The association of soft-tissue rheumatism & hypermobility

Soft-tissue rheumatism (STR–tendinitis, bursitis, fasciitis and
fibromyalgia) accounts for up to 25% of referrals to
rheumatologists. The estimated prevalence of generalized
hypermobility in the adult population is 5-15%. There have
previously been suggestions that hypermobile individuals may
be predisposed to soft-tissue trauma and subsequent
musculoskeletal pain. This study was designed to examine the
mobility status and physical activity level in consecutive
rheumatology clinic attendees with a primary diagnosis of STR.
Of 82 patients up to age 70 yr with STR, 29 (35%) met criteria
for generalized hypermobility. Hypermobile compared to
non-hypermobile individuals reported significantly more
previous episodes of STR (90% vs 51%, P < 0.01), and more
recurrent episodes of STR at a single site (69% vs 38%, P <
0.001). Although we were unable to show any difference in the
time spent carrying out physical activity between the two
groups, the hypermobile patients were performing significantly
more repetitive activities. When specific anatomical sites of
STR were analysed, small joints (elbows, hands and feet)
currently affected with STR were more likely to show localized
hypermobility than if those joints were asymptomatic. These
findings suggest that hypermobility may be a factor in the
development of STR. Repetitive activity may be a contributing
factor towards STR in some hypermobile individuals.

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