Hypermobility in Patients with Chronic Fatigue Syndrome: Preliminary Observations

Abstract

Objective: The present report aims at examining 1. the prevalence of generalized hypermobility in patients with chronic fatigue syndrome [CFS]; 2. whether hypermobile CFS patients experience more pain and have more severe activity limitations/participation restrictions compared to nonhypermobile CFS patients; and 3. whether the history of widespread pain is indicative of generalized hypermobility in patients with CFS.

Methods: Forty-four consecutive patients with CFS filled in the Chronic Fatigue Syndrome Activities and Participation Questionnaire [CFS-APQ] for the assessment of activity limitations/ participation restrictions, rated three visual analog scales [for pain, myalgia, and arthralgia], were screened for generalized hypermobility according to the Beighton et al. (1973) criteria, and were questioned about muscle and joint aches.

Results: Eleven of the 44 [25 percent] subjects met the criteria for generalized hypermobility. The Spearman Rank correlation analysis did not reveal statistically significant correlations between the Beighton et al. scores and any of the self-reported measures [P > 0.01]. Using the Mann-Whitney U test, no statistically significant differences in pain severity and activity limitations/participation restrictions were observed between hypermobile [N = 11] and nonhypermobile [N = 33] patients with CFS [P > 0.01]. The positive likelihood ratio for widespread pain in shifting the odds favoring the presence of generalized hypermobility was 1.24; the negative likelihood ratio was 0.749.

Conclusions: The present report suggests that a subgroup of patients with CFS present with generalized hypermobility, but questions the clinical importance of hypermobility in patients with CFS. A history of widespread pain was not predictive of generalized hypermobility in this sample of CFS patients.

KEYWORDS:

• Chronic fatigue syndrome
• hypermobility
• prevalence
• pain