Hypermobility Spectrum Disorder

Research and understanding of hypermobility syndromes is continuously developing, which means that the 2017 classification best describes the current state of knowledge. As further understanding is gained, some aspects of the classification may change. 

The new term 'hypermobility spectrum disorder (HSD)' will include most people who have been previously diagnosed with joint hypermobility syndrome (JHS) or benign joint hypermobility syndrome (BJHS) and some people who previously had the diagnosis of EDS type 3 (the criteria that applied to EDS 3 have been replaced by the 2017 hEDS criteria which are much more specific and can be seen here). However, the HSD criteria were created as a research criteria rather than diagnostic criteria, have not yet been validated, and work to make the criteria applicable to children is ongoing. As a result, some professionals continue to use the diagnosis of joint hypermobility syndrome (JHS).

It’s important not to over-medicalise hypermobility or create unnecessary fear as around 10% of the population is hypermobile - but most have no symptoms.

HSD can only be diagnosed when other conditions have been excluded, eg EDS, Marfans or Downs syndrome, where joint laxity is part of the condition.

There are four subtypes of HSD and an additional classification of asymptomatic hypermobility, but patients can move between these to reflect how they are affected.

This section focuses on the diagnosis of a hypermobility spectrum disorder. Our ‘Living with hypermobility’ section contains management advice based on presenting symptoms.

It should be noted that patients with HSD require the same validation and symptom-based management as individuals with hEDS. This also protects the few individuals diagnosed as having an HSD who may later turn out to have a connective tissue disorder.