The Arthritis Research UK-funded study, published in the journal Arthritis and Rheumatism and led by researchers from the University's School of Clinical Sciences, found that young people with hypermobility at the age of nearly 14 had approximately a two-fold increased risk of having pain in the shoulder, knee, ankle and foot when they were 18. The risk of knee pain in youngsters with hypermobility who were also obese was increased 11-fold compared to those without hypermobility.
People with hypermobility have an unusually large range of movement in their joints, but although it is very common the condition is poorly understood. Some scientists have suggested that this ability to bend and stretch the joints outside of the normal range may result in pain or arthritis in later life. Nearly 50 per cent of adolescents report muscle or joint pain in the last month lasting for a day or longer, which in a small proportion may persist for long periods, sometimes into adulthood.
The Bristol team led by Professor Jon Tobias recruited almost 3,000 young people from the Children of the 90s (ALSPAC) for their study; the first prospective evaluation of the relationship between joint hypermobility and musculoskeletal pain in adolescence.
Jon Tobias, Professor of Rheumatology and co-director of the Musculoskeletal Research Unit, said: “We believe that establishing joint hypermobility as a contributory factor to musculoskeletal pain in older teenagers is significant, and may lead to better treatment for affected youngsters, including physiotherapy and exercise programmes. Our results also suggest that joint hypermobility only predisposes to pain at certain joints, presumably reflecting the role of local mechanical factors. For example, joints such as the knee are exposed to relatively large forces during locomotion; the same mechanical factors may explain the predilection of these sites to the development of osteoarthritis in later life.
“Further studies are justified to determine whether the increased risk of joint pain in adolescents with joint hypermobility has long-term consequences, including a greater risk of osteoarthritis.”
The data from Bristol contrasts with a recent systematic review and meta-analysis of the relationship between joint hypermobility and musculoskeletal pain which showed no evidence of an association in European populations, although there did seem to be a link in African and Asian populations. However, this new study was considerably larger than previous investigations, and as well as examining joint pain in general, the Bristol team also looked at joint pain at specific sites.