Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are conditions that affect the connective tissue in the body. They can cause joints to move beyond the normal range, which often leads to chronic pain, fatigue, and other symptoms that affect daily life.
For people living with hypermobility-related chronic pain who have not found relief from standard treatments, medical cannabis may be an option to discuss with a specialist.
Ehlers-Danlos syndromes (EDS) are a group of inherited connective tissue disorders. There are 13 recognised types, each with specific diagnostic criteria. Hypermobile EDS (hEDS) is the most common type and shares many features with HSD.
The main difference lies in diagnosis. A diagnosis of hEDS requires meeting specific criteria set out by international experts in 2017. These criteria include measures of joint hypermobility, additional features affecting the skin and other body systems, and ruling out other conditions.
When someone has symptomatic joint hypermobility but does not meet all the criteria for hEDS, they may receive a diagnosis of HSD. This does not mean their symptoms are less significant. Both conditions can cause chronic pain and affect quality of life in similar ways.
There are currently thirteen classified types of EDS. To diagnose a patient with a certain type of EDS, a healthcare professional will match their symptoms to the criteria of each variation to identify the type of EDS that fits.
The majority of the 13 EDS variations are rare; however, the most common types are:
People with HSD and hEDS can experience a wide range of symptoms. The most common include:
Research suggests these conditions often occur alongside other health issues. A large international survey found that people with hEDS reported an average of 24 different health conditions, highlighting how these disorders can affect multiple body systems.
Diagnosis of HSD and hEDS usually begins with a detailed medical history and physical examination. A healthcare professional will assess joint flexibility using the Beighton score, which measures hypermobility at specific joints.
For hEDS, the 2017 international diagnostic criteria are used. These consider joint hypermobility alongside other features such as skin involvement, family history, and the presence of related symptoms. When someone does not meet these specific criteria but has symptomatic hypermobility, a diagnosis of HSD may be given.
Reaching a diagnosis can take time. Research indicates that the average time from first symptoms to diagnosis for hEDS is over 22 years. This delay can be frustrating, but getting the right diagnosis helps ensure appropriate care and support.
Physiotherapy is often a cornerstone of management. A physiotherapist experienced in hypermobility can help develop an exercise programme to strengthen muscles around joints, improve stability, and reduce the risk of injury.
Pain relief may include over-the-counter medications, prescribed painkillers, or referral to a specialist pain clinic. Approaches such as pacing activities, heat therapy, and transcutaneous electrical nerve stimulation (TENS) may also help some people.
Living with chronic pain can affect mental health. Cognitive behavioural therapy (CBT) and other psychological approaches can help people develop coping strategies and manage the emotional impact of their condition.
An occupational therapist can advise on equipment and techniques to make daily activities easier and reduce strain on joints.
When standard treatments do not provide sufficient relief, some people may explore additional options through specialist clinics, which can include medical cannabis.
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