Hypermobile Ehlers-Danlos syndrome (EDS) is one of the most common genetic disorders that affect connective tissue. Its diagnosis requires assessing joint hypermobility, connective tissue concerns, family history, and other musculoskeletal issues. This medical condition exists on a spectrum and usually involves chronic pain, which negatively affects someone’s quality of life.
A team of researchers in Belgium recently published a study called “Exploring pain mechanisms in hypermobile Ehlers-Danlos syndrome: a case-control study” in the European Journal of Pain. In this groundbreaking study, they established a possible link between imbalances in sensory signals and chronic pain in people with hypermobile EDS.
Chronic Pain in Hypermobile Ehlers-Danlos Syndrome
Chronic pain is a very common and debilitating symptom of hypermobile although few targeted studies on its mechanisms exist.
Other common symptoms of hypermobile EDS include:
- Chronic fatigue
- Cardiovascular and blood pressure conditions
- Gastrointestinal disorders
- Dysautonomia that can result in fainting, dizziness, and other issues
- Higher risk of developing osteoarthritis
- Recurring severe headaches
- Pelvic and urinary dysfunction
All those symptoms can contribute to someone’s chronic pain. Ascending and descending neurological signals play a central role in the development and experience of chronic pain in individuals with hypermobile EDS. Ascending signals happen when nerves notice pain and send a related signal to the brain while descending signals occur when the brain tries to regulate pain signaling.
New Research on Sensory Signal Imbalances and Chronic Pain
The research team studied 20 women with hypermobile EDS who experienced chronic pain and a control group of 20 sex-matched healthy individuals with no known medical condition or reported pain. Both groups received multiple standardized pain assessments.
They measured ascending pain signals by calculating the temporal summation of pain (TSP). To achieve this, they evaluated when each study participant reached their pain threshold during the gradual application of hot and cold on the skin.
The researchers calculated conditioned pain modulation (CPM) and exercise-induced hypoalgesia (EIH) for descending pain signals. The assessment involved either submerging one’s hands in hot water for CPM or a cycling workout (EIH).
Descending pain signals were assessed by calculating conditioned pain modulation (CPM) and EIH. These involved a similar temperature-based assessment, but participants first either submerged their hands in hot water (CPM) or exercised by cycling (EIH) to activate descending signals.
Individuals with hypermobile EDS showed higher values in their TSP and lower values in their EIH assessments, but both groups showed only minor fluctuations in their CPM numbers.
These results indicate increased central pain facilitation in people with hypermobile Ehlers-Danlos syndrome. Their EIH response also raises the question of the impact of exercise therapy on pain management for this specific medical condition.
Future Studies on Sensory Signal Imbalances, Exercise-Induced Hypoalgesia, and Hypermobile EDS
The researchers recommended additional studies to assess a larger pool of individuals with hypermobile EDS to confirm or reevaluate their findings. Those medical professionals also suggested including individuals with hypermobile EDS who may not use pain medications on a regular basis to obtain more comprehensive data.
They also expressed the need for further research on exercise-induced hypoplasia given the central role exercise therapy can play in treating chronic pain.
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