Journal CME June 2026: Exploring the relationship between joint hypermobility and chronic pain in youth: Diagnostic challenges and the Beighton Scale-PM R - 2025 - Frye - Exploring the relationship between joint hypermobility and chronic pain in youth Diagnostic

PM R - 2025 - Frye - Exploring the relationship between joint hypermobility and chronic pain in youth Diagnostic

Pdf Summary

This retrospective chart review examined youth seen in a pediatric chronic pain clinic to better understand the link between joint hypermobility and chronic widespread musculoskeletal pain, and to evaluate how consistently the Beighton Scale is used. Among 164 eligible patients, 135 had Beighton scores documented, and 31.9% had positive scores. However, scoring was highly inconsistent: over half of patients assessed by multiple providers had conflicting Beighton ratings, and agreement was only fair when classifying scores as positive or negative. Diagnostic labels were also inconsistent, with nine different hypermobility-related diagnoses used. Nearly all patients with hypermobility and pain reported pain outside hypermobile joints as well, and more than half had painless hypermobile joints, suggesting that hypermobility does not fully explain chronic pain in many cases.<br /><br />The study also found that some patients diagnosed with hypermobile Ehlers-Danlos syndrome (hEDS) did not meet full criteria on later genetics evaluation, while some labeled with joint hypermobility syndrome (JHS) actually met hEDS criteria. This highlights challenges in diagnosis, documentation, and provider training. The authors conclude that hypermobility is common in youth with chronic pain, but the Beighton Scale has limitations and should not be used alone to diagnose hEDS. They recommend standardized criteria, better clinician training, and a treatment focus on function, physical therapy, and multidisciplinary pain management rather than on flexibility scores alone.

Keywords

joint hypermobility

chronic widespread musculoskeletal pain

pediatric chronic pain

Beighton Scale

hypermobile Ehlers-Danlos syndrome

joint hypermobility syndrome

diagnostic inconsistency

retrospective chart review

multidisciplinary pain management

physical therapy