Hypermobility And Autism Spectrum

June 21, 2024

Understanding Hypermobility

Hypermobility refers to an exaggerated increase in the range of mobility in a joint. It is a condition that can affect individuals of all ages and genders. Understanding the definition and causes of hypermobility is essential to better comprehend its association with autism.

Definition of Hypermobility

Joint hypermobility (JH) is characterized by an excessive range of motion in a given joint. It is estimated that JH has a prevalence between 10-30% in males and 20-40% in females, with higher rates in women than in men [1]. Hypermobility is often a congenital and hereditary trait that results from alterations in collagen synthesis, a protein that provides structure and stability to connective tissues, including joints.

Causes of Hypermobility

The primary cause of hypermobility is thought to be an alteration in collagen synthesis, affecting the integrity of ligaments and other connective tissues. Collagen-related genes are believed to play a role in the development of joint hypermobility syndrome. This syndrome is characterized by loose joints due to weak ligaments caused by defects in collagen.

Hypermobility can be influenced by various factors, including genetics. It is more commonly observed in children and young people, and it often improves as they age [3]. Further research is being conducted to gain a deeper understanding of the complex interplay between genetic factors and hypermobility.

By comprehending the definition and causes of hypermobility, we can explore its connections to other conditions such as autism. In the following sections, we will delve into the relationship between hypermobility and autism, shedding light on the research findings and shared comorbidities.

Joint Hypermobility Syndrome

Joint Hypermobility Syndrome is a condition characterized by excessive flexibility and range of motion in joints. Let's take a look at the diagnosis and treatment options for this syndrome.

Diagnosis of Joint Hypermobility

Diagnosing Joint Hypermobility Syndrome involves a comprehensive evaluation by a healthcare professional. The assessment typically includes the following:

Physical Examination: A healthcare provider will perform a physical exam to assess the range of motion in various joints. They may use the Beighton scoring system, which evaluates flexibility in specific joints, such as the fingers, wrists, elbows, and knees.
Blood Tests: Some cases of joint hypermobility may be associated with genetic conditions or other underlying disorders. Blood tests may be conducted to check for possible genetic conditions or to rule out other medical conditions that could cause joint hypermobility.

Additional tests or questionnaires, such as the five-point hypermobility questionnaire, may also be utilized to aid in the diagnosis.

Treatment for Joint Hypermobility

The primary goal of treatment for Joint Hypermobility Syndrome is to manage symptoms and improve quality of life. Treatment options may vary depending on the individual's specific needs and symptoms. Here are some common approaches:

Physical Therapies: Physical therapies play a crucial role in managing joint hypermobility. Physiotherapy, occupational therapy, and podiatry can be beneficial in improving muscle strength, stability, and overall fitness. These therapies may include exercises to strengthen the muscles around the joints, improve posture, and enhance joint stability [3].
Pain Management: Joint hypermobility can be associated with joint pain and discomfort. Over-the-counter pain relievers, such as paracetamol and anti-inflammatory drugs like ibuprofen, can help alleviate mild to moderate joint pain. However, it's important to consult with a healthcare professional before taking any medications. In some cases, stronger painkillers may be prescribed by a healthcare provider if needed [3].
Lifestyle Modifications: Making certain lifestyle adjustments can also contribute to managing joint hypermobility symptoms. This may include engaging in low-impact exercises, maintaining a healthy weight, practicing good posture, and avoiding activities that put excessive strain on the joints.

It's important to note that the treatment for Joint Hypermobility Syndrome is typically focused on symptom management rather than curing the underlying condition. Healthcare professionals work closely with individuals to develop personalized treatment plans that address their specific needs and symptoms.

Understanding the diagnosis and treatment options for Joint Hypermobility Syndrome can help individuals manage their condition effectively and improve their overall well-being. It's essential to consult with a healthcare professional for an accurate diagnosis and to develop an appropriate treatment plan based on individual needs.

