Ehlers-Danlos Syndrome

Ross Hauser, MDRoss Hauser, MD

Ehlers-Danlos Syndrome (EDS) is also known as joint hypermobility syndrome (JHS) and is a hereditary and quite rare connective tissue disorder characterized by unusually flexible joints, very elastic skin and fragile tissues. The connective tissue of individuals with this syndrome neither forms nor heals properly.

How does Ehlers-Danlos Syndrome or Joint Hypermobility Syndrome develop?

Variations of this syndrome usually result from abnormalities in the different genes that create connective tissue. Many children experience this flexibility in the joints but without other symptoms. Over time the flexibility decreases. Arthritis may eventually develop, and the joints may degenerate beyond repair.

What are the symptoms of Ehlers-Danlos Syndrome?

With this syndrome, the skin and joints are extremely flexible; the skin can be stretched to unusual levels. Wide scars often develop on the elbows, knees and shins. Small, round, hard lumps may also appear under the skin. While in general there is a tendency to bleed easily, a small wound may turn into a large gaping wound that might not bleed much at all. The hypermobility can be documented by the Breighton criteria which involves objective measurement of the hyperextensibility of various joints. While the major presenting complaint for these patients is typically pain in multiple joints, if the hypermobility is left unchecked, joint dislocations and degeneration may result.

Surgeries may be risky due to very sensitive inner organs as well as an inclination to sprains and dislocations. One fourth of all children afflicted with this disease may develop a hunchback and kyphoscoliosis, an abnormal curve of the spine, and many develop flat feet. Hernias are also common. Pregnant women may deliver prematurely due to the extreme flexibility of body tissues. In addition, the membranes containing the fetus may rupture early if the fetus has the syndrome.

Conventional medical treatments may help relieve the symptoms of Ehlers-Danlos Syndrome, but they do not address the root of the problem. By strengthening structural weaknesses in the body, as treatments like Prolotherapy, the problems associated with Ehlers-Danlos Syndrome may be alleviated permanently.

Traditional Approaches to Treating Ehlers-Danlos Syndrome or Joint Hypermobility Syndrome

Although traditional medicine does not have a treatment for regenerating connective tissue and is therefore unable to heal Ehlers-Danlos Syndrome, several options have been suggested, including exercise to improve joint stability and strengthen muscle; self-management to protect joints from injury, reduce pain and conserve energy; and surgery to correct fractures and dislocated joints. The problem with any of these options is that they do little to strengthen the loose joints in the body and, thus, do not alleviate the chronic pain that people with Ehlers-Danlos Syndrome experience.

Caring Medical’s Approach to Ehlers-Danlos Syndrome or Hypermobility

Dr. Hauser’s use of comprehensive Prolotherapy offers great hope to those with symptoms of hypermobility because it is designed to successfully treat the ligament and tendon laxity that accompanies EDS and JHS, as well as strengthen the joints in the body with Prolotherapy and avoid the aggressive arthritis that would eventually lead to irreparable joints with this condition. Chronic pain is most commonly due to tendon and ligament weakness, cartilage deterioration and/or joint instability. The safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. In simple terms, Prolotherapy stimulates the body to repair painful areas. It does so by inducing a mild inflammatory reaction in the weakened ligaments, tendons and cartilage. Since the body heals by inflammation, Prolotherapy stimulates healing.

Prolotherapy offers the most curative results in treating the chronic pain associated with EDS, as well as many other painful conditions and sports injuries. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What’s more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent!

Dr. Ross Hauser’s experience with treating Ehler’s-Danlos Syndrome: Our office has many years’ experience since we have been treating this condition for over 50 years, with Dr. Gustav Hemwall treating many patients with EDS for many years, as well as Dr. Hauser. We have seen patients who came to us in wheelchairs or totally disabled who are now walking normally and no longer disabled and go on to lead normal lives. They basically now live pain-free. Patients with EDS suffer with recurrent dislocations and typically have already had multiple orthopedic surgeries due to the dislocations when they arrive at our door. Some of these patient will stay overnight in a local hotel and have Dr. Hauser treat nearly every joint in their bodies. Typically they require conscious sedation due to the number of areas that are being treated at once. Even severe cases of EDS (and our clinic is known for handling really severe cases), can benefit from Prolotherapy and our approach to whole health.

We believe nobody with EDS should have to live in continual suffering/pain. There is hope – and that hope is in the hands of a qualified experienced Prolotherapy doctor.

Treatment of Joint Hypermobility Syndrome, Including Ehlers-Danlos Syndrome, with Hackett-Hemwall Prolotherapy

Ross Hauser, MDRoss Hauser, MD

Joint hypermobility syndrome (JHS) and Ehlers-Danlos Syndrome (EDS) are both heritable disorders of connective tissue (HDCT) characterized by joint laxity and hypermobility. The conditions are both genetic disorders of collagen synthesis, where the adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. Both conditions have as their hallmark generalized hypermobility which can affect almost every bodily system. The hypermobility can be documented by the Brighton criteria which involves the objective measurement of the hyperextensibility of various joints. While the major presenting complaint of JHS and EDS is arthralgia in multiple joints, if the hypermobility is left unchecked, joint dislocations and degeneration may prevail.

While traditional medical treatments including education and lifestyle advice, behavior modification, physiotherapy, taping and bracing, exercise prescription, functional rehabilitation and pain medications offer some symptomatic control, they do little in regard to curbing the progressive debilitating nature of the diseases. The excessive joint mobility with its subsequent joint degeneration and multiple joint dislocations, can then lead the individual to seek out surgical intervention, which has suboptimal results in the hypermobile patient population versus the normal population. As such, some patients with JHS and EHS are seeking alternative treatments for their pain, including Prolotherapy.

Prolotherapy offers great hope for those with symptoms from generalized hypermobility because it is designed to successfully treat the ligament and tissue laxity that accompanies JHS and EDS. Prolotherapy works by initiating a brief inflammatory response, which causes a reparative cascade to generate new collagen and extra cellular matrix giving connective their strength and ability to handle strain and force. Prolotherapy has a long history of success treating ligament injuries, including patients with joint hypermobility. Studies on Prolotherapy have shown that it eliminates chronic pain even in those patients who have been told by their medical doctor(s) that surgery was the only treatment option for their pain.

Some of the rationale for using Prolotherapy for patients with EDS and JHS include that it has a high safety record, is comprehensive (all or most joints can be treated at each visit), is an outpatient procedure, is cost effective (compared to surgery), pain relief is often quick, and it provides joint stabilization. Perhaps its greatest asset is the fact that this one treatment modality can handle most of the painful musculoskeletal conditions that occur in individuals with EDS and JHS.

Prolotherapy could contribute to the treatment of hypermobility disorders also by preventing the development of precocious osteoarthritis. It has long been known that individuals with JHS and EDS suffer with premature osteoarthritis in various joints and the amount of degeneration correlates with the extent of the individuals hypermobility. The combination of extreme hypermobility and repeated injury is presumed to be what leads to the early osteoarthritis. This is most likely the reason that the hypermobility type of Ehlers-Danlos Syndrome is the most debilitating form with respect to musculoskeletal function.

While the primary author has twenty years experience treating JHS and EDS musculoskeletal symptoms with Prolotherapy, future studies will need to be conducted to best document the exact role Prolotherapy has in the treatment of the musculoskeletal symptoms and hypermobility of JHS and EDS and if it can prevent future joint degeneration in these individuals.

Continue article at the Journal of Prolotherapy