Prolotherapy and joint hypermobility

Joint hypermobility occurs in approximately 10 to 20 percent of the population in Western countries and has a higher rate in Indian, Chinese and Middle Eastern populations.

by Dr. Fred G. Arnold — 

Hypermobile joints are sometimes referred to as loose joints, and those who have them are labeled “double jointed.” Hypermobility of a joint can be entertaining when we see nimble performers at Cirque Du Soleil contort their bodies in strange and awkward ways. However, for some individuals, hypermobility is a very painful and serious condition.

Joint hypermobility — Joint hypermobility occurs in approximately 10 to 20 percent of the population in Western countries and has a higher rate in Indian, Chinese and Middle Eastern populations. These are people who are hypermobile without pain symptoms.

Those people with painful symptoms attributable to their hypermobility may have joint hypermobility syndrome (JHS) or Ehlers-Danlos Syndrome (EDS), which are genetic disorders of connective tissue characterized by joint laxity and hypermobility. Both conditions affect collagen synthesis involving the joints and almost every bodily system.

Collagen is the tissue that helps to form strong tendons, ligaments, muscles, bones, cartilage, menisci, blood vessels and even the skin. Many JHS patients present with signs and symptoms suggestive of fibromyalgia and, thus, they are frequently misdiagnosed. The Brighton criteria, which involves objective measurement of the hyperextensibility of various joints, is effectively used as a diagnostic tool.

Joint pain is the major presenting complaint of JHS and EDS, and if the hypermobility is not treated, joint dislocations, degeneration of the joint and degenerative joint disease can occur. Other conditions associated with hypermobile joints include rotator cuff injuries, recurrent sprains and strains, scoliosis, neck and back injuries due to soft tissue injury, disc herniation, TMJ syndrome and flat feet.

Many hypermobile patients also experience muscle pain, which may be explained by the extra stress placed on muscles as they compensate for lax joints in an attempt to stabilize them. The traditional treatments for joint hypermobility include education/lifestyle advice, behavior modification, physical therapy, taping and bracing, and pain medication. While these treatments may offer a reduction in pain symptoms, they do not address the cause of the problem and do little to curb the progressive debilitation of the disease.

If joint mobility becomes severe enough, some individuals seek surgical intervention. Studies have shown suboptimal results in the hypermobile patients, compared to the normal population. In general, traditional medical treatments are limited to temporary symptom relief.

Prolotherapy and joint hypermobility — Prolotherapy has great success in treating joint injuries, including joint hypermobility. It is designed to treat and strengthen joint laxity that accompanies JHS and EDS. Prolotherapy causes a brief, localized inflammatory response to the weakened joint and stimulates the formation of new collagen, which improves strength and the ability to handle strain and force on the joint. High-resolution ultrasounds and MRIs have confirmed that prolotherapy does stimulate tissue growth.

Summary — The best approach for weakened, hypermobile joints is to directly address the root of the disability, stimulate the repair of the connective tissues, such as ligaments and joint capsules, and stabilize the affected joints.

Prolotherapy should always be considered when other treatments have been unsuccessful and especially when surgery has been recommended. It can provide relief, help slow down the degenerative changes associated with hypermobile joints, prevent joint surgeries and treat painful hypermobile joints without the negative effects of pain medications.

Reference — Journal of Prolotherapy. 2011;3(2):612-629.

Fred G. Arnold, D.C., N.M.D., specializes in prolotherapy/pain rehabilitation services. He is a Diplomate of the American Academy Health Care Providers and one of the few physicians in the nation with both naturopathic and chiropractic degrees. www.prolotherapyphoenix.com, www.phoenixpainrehabilitation.com or 602-292-2978.

Reprinted from AzNetNews, Volume 31, Number 6, December 2012/January 2013.