Re: Joint Hypermobility

[Guest guest]

Hi,

I wonder if this is an effect of oxalate. Cartilage is made up a lot of

molecules called glycosaminoglycans that have a lot of sulfate in them that

binds minerals like calcium and sodium, but their structure is hurt when

those ions are stripped from them. Oxalate may strip the minerals. This

has been noticed in mucus membranes, but I don't know if there is research

looking at cartilage.

I found myself popping when my diet has been high in oxalate, but not when

it is low in oxalate. That's why I've searched for an explanation. I am

at conferences a lot, and hotels tend to serve lots of high oxalate food,

especially those " field green " salads. I would find after about a week

eating that sort of food that you could hear my ankles cracking down those

long hotel hallways, and it was embarrassing!

Some who go low oxalate find that it helps with pain, too. I used to get

the pain and the popping and snapping at the same time, but I wouldn't say

I have fibromyalgia, but my daughter definitely does. She cracks and pops

a lot in her joints like in her neck and is TRYING to do better reducing

oxalates, but it is hard for a teenager to do that. But she is generally

more " stiff " than " loose " . If she bends over to touch her toes, she cannot

get within a foot of the floor, and she is sixteen...

If you want to know what a low oxalate diet entails, look at

lowoxalate.info. I run an internet list for supporting this diet which I

started to help children with autism, but there are MANY conditions where

oxalates aggravate things and all are welcome on our listserve.

At 05:31 AM 4/9/2008, you wrote:

>I was diagnosed with Fibromyalgia a few years ago. All 18 point test!

>

>The Specialist said " Joint looseness " is another symtom.

>

>Anybody know what they do to treat loose joints? My wrists pop and

>snap, my ankles are constantly moving and popping.

>

>But yet, nobody knows what to do!!

>

>Wondering.....

>

>

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[Guest guest]

Hi,

I just thought some of you might enjoy reading the literature on the

association of hypermobility to fibromyalgia. This clearly only effects a

subgroup, and it isn't all that large, but it may be important to

understand that subgroup, because different things might be helpful to

treat the fibromyalgia when it is associated with hypermobility. Those of

you with this condition would probably do well to compare what has helped

you, I would think!

1: Clin Rheumatol. 2007 Apr;26(4):485-7. Epub 2006 Apr 25.

The frequency of hypermobility and its relationship with clinical findings of

fibromyalgia patients.

Sendur OF, Gurer G, Bozbas GT.

Department of Physical Medicine and Rehabilitation, Adnan Menderes University

Medical School Hospital, Aydin 09100, Turkey.

The etiology and pathogenic mechanisms of fibromyalgia (FM) are unknown. A

number

of studies have suggested that there was a link between hypermobility and

FM. In

this study, we aimed to expose the frequency of hypermobility in FM

patients and

its relation with clinical findings. For this reason, 236 women (118 FM

women as

study group and 118 healthy women as control group) were enrolled in the study.

Joint hypermobility was evaluated in the participants by using Beighton scoring

system. The rate of joint hypermobility among FM patients (Beighton score of at

least 4 or more) was found to be higher than the control group (46.6 vs 28.8%).

This result was also statistically meaningful (p<0.05). In addition, the mean

Beighton score of FM group was observed to be higher than the control (3.68 vs

2.55, p<0.001). Although not reaching statistical difference (p>0.05), more

severe clinical findings were observed in FM patients with hypermobility when

compared with ones without.

PMID: 16636935 [PubMed - indexed for MEDLINE]

2: Clin Rheumatol. 2006 May;25(3):291-3. Epub 2005 Oct 16.

Hypermobility in women with fibromyalgia syndrome.

Ofluoglu D, Gunduz OH, Kul-Panza E, Guven Z.

Department of Physical Medicine and Rehabilitation, School of Medicine, Marmara

University, Istanbul, Turkey. dofluoglu@...

The purpose of this study was to evaluate the relationship between

hypermobility

and fibromyalgia syndrome (FS) in women. Ninety-three women with FS who met the

American College of Rheumatology criteria for FS and 58 healthy women

without FS

were included in this study. All women were examined for hypermobility by

blinded

observers using the Beighton criteria. The mean age was 43.5+/-9.9 (21-68) and

40.2+/-11.1 (21-63) years in the FS and control groups, respectively, and

the two

groups were statistically similar (p>0.05). The mean Beighton total score was

4.7+/-2.1 and 2.9+/-2.4 in the FS and control groups, respectively (p<0.0001).

The frequency of joint hypermobility was 64.2% in the FS group and 22% in the

control group. In accordance with the Beighton criteria (p<0.05), we found that

the joint hypermobility ratio was significantly higher in patients with FS than

in subjects without FS. Additionally, we evaluated the correlation between the

total Beighton score and the age and number of trigger points. There were

negative correlations between the total Beighton score and the age (r=-0.42,

p<0.001) and number of trigger points (r=-0.24, p=0.03) in all patients.

