Case of the Month #30: Pain and Hypermobility

Published: 27/07/2023


Miss L is a 33-year-old female who was referred by a primary care physiotherapist to the chronic pain service with persistent widespread pain and joint hypermobility.

She has experienced joint pain since her teenage years and put it down initially to injuries she sustained as a gymnast. She recalled she had always been flexible, but her pain gradually became more of a problem for her since leaving school and moving to university. She struggled to keep up with her studies and was seen by several GPs and physiotherapists in her early 20s. She was seen by a rheumatologist last year who diagnosed hypermobility spectrum disorder. Her pain was increasingly impacting on her quality of life, so she was seen again by a physiotherapist who went on to refer her to the pain management service. 

  • If you were the pain clinician seeing her for her first consultation, what questions would you like to ask?
  • What might you look for on examination of the patient?
  • Would you ask for any further investigations?