A role for physiotherapy in managing pain in hypermobility?

Abstract

Background: Prevalence of joint hypermobility in the UK adult population is approximately 30% and this population can present with pain as a significant symptom. Management of hypermobility is mainly focused on providing symptomatic relief (rather than curative treatment) including pain management, education, and of interest here, physiotherapy and therapeutic exercise. At present, there is very little in the literature exploring the effectiveness of physio- and exercise-therapy in those with symptomatic hypermobility.

Methods: All studies included adult participants with sample sizes ranging from n=11 to 28. All five studies used clinically confirmed diagnoses, with one also including self-reported diagnoses. Three studies focused specifically on pain in knee joints, whilst two looked at pain across the whole body. This literature review included five systematic reviews with adult participants with outcome measures at baseline and a follow-up period (from 4 weeks to 1 year).

Results: This review identified that following an exercise programme, improvements in pain over time were demonstrated. Four of the five systematic reviews found decreases in pain scores at follow-up compared to baseline. This was also contrasted in control groups without exercise intervention and receiving advice only. The final review found increase in pain scores with reports of iatrogenic injury associated with quality of professional contact.

Conclusion: Overall, patients did benefit from physio- and exercise-therapy shown through decreases in the measures of pain at follow up compared to baseline.