From a clinical perspective, asymptomatic joint hypermobility, HSDs, and hEDS can all be brought back to a single continuous spectrum ranging from isolated joint hypermobility at one end to hEDS at the other (passing through the various HSDs along the way):
Is hEDS worse than HSD?
Not necessarily. ‘Both sit on a vast spectrum and can cause the same symptoms. The spectrum acknowledges that there can be severe effects on lives, whether they’re the direct result of joint hypermobility, or because they are known to be associated with having joint hypermobility. What is important is that the problems that arise, whatever the diagnosis, are managed appropriately and that each person is treated as an individual. Both disorders can be equal in severity but, more importantly, both need similar management, validation and care’ (1 & 2 Ehlers-Danlos Society 2017).
To fully understand the whole range of variations seen in the spectrum spanning joint hypermobility, through hypermobility spectrum disorders and hEDS, it is likely that geneticists will need to look towards a genetic model that allows for the expression of the single or multiple gene mutation(s) to be further influenced by other genetic, environmental, or constitutional factors.
For many people, the distinction between hypermobility spectrum disorder and the hypermobile type of Ehlers-Danlos syndrome not an important one 'clinically', as treatments are similar. 'Exceptions include more severely affected patients, such as those who require braces or surgery to stabilise their joints and who also experience other complex problems, such as weakness or loss of feeling in arms or legs, and those with certain eye problems or a family history of aneurysms, all of whom if possible should see a specialist with knowledge of EDS, in part to rule out other more serious types of EDS.' (Dr Alan G. Pocinki MD PLLC).
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