5 doctors weighed in:

Why does my flexi joint and fibromyalgia flare up more before my period?

5 doctors weighed in
Dr. Ronald Krauser
Internal Medicine - Rheumatology
3 doctors agree

In brief: No one knows

This is not a consistent occurrence in patients with fibromyalgia but it is an occasional complaint.
The exact cause is unknown.

In brief: No one knows

This is not a consistent occurrence in patients with fibromyalgia but it is an occasional complaint.
The exact cause is unknown.
Dr. Ronald Krauser
Dr. Ronald Krauser
Thank
Dr. Laurence Badgley
General Practice

In brief: Relaxin

Imo hypermobile joints, which are associated with #fibromyalgia (see british joint hypermobility syndrome studies) become even more loose during menses ; pregnancy.
Reason likely an hormone called relaxin secreted at these times, causing greater laxity of ligaments. Loose joints place greater stress on tendons ; muscles, which attempt to compensate for loose ligaments. Gravity is the enemy.

In brief: Relaxin

Imo hypermobile joints, which are associated with #fibromyalgia (see british joint hypermobility syndrome studies) become even more loose during menses ; pregnancy.
Reason likely an hormone called relaxin secreted at these times, causing greater laxity of ligaments. Loose joints place greater stress on tendons ; muscles, which attempt to compensate for loose ligaments. Gravity is the enemy.
Dr. Laurence Badgley
Dr. Laurence Badgley
Thank
2 comments
Dr. Ronald Krauser
Another absurd post citing outdated and disproven studies.
Dr. Laurence Badgley
Dr. Ronald Krauser, Rheumatologist, commented that he has, "found no increased incidence of hypermobility in my scores of patients with FM". His comment is not atypical. In 1999, a study in England revealed that amongst Rheumatology referrals only 4.67% of persons with the joint hypermobility phenotype were being recognized, despite criteria for evaluating JHS (Brighton criteria). A study reviewer stated, "hypermobility is under-medicalized!" (British Society of Rheumatology members' Hypermobility Syndrome perception survey, 1999 [Grahame R, Bird H. Rheumatology 40 (5): 559-69, 2001 ]). As early as 1966, it was stated, "another view is that isolated ligamentous laxity is a mild mesenchymal developmental disorder which lies at one end of a spectrum of heredofamilial connective tissue disease with a fully-developed picture of Marfan's and Ehlers-Danlos at the other (Kirk JA, Ansell BM, and Bymster EG. Ann Rheum Diseases 1967 26: 419-425). In 1993, a study tested an hypothesis that joint hypermobility is participant in the pain of fibromyalgia. 338 children between 9 and 15 were evaluated with findings that 13% had joint hypermobility and 6% had fibromyalgia per ACR criteria. 81% of the children with fibromyalgia had joint hypermobility. 40% of the children with joint hypermobility had fibromyalgia. One conclusion was, "the study suggests that there is a strong association between joint hypermobility and fibromyalgia in school children (Buskila et al. Joint Hypermobility in School Children. Annals of Rheumatic Disease 1993, 52:7, 494-496). In 1998, a study in Spain compared 66 women with fibromyalgia to 70 women with other Rheumatologic diseases. The study found that 27% of women with fibromyalgia had joint hypermobility compared to 11.4 % of women with other Rheumatologic disorders (Acasuso-Diaz and Collantes-Estevez. Joint Hypermobility in Paients with Fibomyalgia. Arthritis & Rheumatism, Vol. 11, issue 1, pp 39-42, February 1998). The study suggested that joint hypermobility and fibromyalgia are associated, and that joint hyperlaxity may play an important role in the pathogensis of fibomyalgia pain. FitzCharles opined, in 2000, "there is increasing evidence that at least a sub-group of patients with soft tissue musculoskeletal pain, widespread pain, or fibromyalgia are hypermobile. Clearly, hypermobility is not the only or the major factor in the development of widespread pain or fibromyalgia, but rather a contributing mechanism in some individuals" (FitzCharles M. Is Hypermobility a Factor in Fibromyalgia?" Journal of Rheumatology, Vol: 27. no.7, pp 1587-1589, 2000). A book devoted to the subject was published (Elsevier in 2010). "Hypermobility, Fibromyalgia, and Chronic Pai n", edited by Professor Rodney Grahame; past editor of "Rheumatology", and presidency of British Society for Rheumatology. In this textbook, several British physicians present impressive clinical data about the significant association of joint hypermobility and fibromyalgia, and this work is advised for anyone skeptical about joint hypermobility as a genetic variation that predisposes people to devastating pain syndromes and organ dysfunctions. My view is that British doctors have connected the dots because they have always retained concern for physical and functional medicine diagnosis, as manifested by their fondness for Osteopathic Medicine (such as the work and writings of Leon Chaitow, D.O.) and Orthopedic Medicine, a specialty not found in the United States, as exemplified by the work and writings of James Cyriax, M.D. (deceased). Somewhere in the midst of practicing medicine for 48 years, I discovered a truism as follows: "what is not looked for is rarely seen". Joint hypermobility is common and so is fibromyalgia. It takes less than 60 seconds to have a patient demonstrate whether they can touch their thumb to their radial forearm, bend over and put their palms on the floor, and hyperextended their elbows. These patients, mostly women, will tell you of their ability to put their feet behind their neck and back bridge as a child and having had repetitive ankle sprains as children. They are also commonly aware that their menstral pain is worse than that of other women. When the physician makes this minimal effort he/she will most assuredly discover Joint Hypermobility Syndrome in a goodly portion of their fibromyalgia patients. Remember, there was a time when all physicians practiced medicine without knowledge of microbes. Antonie van Leeuwenhoek helped us to begin to see and study them, and now we use this knowledge to cure disease.
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Dr. Adam Levy
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