Hypermobility is a common obsevation in our clinics and is often associated with persisting pain, stress and anxiety. Increasingly neuroscience studies are linking body, brain and mind to highlight the fact that we must address all these dimensions within a contemporary treatment and training programme. In particular, we know that there is a strong association between those who are hypermobile (see here for the Brighton classification) and panic disorder – see here.
‘the most significant and important association between joint hypermobility syndrome (JHS) and any other disorder from a clinical point of view is with panic disorder’ Garcia-Campayo et al. (2011) – see here
Last year a study by Eccles et al. (2012) described hypermobility as a ‘multisystem phenotype’:
Br J Psychiatry. 2012 Jun;200(6):508-9.
Brain structure and joint hypermobility: relevance to the expression of psychiatric symptoms.
Eccles JA, Beacher FD, Gray MA, Jones CL, Minati L, Harrison NA, Critchley HD.
Joint hypermobility is overrepresented among people with anxiety and can be associated with abnormal autonomic reactivity. We tested for associations between regional cerebral grey matter and hypermobility in 72 healthy volunteers using voxel-based morphometry of structural brain scans. Strikingly, bilateral amygdala volume distinguished those with from those without hypermobility. The hypermobility group scored higher for interoceptive sensitivity yet were not significantly more anxious. Our findings specifically link hypermobility to the structural integrity of a brain centre implicated in normal and abnormal emotions and physiological responses. Our observations endorse hypermobility as a multisystem phenotype and suggest potential mechanisms mediating clinical vulnerability to neuropsychiatric symptoms.
Tying together specialties with science is a vital step forward and one that we embrace at Specialist Pain Physio Clinics. In particular, joining the dots from neurology to rheumatology to psychiatry to gastroenterology to gynaecology is one of our main aims as there are underpinning changes in the neuroimmune system that present as a range of functional pains that are seemingly different complaints yet all feature central sensitisation. Therefore we can target the sources for more effective outcomes, pointing the individual’s compass towards wellness and life satisfaction.
Learn to deal with your anxiety with mindfulness based stress reduction, movement, exercise & positive emotion – Specialist Pain Physio treatment, training & coaching
People who are hypermobile who also decsribe a range of funtional pains (e.g. IBS, fibromyalgia, TMJ pain, migraine, pelvic pain) along with anxiety, panic and depression (not necessarily all of these problems) certainly require a comprehensive approach: for example, strategies to deal with the pain and symptoms, training to improve body awareness and normal movement, techniques to tackle negative thinking, anxiety and emotions as well as those that develop positive emotions and accomplishment, ways to enhance performance and ultimately to improve quality of life.
Contact us to make an appointment and see how you can move forward: 07932 689081