Hypermobility and Genetic Conditions

In some cases, hypermobility can be associated with underlying genetic conditions. Two notable conditions linked to hypermobility are Heritable Disorders of Connective Tissue (HDCT) and Ehlers-Danlos Syndrome.

Heritable Disorders of Connective Tissue

Heritable Disorders of Connective Tissue (HDCT) is a group of rare medical conditions that can be associated with joint hypermobility syndrome. These conditions are characterized by abnormalities in the genes responsible for the production of collagen, a protein that provides strength and support to various connective tissues in the body. Weak ligaments caused by defects in collagen lead to loose joints and increased flexibility in individuals with HDCT [2].

Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) is one specific type of Heritable Disorder of Connective Tissue that is closely associated with joint hypermobility. EDS is a group of inherited connective tissue disorders characterized by joint hypermobility, stretchy skin, and fragile blood vessels. There are several subtypes of EDS, each with its own set of symptoms and genetic variations. Individuals with EDS often experience joint pain, joint dislocation, and skin that bruises easily.

To diagnose Heritable Disorders of Connective Tissue or Ehlers-Danlos Syndrome, healthcare professionals may use a combination of physical examinations, blood tests, and genetic testing to assess joint hypermobility and identify any underlying genetic abnormalities. These tests help to differentiate between joint hypermobility syndrome as a standalone condition and hypermobility associated with more complex genetic disorders.

Understanding the connection between hypermobility and genetic conditions like Heritable Disorders of Connective Tissue and Ehlers-Danlos Syndrome is important, particularly for individuals with joint hypermobility syndrome. If there are concerns about the possibility of an underlying genetic condition, it is advisable to consult with a healthcare professional for a comprehensive evaluation and appropriate management strategies.

Hypermobility and Gastrointestinal Issues

People with hypermobility may experience a range of symptoms beyond joint-related issues. Researchers have found a link between hypermobility and gastrointestinal issues, such as irritable bowel syndrome (IBS). Let's explore this connection and the dietary recommendations that may help alleviate symptoms.

Link to Irritable Bowel Syndrome

Hypermobility has been associated with an increased risk of gastrointestinal issues, including irritable bowel syndrome (IBS). IBS is a common functional gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. The exact mechanisms underlying the link between hypermobility and IBS are not yet fully understood, but it is believed to involve alterations in gut motility and sensitivity.

Research has shown a higher prevalence of IBS in individuals with hypermobile joints compared to those without hypermobility. It is important to note that not all individuals with hypermobility will develop IBS, but the risk may be higher.

Dietary Recommendations

For individuals with hypermobility and gastrointestinal issues like IBS, dietary modifications may help alleviate symptoms. While specific dietary recommendations may vary depending on individual needs and sensitivities, here are some general guidelines that may be beneficial:

Identify and avoid trigger foods: Keep a food diary to identify any specific foods that worsen your symptoms. Common triggers include spicy foods, caffeine, carbonated beverages, and high-fat foods. Eliminating or reducing the intake of these trigger foods may help improve gastrointestinal symptoms.
Fiber intake: Gradually increase your fiber intake through sources like fruits, vegetables, whole grains, and legumes. Fiber can help regulate bowel movements and alleviate constipation, a common symptom in individuals with IBS.
Low FODMAP diet: Consider trying a low FODMAP diet under the guidance of a healthcare professional or registered dietitian. FODMAPs are certain types of carbohydrates that can trigger symptoms in individuals with IBS. This diet involves temporarily eliminating high FODMAP foods, then gradually reintroducing them to identify specific triggers.
Hydration: Drink an adequate amount of water throughout the day to maintain proper hydration. Staying hydrated can help soften stools and ease bowel movements.
Stress management: Stress and anxiety can exacerbate gastrointestinal symptoms. Incorporate stress management techniques such as relaxation exercises, meditation, and regular physical activity into your routine.

It's important to consult with a healthcare professional or registered dietitian before making any significant dietary changes. They can provide personalized guidance based on your specific needs and help you develop a suitable dietary plan.

