestinal issues like irritable bowel syndrome (IBS). [1]
Balance and Coordination: Many people experience clumsiness or poor balance [1] due to the lack of joint stability.
Skin and Blood Vessels: Symptoms can include thin, stretchy skin [1] and a tendency to bruise easily. [5]
Dizziness: Some individuals experience fainting or dizziness [1], often related to how the nervous system interacts with loose connective tissues.
What causes joint hypermobility syndrome, and how is it diagnosed?
Identifying the underlying cause and getting an accurate diagnosis against established diagnostic criteria is the first step toward effective management.
The Role of Collagen
The syndrome is believed to be linked to genes responsible for producing collagen. [1] Collagen is the "glue" of the body, providing strength and flexibility to ligaments, tendons, and skin. When collagen is defective, ligaments become weak and loose, allowing joints to move far beyond their intended range. [1]
Diagnostic Scoring Systems
Healthcare providers use standardized tests to evaluate hypermobility:
Beighton Score: A nine-point scale that assesses the ability to bend thumbs to forearms, little fingers beyond 90 degrees, and knees or elbows backward. [1] [3]
Five-Point Questionnaire: A series of questions about childhood flexibility and history of dislocations [1] to determine if the condition is systemic.
Physical Exam: A specialist evaluates the range of motion [1] and checks for associated signs like flat feet or stretchy skin.
How is joint hypermobility syndrome managed and treated?
Joint hypermobility syndrome cannot be prevented or cured [1], but physical therapy, supportive footwear, activity changes and pain management [1] can reduce symptoms and prevent injuries.
Physical and Supportive Therapy
Strengthening the muscles surrounding the joints [1] is the most effective way to provide the stability that the ligaments lack:
Physical Therapy: A therapist can design a custom program to improve posture, balance, and muscle tone. [1]
Supportive Gear: Wearing shoes with good arch support or using custom orthotics can help correct flat feet [1] and reduce strain on the ankles and knees.
Activity Modification: Learning to move without overextending joints [1] is crucial for long-term joint health.
Lifestyle and Pain Management
Pain Relief: Over-the-counter medications like acetaminophen or ibuprofen can help manage mild discomfort. [1]
Dietary Adjustments: For those with associated digestive issues, exclusion diets (such as gluten-free or low-FODMAP) may be recommended [1] to identify food intolerances.
Self-Care: Regular exercise, warm baths for stiffness, and taking frequent breaks during physical tasks [1] are essential daily habits.
What is the outlook for joint hypermobility syndrome, and how can people live well?
Most people with the condition see a decrease in symptoms as they reach adulthood [1] and their tissues naturally stiffen.
Aspect | Impact and Guidance |
Prognosis | Symptoms often improve with age; long-term joint protection is key. [1] |
Related Conditions | May be associated with Ehlers-Danlos or Marfan syndromes. [1] |
Activity Level | Regular, low-impact exercise is highly encouraged to maintain strength. |
Daily Safety | Avoid purposeful "contortionist" tricks to prevent ligament damage. [1] |
Conclusion
Joint hypermobility syndrome requires a shift in perspective—from seeing flexibility as a "trick" to recognizing it as a condition that needs careful management. By focusing on muscle strength, joint protection, and systemic health, individuals can lead active, fulfilling lives. If you or your child experience chronic pain alongside extreme flexibility, consult a healthcare provider for a comprehensive evaluation.
For more helpful health resources and visual guides, explore our infographic templates.
Frequently Asked Questions
What is joint hypermobility syndrome?
It is a genetic condition where loose ligaments cause extreme joint flexibility and pain. [1]
Is being double-jointed the same as having the syndrome?
No, many people are flexible without pain, but the syndrome involves pain and other symptoms. [1]
What causes joint hypermobility syndrome?
Genes involved in making collagen, the protein that strengthens connective tissues, are believed to play a role. The exact cause is not fully known. [1]
Who is most commonly affected?
It is most frequent in children, adolescents, and females. [1]
Can joint hypermobility syndrome be cured?
There is currently no cure, but symptoms can be managed effectively. [1]
What is the Beighton score?
Does the condition run in families?
Yes, it is a genetic disorder that often runs in families. [1]
What are the most common symptoms?
Joint and muscle pain, stiffness, fatigue, and frequent injuries. [1]
Can it cause digestive problems?
Yes, it is often linked to issues like irritable bowel syndrome (IBS). [1]
Is joint hypermobility syndrome dangerous?
While not typically life-threatening, it increases the risk of dislocations and chronic pain.
How is it diagnosed?
Through physical exams, flexibility tests [1], and medical history reviews.
What is the best exercise for hypermobility?
Muscle-strengthening [1] and low-impact exercises that stabilize the joints.
Do symptoms change with age?