Hypermobility syndrome is more common in women with FS than in those in the

control group. Therefore, the relationship between hypermobility and FS

should be

taken into consideration in the diagnosis and follow-up of women, especially

those with widespread pain.

PMID: 16228925 [PubMed - indexed for MEDLINE]

3: Clin Exp Rheumatol. 2004 Jul-Aug;22(4 Suppl 34):79.

Hypermobility and fibromyalgia frequency in childhood familial Mediterranean

fever.

Kasapçopur O, Tengirsek M, Ercan G, Yologlu N, Caliskan S, Sever L, Arisoy N.

Publication Types:

Letter

PMID: 15515793 [PubMed - indexed for MEDLINE]

4: J Rheumatol. 2002 Feb;29(2):396-8.

Is hypermobility a factor in fibromyalgia?

Holman AJ.

Publication Types:

Letter

PMID: 11838864 [PubMed - indexed for MEDLINE]

5: J Rheumatol. 2001 Apr;28(4):920-1.

Comment on:

J Rheumatol. 2000 Jul;27(7):1585-6. J Rheumatol. 2000

Jul;27(7):1587-9. J Rheumatol. 2000 Jul;27(7):1774-6. J Rheumatol.

2000 Jul;27(7):1777-9.

Fibromyalgia and hypermobility.

Goldman JA.

Publication Types:

Comment

Letter

PMID: 11327279 [PubMed - indexed for MEDLINE]

6: J Rheumatol. 2000 Jul;27(7):1774-6.

Comment in:

J Rheumatol. 2000 Jul;27(7):1587-9. J Rheumatol. 2001 Apr;28(4):920-1.

Joint hypermobility and primary fibromyalgia: a clinical enigma.

Karaaslan Y, Haznedaroglu S, Oztürk M.

Department of Rheumatology, Fatih University School of Medicine, Ankara,

Turkey.

OBJECTIVE: To investigate the association of joint hypermobility (JH) and

primary

fibromyalgia (FM). METHODS: Eighty-eight patients admitted with widespread pain

and 90 matched healthy controls were blindly evaluated according to

criteria for

the presence of JH and FM. RESULTS: Fifty-six patients initially recognized as

having FM met the American College of Rheumatology (ACR) diagnostic

criteria for

FM and 6 of 90 healthy controls had these criteria at the subsequent blinded

examination. The frequency of JH was 8% in patients with FM and 6% in subjects

without FM (p > 0.05). Interestingly, JH was found in 10 of 32 " FM " patients

(31%) who had not exactly met the ACR criteria for FM. The occurrence of JH was

more common in these patients compared to controls (p < 0.001). In total,

16% of

patients evaluated with widespread pain had associated with JH. CONCLUSION:

Some

patients who have clinical symptoms of FM but do not exactly meet the ACR

criteria could in fact have JH, and these patients may be misdiagnosed as

having

FM. Widespread pain is associated with JH in women under age 50, with some of

them fulfilling ACR tender point criteria for FM.

PMID: 10914866 [PubMed - indexed for MEDLINE]

7: J Rheumatol. 2000 Jul;27(7):1587-9.

Comment in:

J Rheumatol. 2001 Apr;28(4):920-1.

Comment on:

J Rheumatol. 2000 Jul;27(7):1774-6.

Is hypermobility a factor in fibromyalgia?

Fitzcharles MA.

Publication Types:

Comment

Editorial

Review

PMID: 10914836 [PubMed - indexed for MEDLINE]

8: Joint Bone Spine. 2000;67(3):157-63.

Pain, distress and joint hyperlaxity.

Grahame R.

Hypermobility clinic, Rheumatology centre, UCL hospitals, London, UK.

Pain dominates the lives of many patients with hyperlaxity syndromes, most

commonly the Benign Joint Hypermobility Syndrome (BJHS/EDS). As a result

they may

experience psychosocial problems, which in many cases severely affects their

healthy functioning. Above all is the overriding chronic pain in joints,

muscles

and ligaments, which arises from an inherent predisposition to the effects of

everyday trauma, but other factors such as associated osteoarthritis or

fibromyalgia are also important. There may also be neurophysiological

factors at

play producing nociceptive enhancement. Pain and distress of visceral

origin can

result from laxity of connective tissue within or providing support for the

abdominal, thoracic or pelvic viscera leading to hernia, uterine and/or rectal

prolapse, mitral valve prolapse or spontaneous pneumothorax. In children joint

hyperlaxity is an important (and often unrecognised) source of rheumatic

symptoms, which may be ignored or erroneously ascribed to juvenile idiopathic

arthritis. The management of pain and distress in the hyperlaxity syndromes

requires skill, patience, compassion and understanding. Often the results of

conventional anti-rheumatic therapy (including anti-rheumatic drugs and

surgery)

as applied to other rheumatic diseases are disappointing and innovative

approaches are required. Amongst these, for which evidence of efficacy is

available, are physiotherapeutic and orthotic stabilisation of hyperlax joints,

proprioceptive enhancement and the newer pain management techniques including

cognitive behavioural therapy.

