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A 19-year-old female asked:

I have hyper mobility syndrome and difference in leg length, i'm always achey or hurting is this the reason why?

2 doctor answers2 doctors weighed in
Dr. Ronald Krauser
A Verified Doctoranswered
Rheumatology 53 years experience
Possibly: Eds itself is associated with musculoskeletal pain and unequal leg lengths may be a cause of low back pain. If your pain is more generalized it is most likely related to the hypermobility.
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Dr. Laurence Badgley
General Practice 54 years experience
Likely: Joint hypermobility syndrome (jhs) has a broad spectrum symptoms & degrees of joint laxity. Is common in women. Sacroiliac joint can be hypermobile &, as it shifts, invokes functional (not actual) leg length change; imparting tilting of upright body tower, widespread adaptive chronic muscle spasm, & causes fibromyalgia (my own theory). See discussions my chronic pain board at quora.Com (free).
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Laurence Badgley
General Practice 54 years experience
Provided original answer
The unifying genetic relationship in fibromyalgia is probably Joint Hypermobility Syndrome (JHS), a known genetic condition.  I have noted that a good portion of female fibromyalgia sufferers satisfy the Bristol Criteria for JHS, and are able to oppose thumb to lateral radial skin, hyperextended elbows and knees, and can place their palms on the floor with knees locked.  Most could put their feet behind their head and back bridge as youngsters and many can do so as adults.  JHS is a disorder with a spectrum of penetrance; with Marfans and Ehlers-Danlos at the clinical severity end of the spectrum.  My speculation is that the trait is conserved in females because it increases pelvic joint (SIJ and symphysis pubis) flexibility during childbirth.  Many of my patients with fibromyalgia and subclinical JHS delivered their fourth or fifth child in minutes rather than hours.  I speculate that repetitive childbirth, in conjunction with the hormone Relaxin, progressively loosens pelvic ligaments.  This functionality would seem to favor infant survivability.  To my mind fibromyalgia results from the effects of a loose ligament-skeletal system attempting to maintain a medial center of gravity via chronic muscle spasm leading to widespread ischemic trigger points (after the work of Shah at NIH).
Jul 1, 2013
Last updated Dec 10, 2013


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