Joint Hypermobility and Headache: Understanding the Glue That Binds the Two Together – Part 1


  • Derek Neilson MD,

    Corresponding author
    1. Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
    • Address all correspondence to D. Neilson, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 7016, Cincinnati, OH 45229, USA.

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  • Vincent T. Martin MD

    1. Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
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  • Conflict of Interest:

    Dr. Neilson declares no conflict of interest.

    Dr. Martin has the following disclosures:

    1. Allergan: Consultant, speaker

    2. GSK: Research grants

    3. Zogenix: Consultant, speaker

    4. Nautilus: Consultant

    5. Duramed: Speaker



Heritable connective tissue disorders (HCTD) present with a wide array of findings, including headache. Because of their unusual substrate, headaches in HCTD can derive from both common and uncommon circumstances.


Literature review.


Ehlers–Danlos hypermobile type can be recognized by multiple joint findings and its tendency to progress to a multisystem chronic pain syndrome. Ehlers–Danlos classic type also manifests joint laxity and similar pain complaints, but is differentiated by its skin laxity and fragility. Ehlers–Danlos vascular type presents the most severe risk due to blood vessel and hollow organ rupture. Marfan syndrome demonstrates skeletal abnormalities, lens dislocations, and aortic root dilation that can result in dissection.


In a headache patient, recognizing the presence of an HCTD improves the strategy for diagnosis and management. A brief review of findings related to joints, skin, and arteries may prompt further investigation into the HCTDs.