Hypermobility Syndrome: What Is It and Why Does It Cause Pain?
Hypermobility syndrome is a condition in which your joints move beyond the normal range. It is caused by looser connective tissue, which is often inherited. Many people have no symptoms at all. For others, it leads to joint pain, fatigue and repeated injuries. Whole-body standing imaging can show how hypermobile joints affect your overall alignment.
Key takeaways
- Hypermobility means your joints bend further than usual because your connective tissue is more elastic.
- It is common and affects up to one in five adults, but only some develop pain or other symptoms.
- Pain often appears in areas that make up for unstable joints elsewhere in the body.
- Lying-down scans can miss alignment problems that only show when you are standing and bearing weight.
- ScanAlign's EOS imaging captures your full skeleton while you stand upright, helping clinicians see the bigger picture.
If you have ever been told you are "double-jointed", you may have generalised joint hypermobility. For many adults this is completely harmless. But when loose joints start to cause persistent pain, frequent sprains or fatigue, it may be classed as hypermobility syndrome. This is sometimes called hypermobility spectrum disorder.
The tricky part is this: the pain you feel often shows up far from the joint that is actually too flexible. Your body is a connected chain. When one link is loose, other areas tighten up to make up for it. That is why standard scans of a single painful area can come back looking normal, and you are left without answers.
What are the signs of hypermobility syndrome in adults?
The most common signs are widespread joint pain, easy bruising, frequent soft-tissue injuries and fatigue that does not get better with rest. Symptoms vary widely from person to person.
Pain in several joints, often worse after activity or at the end of the day.
Joints that "give way" or roll easily, sometimes from very small movements.
Persistent tiredness because your muscles work harder to keep loose joints stable.
Muscles tighten to protect unstable parts of the spine, causing stiffness and headaches.
You might also notice clicking joints, poor balance or a feeling that your body is working harder than it should just to stay upright. These are all common in adults with hypermobility syndrome.
A note on numbness, weakness or bladder and bowel changes: If you have sudden numbness, weakness in your legs, or any loss of bladder or bowel control, please get urgent medical help from your doctor or your nearest emergency department. These are not typical signs of hypermobility and need to be checked straight away.
What causes hypermobility syndrome?
Hypermobility syndrome is usually caused by inherited differences in collagen, the protein that gives structure to ligaments, tendons and other connective tissue. If your collagen is more elastic than usual, your joints naturally move further.
It often runs in families. You do not need a specific gene test to be diagnosed. A doctor or physiotherapist can check your joint range along with your symptoms and medical history.
Other factors can make symptoms worse over time. Weak core muscles, poor posture habits and desk-based work all reduce the muscle support your joints rely on. This makes pain and instability more noticeable.
How does hypermobility affect your whole-body alignment?
Under your body weight, hypermobile joints often shift slightly out of their ideal position. Your muscles then make up for it, tightening in some areas and weakening in others. This creates a chain reaction through your skeleton.
For example, if your hips are slightly loose, your lower back may curve more to stay stable. Your upper back then rounds forward to balance, and your neck tips backward. The pain you feel in your neck or upper back may actually be driven by instability much lower down.
This is why looking at just one area, such as a single knee or one section of your spine, can miss the full picture. Your body works as a whole, and hypermobility affects it as a whole.
How does a standing EOS scan help with hypermobility syndrome diagnosis?
A standing EOS scan captures your full skeleton, from head to feet, in one image while you are upright and bearing weight. It shows how your joints actually sit under gravity, which lying-down imaging cannot show.
When you lie down for a standard X-ray, CT or MRI, your muscles relax and your joints settle into a resting position. For someone with hypermobility, this can hide the very shifts and compensations that cause pain in daily life. A standing scan shows your skeleton as it truly works.
The EOS system also uses about 90% less radiation than a standard X-ray, around ten times less. This makes it a practical option if you need follow-up imaging over time.
Want to understand how your alignment is affected? A free video consultation, from your own home, can help you decide whether a standing scan in London is the right next step.
Book a free video consultationWhen MRI may be more helpful: EOS is excellent for bones, joints and overall alignment. But if your clinician suspects soft-tissue damage, disc problems or nerve involvement, MRI is usually the better tool. The two scans complement each other well.
What support is available for hypermobility syndrome in adults?
Management usually centres on strengthening the muscles around your joints, so they give the stability your ligaments cannot. Physiotherapy, tailored exercise and pacing your activity levels are the main approaches recommended by the NHS in the UK and by rheumatology specialists.
ScanAlign does not provide treatment. It is a diagnostic imaging clinic. What it does provide is a detailed picture of your alignment. This helps your physiotherapist, osteopath or consultant plan the right programme for you. When your clinician can see exactly where your skeleton shifts under load, they can target their work far more precisely.
Many adults with hypermobility syndrome also ask whether it counts as a disability. The answer depends on how much it affects your daily life. Some people with significant symptoms may be eligible for workplace adjustments or disability support. Your doctor or a specialist can advise on this.
Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
You can learn more about how full-body alignment imaging works on our EOS scan overview page.
Frequently asked questions about hypermobility syndrome
Hypermobility syndrome is a condition in which your joints move beyond the normal range because of looser connective tissue. It can cause joint pain, fatigue and repeated injuries in some adults, though many hypermobile people have no symptoms at all.
They overlap a great deal. Hypermobility spectrum disorder is a newer term that covers a range of symptoms linked to joint hypermobility. Both describe the same basic problem: joints that move too far, with symptoms that vary from mild to significant.
A doctor or physiotherapist checks your joint flexibility using a standard scoring system, along with your history of symptoms. Blood tests or genetic tests are not usually needed. Imaging such as an EOS scan can then show how hypermobility affects your overall alignment.
Hypermobility itself is usually present from birth, though you may not notice symptoms until adulthood. Changes in activity level, muscle strength or hormones can make existing hypermobility cause more symptoms over time.
It depends on how it affects your daily life. If your symptoms significantly limit your ability to carry out normal activities, you may qualify for workplace adjustments or disability support. Speak to your doctor for advice on your own situation.
When you lie down, gravity is removed and your muscles relax. Loose joints settle into a resting position that can look normal on the scan. Standing imaging captures your skeleton under your full body weight, showing the shifts and compensations that actually cause your symptoms.
An EOS scan uses about 90% less radiation than a standard X-ray, around ten times less. This makes it a practical choice, especially if follow-up scans are needed over time.
No. ScanAlign is a private self-pay clinic and you can refer yourself. You start with a free video consultation to discuss your symptoms and confirm whether a scan is suitable for you.
For patients travelling from abroad, the price is confirmed during the free video consultation. You can find details about what is included on our FAQs and cost page.
An EOS scan does not diagnose hypermobility syndrome directly. Diagnosis is based on a clinical assessment of your joint flexibility and symptoms. What the EOS scan does is show how hypermobility affects your skeletal alignment. This gives your clinician valuable information for planning your care.
See how your whole body lines up
A free video consultation helps you understand whether standing whole-body imaging in London is the right next step for your hypermobility symptoms.
Book a free video consultationRelated pages
Sources
- NHS. "Joint hypermobility." nhs.uk. Accessed 2024.
- Castori M, et al. "A framework for the classification of joint hypermobility and related conditions." American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 2017;175(1):148-157.
- The Ehlers-Danlos Society. "What is HSD?" ehlers-danlos.com. Accessed 2024.
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.