Tuesday, July 24, 2012

Benign Joint Hypermobility Syndrome (BJHS) and Fibromyalgia

Hypermobility of joints is seen quite often, and it needn´t always be called a disease, but in any case it describes a better than normal mobility of joints like putting legs behind the head, bending thumbs backwards to the wrists, or other features. People with hypermobility like doing yoga, gymnastics, and more, where they can use their hypermobile joints. These aren´t the people, we are concerned with here. People suffering from benign joint hypermobility syndrome complain about joint or muscle pain, with daytime pain, discomfort after exercise, or awakening during nighttime. Some symptoms are like fibromyalgia.
I´ve attended several lectures and sessions with Professor Rodney Grahame from London. He introduced me to the criteria used to diagnose BJHS, which are also know as the Brighton Criteria. The Brighton Criteria include a set of scoring hypermobile joints, known as the Beighton Score: little fingers bending backward past 90°, thumbs touching the forearm, elbow bending backward, knee bending backward, and placing flat hands on the floor with straight legs. Highest score is 9/9.
The Brighton Criteria differentiate between major and minor criteria. “The BJHS is diagnosed in the presence two major criteria, or one major and two minor criteria, or four minor criteria. Two minor criteria will suffice where there is an unequivocally affected first-degree relative.” “BJHS is excluded by presence of Marfan or Ehlers-Danlos syndromes (other than the EDS Hypermobility type (formerly EDS III) as defined by the Ghent 1996 (8) and the Villefranche 1998 (9) criteria respectively).”
With arthralgia, back pain, epicondylitis we come to the vicinity of fibromyalgia. Though both diseases can be distinguished, they might be coexistant in an individual. I have diagnosed both diseases in a few patients, with needs special consideration concerning therapy.
A basic therapeutic principle is to exercise as strong muscles help to stabilise joints; walking, skating, cycling, swimming can be recommended. Trying to avoid overstretching helps, too. Medication is´t ussually necessary. There are lots of tips on the Hypermobility self help page: http://www.hypermobility.org/  

If you suffer from both the benign joint hypermobility syndrome (BJHS) and fibromyalgia syndrome, see that both are diagnosed correctly. Both need to be addressed seperately, when it comes to treatment recommendations, though some may be exactly the same.

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