Researchers believe that extreme joint flexibility may increase the risk of developing I chronic fatigue syndrome, a painful and fatiguing condition usually affecting women—often, with no reasonable explanation.

The link was first discovered accidentally at Johns Hopkins Children's Center, where a young girl was being treated for chronic fatigue syndrome for three years before it was noticed that she could bend and twist her joints much more than normal.

"I was chagrined that my physical examination had not included that. So, we decided to look into it," notes pediatrician Dr. Peter Rowe.

The Discovery

Rowe soon learned that most of the 60 children and teens who had been treated at his center for CFS had hypermobility in at least four joints. That means they could move their joints well beyond the normal range of motion, such as being able to bend a pinkie 90 degrees backward, touch the thumb to the forearm, or bend at the waist and rest both hands flat on the ground.

"Some of the kids would be able to put their leg behind their head in a seated position," says Rowe. "Others could do the splits. Once we saw this over and over, we thought it was something that needed more study."

That's significant, considering that no more than two in 10 people in the general population have a single hyper-flexible joint.

Although this link doesn't mean that hypermobility will result in CFS, it offers new clues into how the painful and fatiguing syndrome develops and possibly, a new way to identify at-risk patients.

Removing Stigma

In the past, some doctors regarded the syndrome as a psychosomatic byproduct of depression. And those who saw it as a legitimate illness could find few physiological signs of it. CFS often generates ambiguous complaints about pain in the joints and a general malaise.

At the very least, Rowe's connection may remove some stigma associated with CFS, which strikes about four per 1,000 adults. Children are less affected.

"In the past, you had a tremendous amount of skepticism about (CFS), which created a certain amount of stigma for people who have it," says Leonard Jason, a professor of psychology and director of the Center for Community Research at DePaul University in Chicago.

Diagnosing Chronic Fatigue Syndrome

Now, a CFS diagnosis is made if a patient has a sudden onset of fatigue that lasts at least six months and at least four of the following eight symptoms: impaired memory, sore throat, tender neck or tender lymph nodes in the armpit, muscle pain, joint pain, new headaches, troubled sleep and a feeling of malaise after exertion.

The Explanation

How could joint hypermobility be connected with CFS? That's currently under study, but there are some theories…

Rowe says that flexible joints may stress the peripheral nerves in the arms and legs, thereby fatiguing the entire nervous system, or the excessive range of motion may indirectly cause the syndrome.

"For example, if you're prone to injury because of your joints, you might decrease your activity, which studies have shown can lead to (the syndrome)," he notes.

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