By understanding the link between hypermobility and gastrointestinal issues, and implementing appropriate dietary modifications, individuals with hypermobility and related conditions like IBS can potentially find relief from their symptoms.

Hypermobility in Children and Young People

When it comes to hypermobility, it is important to understand its prevalence and age factors, especially in children and young people. Hypermobile joints, also known as joint hypermobility, refer to an exaggerated increase in the range of motion of a joint. The prevalence of hypermobility is estimated to be between 10-30% in males and 20-40% in females. Let's explore the prevalence and age factors associated with hypermobility in children and young people.

Prevalence and Age Factors

Hypermobility syndrome is most common in children and young people. It has been observed that people assigned female at birth (AFAB) and individuals of Asian and Afro-Caribbean descent are more likely to be affected by hypermobility syndrome [2]. The exact reasons for these prevalence differences are still being studied. However, it is important to note that hypermobility can affect individuals of any gender and ethnicity.

Improvement with Age

One positive aspect of hypermobility in children and young people is that it often improves as they get older. As children grow, their ligaments and muscles tend to strengthen, providing better support to the joints. This improvement with age is a reassuring factor for parents and caregivers.

It is worth mentioning that hypermobility can be associated with other conditions, such as Ehlers-Danlos syndrome, which is a group of connective tissue disorders. If you suspect your child may have hypermobility or related concerns, consulting a healthcare professional, such as a pediatrician or rheumatologist, can provide a proper diagnosis and guidance.

Understanding the prevalence and age factors of hypermobility in children and young people is essential for parents and caregivers. Monitoring your child's joint mobility and seeking medical advice if you have concerns can help ensure their overall well-being. It is important to remember that hypermobility is a spectrum, and each individual's experience may vary.

Hypermobility and Autism Link

Research has shown a significant link between hypermobility and autism spectrum disorder (ASD), shedding light on the potential comorbidity between these two conditions. Understanding this connection can help parents navigate the challenges and seek appropriate support for their children.

Research Findings

Multiple studies have demonstrated a strong association between hypermobility and ASD. A study conducted in Sweden involving 199 individuals with ASD and 419 non-ASD community controls revealed a significant relationship between ASD and generalised joint hypermobility (GJH). Adjusted odds ratios of 3.1 were reported for GJH and 4.9 for symptomatic GJH, indicating a higher prevalence of hypermobility in individuals with ASD compared to those without ASD.

The prevalence rates of GJH, as measured by the Beighton Scoring System, were also found to be higher among individuals with ASD. In the same study, rates of 44.7% for females and 21.6% for males were observed for participants with ASD. These findings emphasize the importance of recognizing and addressing hypermobility in individuals on the autism spectrum.

Shared Comorbidities

In addition to the research findings, it's important to consider the shared comorbidities between hypermobility and ASD. Individuals with hypermobile ASD have been found to have higher rates of autoimmune disorders, dysmenorrhea, endometriosis, arthralgia, and other types of chronic pain compared to non-hypermobile individuals with ASD. Arthralgia, or joint pain, was reported by all participants in the hypermobile ASD group, with 75% experiencing other types of chronic pain, including fibromyalgia.

Understanding these shared comorbidities is crucial for providing holistic care to individuals with ASD who also experience hypermobility. It highlights the need for a multidisciplinary approach, involving healthcare professionals from various specialties, to address both the physical and neurodevelopmental aspects of these conditions. By addressing hypermobility alongside other aspects of ASD, individuals can receive more comprehensive support and management.

As a parent of a child with ASD, it is important to stay informed about the potential links between hypermobility and autism. If you suspect hypermobility in your child, consult with a healthcare professional who can provide a thorough evaluation and appropriate guidance. Early recognition and intervention can lead to better outcomes and improved quality of life for individuals with both ASD and hypermobility.

For more information on autism-related topics, feel free to explore our articles on functional behavior analysis, the overlap between autism and ADHD, medication options like Abilify, and more.