Yes, symptoms often decrease as people get older [1] and their joints stiffen.
What are "loose ligaments"?
Ligaments that are too weak to keep joints within a normal range of motion. [1]
Can it cause dizziness?
Yes, some people experience dizziness or fainting spells. [1]
What is an exclusion diet?
A diet that removes certain foods to test for intolerances, often used for associated IBS. [1]
Are there medications for the syndrome?
Pain relievers like ibuprofen or acetaminophen are commonly used for symptom management. [1]
Should I see a physical therapist?
Yes, physical therapy is one of the most recommended treatments. [1]
Can hypermobility lead to arthritis?
Chronic instability can increase wear and tear on joints over time.
What is the difference between hypermobility and EDS?
Joint hypermobility syndrome can be a sign of Ehlers-Danlos syndrome [1], which is more severe.
Does it affect balance?
Yes, clumsiness and poor balance are common symptoms. [1]
What kind of shoes should I wear?
Supportive shoes with good arch support are recommended. [1]
Can warm baths help?
Yes, they are effective for easing joint stiffness and muscle pain. [1]
Are flat feet a symptom?
Yes, flat feet are common in people with hypermobile joints.
Can I still play sports?
What is the "five-point questionnaire"?
A screening tool for hypermobility based on five specific questions. [1]
Does it affect the skin?
Is it more common in certain ethnicities?
It is more frequently reported in people of Asian and Afro-Caribbean descent. [1]
What is collagen?
The primary structural protein in the body's connective tissues.
Can it cause bladder issues?
Yes, some individuals experience bladder-related symptoms. [1]
Why does it cause fatigue?
Muscles have to work harder to stabilize loose joints, leading to exhaustion.
What are orthotics?
Custom shoe inserts designed to support the feet and improve alignment.
Can hypermobility be prevented?
No, because it is a genetic condition. [1]
Should I avoid stretching?
You should avoid purposeful overextension [1] or "party tricks" that strain ligaments.
Can hypermobility cause "growing pains"?
Hypermobility can contribute to limb pain in some children, which may be mistaken for growing pains.
What is the role of a rheumatologist?
A specialist who often diagnoses and manages joint and connective tissue disorders. [5]
Can it affect the jaw?
Yes, it can lead to TMJ (temporomandibular joint) issues.
How does posture affect hypermobility?
Good posture helps distribute weight correctly and reduces joint strain.
Is there a specific "hypermobility diet"?
No, but managing food intolerances may help with associated digestive symptoms. [1]
What are dislocated joints?
When the bones in a joint are forced out of their normal positions.
Can it cause sleep problems?
Chronic pain and discomfort can interfere with restful sleep.
Why is it called a "syndrome"?
Because it involves a group of related symptoms beyond just flexibility.
Can I use braces for my joints?
Sometimes braces are used [6], but muscle strengthening is the preferred long-term solution.
Should I call a doctor for severe joint pain?
Yes, you should always consult a professional for persistent or severe pain.
What is the most important thing to remember?
Protecting your joints through strength and proper movement is essential.
Related Reading
Learn more in our guide to Beighton Score: How Joint Hypermobility Is Measured and What Your Score Means.
References
Cleveland Clinic. Joint Hypermobility Syndrome. Cleveland Clinic. Last updated September 1, 2021. https://my.clevelandclinic.org/health/diseases/21763-joint-hypermobility-syndrome
Pacey V, Nicholson LL, Adams RD, et al. Generalized joint hypermobility and risk of lower limb joint injury during sport: a systematic review with meta-analysis. Am J Sports Med. 2010;38(7):1487-1497. PMID 20601606. https://doi.org/10.1177/0363546510364838
Malek S, Reinhold EJ, Pearce GS. The Beighton score as a measure of generalised joint hypermobility. Rheumatol Int. 2021;41(10):1707-1716. PMID 33738549. https://doi.org/10.1007/s00296-021-04832-4
Tinkle B, Castori M, Berglund B, et al. Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome type III and Ehlers-Danlos syndrome hypermobility type): clinical description and natural history. Am J Med Genet C Semin Med Genet. 2017;175(1):48-69. PMID 28145611. https://doi.org/10.1002/ajmg.c.31538
NHS. Ehlers-Danlos syndromes. NHS. Last reviewed October 4, 2022. https://www.nhs.uk/conditions/ehlers-danlos-syndromes/
Cleveland Clinic. Ehlers-Danlos Syndrome: Types of EDS & Treatment. Cleveland Clinic. Last updated July 14, 2026. https://my.clevelandclinic.org/health/diseases/17813-ehlers-danlos-syndrome
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always seek the counsel of a qualified healthcare professional regarding any medical condition or emergency. If you are experiencing a life-threatening emergency, call 911 or your local emergency services immediately.
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