Hypermobile Ehlers-Danlos Syndrome (hEDS) & Hypermobile Spectrum Disorder (HSD)

What Are hEDS & HSD? 

Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS) fall along a spectrum of joint hypermobility conditions. While they have different diagnostic criteria, they share many overlapping symptoms and similar management strategies.

Both hEDS and HSD are connective tissue conditions that make joints overly flexible and less stable, which can lead to pain, dislocations, and soft tissue injuries. They can also affect connective tissue throughout the body, causing symptoms that go beyond the joints, such as fatigue and digestive issues.

Common Signs & Symptoms

• Joint dislocations or subluxations

• Chronic pain

• Fatigue

• Soft, stretchy or fragile skin

• Bruising

• Poor proprioception

• Digestive symptoms

These symptoms can affect people with either hEDS or HSD

hEDS is diagnosed when a person meets strict clinical criteria, while HSD is diagnosed when someone has symptomatic hypermobility but does not meet all the criteria for hEDS. Despite these differences, treatment and self-care approaches are generally the same for both conditions.

Understanding Generalized Joint Hypermobility (GJH)

Generalized Joint Hypermobility (GJH) refers to a clinical finding, not a medical diagnosis. It means that multiple joints move beyond the typical range expected for a person’s age and sex.

Key Features of GJH:

• Often asymptomatic – many people with GJH experience no pain or dysfunction

• Common in certain populations, such as children, dancers, gymnasts, and some ethnic groups

• Measured using tools like the Beighton score (a score of 5 or more out of 9 suggests GJH in adults under 50)

Importantly, GJH by itself is not a disorder. However, if joint hypermobility is accompanied by symptoms such as pain, instability, or fatigue, it may indicate a condition like HSD or hEDS. The presence of GJH is one piece of the puzzle in evaluating whether someone meets criteria for a connective tissue disorder.

Treatment in hEDS or HSD

Management is often similar for both hEDS and HSD. Physical therapy can help build strength and stability for hypermobile joints. Energy conservation and pacing strategies help people balance activity and rest to avoid flare-ups. Many find that ergonomic supports, braces, or assistive devices provide extra joint protection during daily activities. Mind-body approaches — such as yoga, breathwork, or gentle movement — can help manage pain and improve body awareness.

A multidisciplinary, supportive approach — combining physical therapy, occupational therapy, pain management, and mental health support — works best regardless of whether someone has an hEDS or HSD diagnosis.

Connection to Other Multisystem Disorders

Many people with hEDS or HSD also deal with conditions like dysautonomia (especially POTS) and Mast Cell Activation Syndrome (MCAS). 

Other Helpful Resources

Check out this comprehensive YouTube playlist and the helpful button links below for even more information on hEDS and HSD.