Joint Instability Syndrome: A Case Study
Pain is one of the most common features of EDS, particularly in the hypermobile and classical types (Voermans N.C. 20110 / Shirley E.D. 2012). In EDS-H/JHS, it presents with neuromusculoskeletal signs and symptoms (interactions between nerves, muscles and the skeleton), and, unusually, it is pain without the inflammatory component of other rheumatological diseases. (Hakim A.J. XXX). It can be experienced both as a result of acute injuries (dislocations, tendonitis etc.) and in the form of chronic pain (now frequently referred to as ‘persistent’ pain). As is the case with many other symptoms of EDS-H / JHS, pain rarely fits neatly into a single category. For many, it is a combination of both ‘chronic‘ pain and ‘acute‘ pain, and is, perhaps,
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Stanitski D.F. et al report joint pain in 88% of patients and Voermans N.C. et al in 90%, with functional impairment affecting 87%.
‘It often starts as occasional/recurrent joint pain facilitated/triggered by joint instability, dislocations and sprains, but subsequently it becomes diverse in character, frequently manifesting in the form of widespread myalgias and arthralgias and often with neuropathic features’ (Castori M. 2012).
Unfortunately, at the moment, the causes of pain
(other than that arising as an initial acute response to injuries such as dislocation), are not fully understood by experts, leading to much misunderstanding in the medical community and often leaving patients feeling isolated and confused (Tinkle B. 2010 / Berglund. S 2000). It is likely, however, that it is caused by a Y combination of excessive movement increasing stress on joint surfaces, ligaments and neighbouring structures (Simpson M.R. 2006) and a complex mixture of nociceptive, neuropathic, myofascial, and osteoarthritic pain
Stanitski D.F. et al report joint pain in 88% of patients and Voermans N.C. et al in 90%, with functional impairment affecting 87%.
‘It often starts as occasional/recurrent joint pain facilitated/triggered by joint instability, dislocations and sprains, but subsequently it becomes diverse in character, frequently manifesting in the form of widespread myalgias and arthralgias and often with neuropathic features’ (Castori M. 2012).
Unfortunately, at the moment, the causes of pain
(other than that arising as an initial acute response to injuries such as dislocation), are not fully understood by experts, leading to much misunderstanding in the medical community and often leaving patients feeling isolated and confused (Tinkle B. 2010 / Berglund. S 2000). It is likely, however, that it is caused by a Y combination of excessive movement increasing stress on joint surfaces, ligaments and neighbouring structures (Simpson M.R. 2006) and a complex mixture of nociceptive, neuropathic, myofascial, and osteoarthritic pain