Hip Pain in Hypermobile Ehlers-Danlos Syndrome
Yes, hip pain is extremely common in individuals with hypermobile Ehlers-Danlos syndrome (hEDS), representing one of the core musculoskeletal manifestations of this condition.
Prevalence and Clinical Significance
Hip pain occurs as part of the widespread joint pain that affects hEDS patients, with research demonstrating that 43% of hEDS patients suffer from severe pain and approximately two-thirds experience high levels of mobility disability 1. The joint pain in hEDS is characterized by:
- Recurrent joint dislocations or subluxations affecting multiple joints, particularly shoulders, patellae, and digits, though hip involvement is also significant 2
- Joint hypermobility confirmed by Beighton score ≥5/9 points for adults under 50 years, which predisposes to chronic pain across multiple joints including the hips 2
- Chronic and highly disabling pain due to the variety, accumulation, and duration of painful symptoms 1
Hip-Specific Pathology in hEDS
Hip pain in hEDS patients often stems from extreme capsular laxity and soft-tissue instability rather than bony abnormalities 3. Key features include:
- Complaints of "giving way" and pain with an easily distractible hip under manual traction 3
- Patulous (abnormally loose) hip capsule at the time of surgical evaluation 3
- Symptomatic femoroacetabular impingement (FAI) found in 93.8% of hEDS patients with hip pain requiring arthroscopic evaluation 3
- Increased femoral version is common, though acetabular dysplasia is not typically present 3
Pain Characteristics and Impact
The hip pain in hEDS is part of a broader pain syndrome that significantly impacts quality of life:
- Delay in diagnosis, being professionally active, and thoughts of helplessness increase the likelihood of severe pain 1
- Age, fatigue, and body mass index predict mobility disability, which often includes hip-related limitations 1
- Pain is of high concern among people with hEDS, warranting specialized pain management approaches 4
Clinical Pitfall to Avoid
Do not assume hip pain in hEDS patients is purely mechanical or related to dysplasia. The primary pathology is extreme soft-tissue laxity and capsular instability, not bony abnormalities 3. Standard orthopedic approaches may fail if this underlying connective tissue pathology is not recognized and addressed appropriately.