top of page

Hypermobile Spectrum Disorders

When joints move beyond their normal limits this is considered Joint Hypermobility (JH).

The joints that are affected can be a few which is considered Localised joint hypermobility (fewer than five). Those with five or more joints affected have what is called Generalised joint hypermobility (GJH). Joint hypermobility can be acquired through injury, joint disease, hormonal disorders and/or genetic issues. Having hypermobile joints does not automatically mean you have Ehlers-Danlos Syndrome


Hypermobile Spectrum Disorders (HSD) are a spectrum of disorders characterised by symptomatic JH and are usually diagnosed after other connective tissue disorders like Ehlers-Danlos Syndrome (EDS) have been excluded. HSD is not a lesser diagnosis and can be quite severe and require similar management and care as Hypermobile EDS. Historically this used to be called Benign Joint Hypermobility - but the word "benign" was felt to be dismissive of the level of symptoms being experienced by patients. 


There are subtypes of HSD depending on the extent and location of the hypermobility. The severity and level of symptoms can range among the hypermobility spectrum.

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

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

  • Localised 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 previous GJH with a current 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 -  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 where our bodies relative position and movement in space is. 

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


The Beighton Score does not diagnose anything just shows these joints are hypermobile- Physiopedia

bottom of page