Publication Types:

Review

PMID: 10875311 [PubMed - indexed for MEDLINE]

9: Arthritis Care Res. 1998 Feb;11(1):39-42.

Joint hypermobility in patients with fibromyalgia syndrome.

Acasuso-Díaz M, Collantes-Estévez E.

Sant Jordi Centro Médico Reus, Tarragona, Spain.

OBJECTIVE: To test the hypothesis that joint hyperlaxity can play some role in

the pathogenesis of pain in primary fibromyalgia. METHODS: A total of 66 women

with fibromyalgia (according to the 1990 American College of Rheumatology

criteria) and 70 women with other rheumatic diseases were examined for joint

laxity based on 5 criteria (The Non-Dominant Spanish modification). Individuals

meeting 4 or 5 criteria were considered to be hyperlax. RESULTS: Joint

hyperlaxity was detected in 18 (27.3%) of the patients with fibromyalgia and 8

(11.4%) of those with another rheumatic disorder. The statistical analysis

revealed significant differences (P < 0.05) between both groups.

CONCLUSION: The

results of this study suggest that joint hypermobility and fibromyalgia are

associated. Joint hyperlaxity may play a prominent role in the pathogenesis of

pain in fibromyalgia.

PMID: 9534492 [PubMed - indexed for MEDLINE]

10: Ann Rheum Dis. 1993 Jul;52(7):494-6.

Joint hypermobility and fibromyalgia in schoolchildren.

Gedalia A, Press J, Klein M, Buskila D.

Department of Pediatrics, Louisiana State University Medical Center, New

Orleans

70112-2822.

OBJECTIVES--To test the hypothesis that joint hypermobility may play a part in

the pathogenesis of pain in fibromyalgia, schoolchildren were examined for the

coexistence of joint hypermobility and fibromyalgia. METHODS--The study group

consisted of 338 children (179 boys, 159 girls; mean age 11.5 years, range 9-15

years) from one public school in Beer-Sheva, Israel. In the assessment of joint

hypermobility, the criteria devised by and Bird were used. Any child who

met at least three of five criteria was considered to have joint hypermobility.

Children were considered to have fibromyalgia if they fulfilled the 1990

American

College of Rheumatology criteria for the diagnosis of fibromyalgia, namely,

widespread pain in combination with tenderness of 11 or more of the 18 specific

tender point sites. The blind assessments of joint hypermobility (by AG) and

fibromyalgia (by DB) were carried out independently. RESULTS--Of the 338

children

43 (13%) were found to have joint hypermobility and 21 (6%) fibromyalgia; 17

(81%) of the 21 with fibromyalgia had joint hypermobility and 17 (40%) of

the 43

with joint hypermobility had fibromyalgia. Using chi 2 statistical analysis,

joint hypermobility and fibromyalgia were found to be highly associated.

CONCLUSIONS--This study suggests that there is a strong association between

joint

hypermobility and fibromyalgia in schoolchildren. It is possible that joint

hypermobility may play a part in the pathogenesis of pain in fibromyalgia. More

studies are needed to establish the clinical significance of this observation.

PMID: 8346976 [PubMed - indexed for MEDLINE]

11: South Med J. 1991 Oct;84(10):1192-6.

Hypermobility and deconditioning: important links to fibromyalgia/fibrositis.

Goldman JA.

Department of Medicine (Rheumatology-Immunology), Emory University School of

Medicine, Atlanta, Ga.

In this study 210 patients who were identified as having

fibromyalgia/fibrositis

were evaluated for hypermobility of joints. The patients were then

instructed to

perform an exercise program, and thereafter their compliance with the

program and

its effect on their symptoms were evaluated. The data were then analyzed using

the Student's t test and Pearson's correlation coefficient. Patients who

exercised during the study had improvement. Because the hypermobile

patients as a

group exercised more than the nonhypermobile group, they showed greater

improvement than the nonhypermobile group (58% versus 30%). Patients with

fibromyalgia/fibrositis who have articular hypermobility are more likely to

exercise, which will improve their symptoms. The ability to show the objective

findings of hypermobility to a person with fibromyalgia/fibrositis, a diagnosis

based on subjective symptoms and signs, facilitates management of the patient.

These tangible signs help the patient accept and adjust to the diagnosis of

fibromyalgia/fibrositis.

PMID: 1925717 [PubMed - indexed for MEDLINE]

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