Pain Management for Benign Joint Hypermobility Syndrome

Relief of Chronic Pain, Muscle Stiffness and Fatigue

Even if the person with hypermobile joints is pain free and leads a normal life, it is essential that full movement through their joint range is maintained.

Daily stretches are of paramount importance. The thoracic spine is the first place to stiffen in adolescents and 90° trunk rotation should be encouraged. To ensure 90° rotation to both sides, try sitting in a dining chair and twisting around to hold the back of the chair, so that your shoulders are at right angles to your pelvis. Repeat to the opposite direction. Do this once a day.

It is important that daily sessions of muscle relaxation should also occur. If you feel that you might need help with relaxing, ask your physiotherapist to teach you some of the techniques.

Ensure that you breathe with your diaphragm. It is important that you oxygenate your bodt maximally to keep the tissues healthy and energetic. The diaphragm is the most energy efficient muscle of respiration.

Isometric / static strengthening exercises should be done to stabilise the joints.

Balance education and proprioceptive improvement exercises should be encouraged too.

There may be a need to support the flat foot with insoles and a referral to a podiatrist or physiotherapist may be indicated.

Abdominal muscle strengthening exercises are important too. Prior to any movement of the upper or lower limbs, the trunk is stabilised by the automatic contraction of the abdominal muscles. When the abdominals are weak, the trunk, which includes the back, is less stable, limb movements are less co-ordinated and back injury more likely. Practise pulling in the low abdominal muscles and pelvic floor as you continue to breath normally and as you perform everyday activities.

Lying for 5 minutes daily, on your side or back, with your legs curled up, helps the discs imbibe water, thereby improving their hydration and shock absorbing properties.

Good hydration of body tissues is an essential factor in protection, repair and maintenance. Drinking plenty, (preferably water) before and after sport, is vital for healthy tissues.

Participating in racket sport has been found to significantly increase upper trunk strength and reduce the incidence of neck and shoulder pain.

Make sure you rest your joints each day. This does not mean that you must lie down and sleep but ensure you avoid fixed positions. FIDGET!! Only stay at one task or in any one position for a maximum of half an hour.

Have a daily programme of management; pace your activities, avoid repetitive tasks and fixed positions, keep your joints moving without overstretching, try taking up Yoga or Pilates exercise.

Change your way of life - the way you move; when to exercise; continually correct your posture; take rest times

Become a problem solver by managing daily tasks to suit your body. Look at ways of changing your environment so that, for example, work surfaces are at the correct height, avoid continually bending. Provide cushioning between your body and the world with softening aids, adaptations of your environment. These could include self help tchniques such as wedge cushions, strapping to prevent over movement of vulnerable joints, muscle and nerve mobilising exercises, massage and treatment of tender trigger points.

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