Joint Hypermobility Is a Risk Factor for Musculoskeletal Pain During Adolescence: Findings of a Prospective Cohort Study: Joint Hypermobility is a Risk Factor for Musculoskeletal Pain

Jonathan H. Tobias, Kevin Deere, Shea Palmer, Emma M. Clark, Jacqui Clinch

Research output: Contribution to journalArticlepeer-review

107 Citations (Scopus)

Abstract

Objective
To determine whether joint hypermobility (JH) in childhood is a risk factor for the subsequent development of musculoskeletal pain.
Methods
JH was determined according to the Beighton score at age 13.8 years in children from the Avon Longitudinal Study of Parents and Children (ALSPAC), using a cutoff of ≥6 for the presence of hypermobility. Musculoskeletal pain was evaluated by questionnaire at age 17.8 years. Logistic regression analysis was performed in 2,901 participants (1,267 boys and 1,634 girls) who had complete data.
Results
A total of 4.6% of participants had JH at age 13.8 years. Moderately troublesome musculoskeletal pain at age 17.8 years was reported most commonly in the lower back (16.1%), shoulder (9.5%), upper back (8.9%), knee (8.8%), neck (8.6%), and ankle/foot (6.8%). JH was associated with an increased risk of at least moderately troublesome musculoskeletal pain at the shoulder (odds ratio [OR] 1.68 [95% confidence interval (95% CI) 1.04, 2.72]), knee (OR 1.83 [95% CI 1.10, 3.02]), and ankle/foot (OR 1.82 [95% CI 1.05, 3.16]) (adjusted for sex, maternal education, and body mass index). An equivalent relationship was not observed at other sites, including the spine, elbows, hands, and hips. In analyses examining interactions with obesity, associations between JH and knee pain showed higher ORs in obese participants (OR 11.01) as compared with nonobese participants (OR 1.57) (P = 0.037 for the interaction of hypermobility and obesity).
Conclusion
JH represents a risk factor for musculoskeletal pain during adolescence, comprising a specific distribution, namely, the shoulder, knee, and ankle/foot. These relationships were strongest in the presence of obesity, which is consistent with a causal pathway whereby JH leads to pain at sites exposed to the greatest mechanical forces.
Original languageEnglish
Pages (from-to)1107-1115
Number of pages9
JournalArthritis & Rheumatism
Volume65
Issue number4
DOIs
Publication statusPublished - 28 Feb 2013
Externally publishedYes

Fingerprint

Dive into the research topics of 'Joint Hypermobility Is a Risk Factor for Musculoskeletal Pain During Adolescence: Findings of a Prospective Cohort Study: Joint Hypermobility is a Risk Factor for Musculoskeletal Pain'. Together they form a unique fingerprint.

Cite this