Hypermobility
Hypermobility:
Joint hypermobility is a common condition and can often be
diagnosed and managed in primary care. The vast majority of people
with hypermobile joints do not require onward referral and can be
reassured. The main treatment is improving muscle strength and
fitness so that joints are protected.
Patients may find it helpful to be referred to physiotherapy,
especially if joint pain or dislocation is a feature. The
rheumatology physiotherapists at UHBristol do not see
patients with hypermobility but there are services locally that can
be accessed. Please see advice on management pathways for GPs
below.
Information for patients
https://www.versusarthritis.org/about-arthritis/conditions/joint-hypermobility/
https://www.nhs.uk/conditions/joint-hypermobility-syndrome/
Information for referral pathways for GPs (Remedy
website accessed October 2019):
To help clinicians decide on the most appropriate management of
symptoms in adults with isolated musculoskeletal hypermobility a
guideline (pdf) has been produced.
If the patient fits the criteria for specialist physio please
refer via e-referral (by choosing "specialty";
"rehabilitation"; clinic type: NOS) This will bring up the
RNHRD service (Bristol and wider area services TBC)
To help clinicians decide whether an adult with musculoskeletal
hypermobility requires further investigations or onward referral
for identification of an underlying collagen abnormality a
guideline for referral (pdf) has been produced.
Patients with more severe or debilitating symptoms may have
Hypermobility Syndrome (HMS).
The RNHRD (Bath) Rheumatology Therapy Service offers a
multi-disciplinary approach with both physiotherapy and
occupational therapy intervention available for patients with HMS.
However, they do not offer a diagnostic service; diagnosis of HMS
should take place in primary care.
There is a
Referral Pack for GPs produced by the Royal National Hospital
for Rheumatic Diseases in Bath which gives advice on diagnosis
using the Beighton score and when and where to refer including red
flags.
https://remedy.bnssgccg.nhs.uk/adults/rheumatology/hypermobility/
