Treating joint hypermobility

Treatment is not necessary if you have joint hypermobility that does not cause any symptoms.

However, you may need treatment if you have joint hypermobility syndrome, which causes symptoms such as joint pain.

Depending on your symptoms of joint hypermobility, your condition may be treated by a number of healthcare professionals including:

• your GP 
• a rheumatologist – a specialist in conditions that affect muscles and joints
• a physiotherapist – a healthcare professional using physical methods, such as massage and manipulation, to promote healing and wellbeing
• an occupational therapist – a healthcare professional who can identify potential problem areas in everyday life, such as getting dressed, and work out practical solutions
• a podiatrist – a footcare specialist

If you have any related conditions, such as flat feet or varicose veins, you can use the Heath A-Z index to find information about how they will be treated.

Physiotherapy and exercise

Physiotherapy, often referred to as physio, can help people with hypermobile joints in a number of ways. For example, physiotherapy may be used to:

• reduce pain
• improve muscle strength and fitness
• improve posture
• improve your sense of your body’s position and movement (proprioception)
• correct the movement of individual joints

A physiotherapist with knowledge about joint hypermobility syndrome can be very useful as some physiotherapy treatments can make symptoms worse.

There are a range of physiotherapy techniques that can be used. For example, you may be given an exercise programme that includes strength and balance training, special stretching techniques and advice about pacing.

Pacing involves balancing periods of activity with periods of rest. It means not overdoing it or pushing yourself beyond your limits because if you do, it could slow your long-term progress. Read more about physiotherapy and the different techniques used.

The Hypermobility Syndrome Association also provides useful advice about pain management through stretching, relaxing the muscles and doing gentle exercises.

One recent study of physiotherapy in children with joint hypermobility syndrome found that a general programme to improve muscle strength and fitness was just as effective as a programme aimed at specific joints. Both groups of children in the study experienced significantly reduced pain. 

Occupational therapy

Occupational therapy aims to promote people’s health and wellbeing through their everyday activities. If you have joint hypermobility syndrome, an occupational therapist can help adapt your home and way of life around your condition.

Occupational therapy can be particularly useful in helping children with joint hypermobility syndrome who have problems with handwriting.

By using techniques to help improve your ability, or by changing the environment or equipment you are using, an occupational therapist can help you regain or improve your independence. For example:

• bed rails can be fitted to help you get in and out of bed
• toilet seats can be raised
• small pieces of equipment can be used to help with dressing

Read more about the types of treatments available through occupational therapy.

Podiatry

Flat feet, where the inner part of the feet (the arches) are flattened, are frequently associated with hypermobility. This is because the foot arches collapse under your body weight due to the ligaments (bands of connective tissue) on the bottom of your feet being too loose.

Repositioning your foot arches by wearing insoles may help reduce knee and ankle pain. Read more about flat feet.

Painkillers

Medication can also be used to treat pain associated with joint hypermobility syndrome.

Painkillers, such as paracetamol, available over the counter from pharmacies, can be used. You may also be prescribed a medicine that contains both paracetamol and codeine, which is a stronger type of painkiller. Calpol is particularly helpful for children with joint hypermobility syndrome.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to relieve any swelling of the joint.

Painkillers and NSAIDs are also available in the form of gels or sprays that can be applied directly onto painful joints.

Check the patient information leaflet that comes with your medication to make sure it is suitable for you. For example, ibuprofen should be used with caution in people with:

• asthma – where the airways of the lungs become inflamed (swollen) 
• kidney problems 
• liver problems

Some people with joint hypermobility syndrome may find pain medication is not effective.

For example, there have been reports of local anaesthetic used during a surgical procedure not having an effect in people with joint hypermobility syndrome. If you are having a procedure that requires anaesthesia, such as dental treatment, you may want to discuss the issue with your dentist beforehand. 

Pain management

If painkillers are not effective in reducing your pain, you may benefit from being referred to a pain specialist at a pain clinic. Staff at the clinic will be able to provide further advice and treatment.

For example, a pain management programme that incorporates cognitive behavioural therapy (CBT) is one way that people with joint hypermobilty syndrome can learn to manage their pain when painkillers are not working.

Read more about NHS help for people with pain.

Surgery

Surgery is not recommended for joint hypermobility (where alternative non-surgical treatment is available) because joint tissue does not heal well and it can lead to osteoarthritis (arthritis that affects the cartilage within the joint).

The exception to this is in cases where there is a ruptured (split) tendon, which should be repaired surgically. Tendons are the tough, rubbery cords that link muscles to bones.