Hypermobility Spectrum Disorders

Hypermobility Spectrum Disorders (HSD) are a group of conditions related to Joint Hypermobility (JH). When joints move beyond the normal limits this is considered joint hypermobility. While joint hypermobility is a feature seen in Ehlers-Danlos Syndromes not all types of JD are caused by EDS. HSD is usually diagnosed after other EDS types have been excluded. HSD is not a lesser diagnosis and can be quite severe and requires similar management and care as Hypermobile EDS.


Joint hypermobility can occur in isolation or as part of other conditions (Liked EDS). The joints that are affected can be from a few (fewer than five) localised joints (localised joint hypermobility). Those with five or more joints affected have what is called generalised joint hypermobility (GJH). Both types can either be inherited or acquired issues, with GJH the more likely to be inherited. Joint hypermobility can be acquired through training such as gymnastics, injury, joint disease and/or hormonal disorders. 

There are subtypes of JH depending on where the hypermobility occurs. The severity and level of symptoms can range in among the hypermobility spectrum.

  • Generalised HSD - Can be assessed by the Beighton score and other measures in conjunction with one or more secondary musculoskeletal issues.

  • Peripheral HSD - Is limited to hands and feet plus and additional musculoskeletal issue. 

  • Localized HSD - Is where JH occurs in one or a group of joints with secondary musculoskeletal issues related to hypermobile joints 

  • Historical HSD - As we age joint hypermobility can decrease. H-HSD has reported the previous GJH with a negative Beighton score plus musculoskeletal issues. 

Musculoskeletal Issues Secondary to JH

As mentioned the types of HSD can require additional musculoskeletal issues to be present for diagnosis. These can include, but are not limited to:

  • Trauma - These can include dislocations, subluxations, and soft tissue damage. These can cause damage or functional issues in the joint.  

  • Chronic Pain - For pain to be considered chronic it needs to last at least 6 months.

  • Disturbed Proprioception - Our sense of our bodies relative position and movement in space. 

For more information on HSD please go to The Ehlers-Danlos Society