Chronic Pain and Ehlers-Danlos Syndrome (EDS)
Ehlers-Danlos syndrome (EDS) is a group of hereditary connective tissue disorders,
characterized by joint hypermobility, skin hyperextensibility and tissue fragility
. Chronic pain is a frequent but difficult-to-manage symptom.
Pain manifestations in EDS
- Prevalence and severity: Chronic pain is widespread, especially in the hypermobile type (hEDS). It is often severe, leading to significant impairment of daily life.
- Location and nature: Pain may be generalized or localized, mainly affecting the shoulders, hands and knees. It is often resistant to conventional treatments.
Underlying pain mechanisms
- Multifactorial causes:
◦ Nociceptive pain due to structural joint changes.
◦ Neuropathic pain and central sensitization.
◦ Altered proprioception and muscle weakness.
◦ Influence of psychological factors such as anxiety and depression. - Aggravating factors: Hypermobility, dislocations, surgical history, and poor
sleep quality.
Pain management and treatment
- – Multidisciplinary approaches:
◦ Physiotherapy and occupational therapy.
◦ Cognitive behavioral therapy (CBT).
◦ Targeted pharmacological interventions.
- Specific treatments:
◦ Use of orthotics and durable medical devices.
◦ Complementary treatments (acupuncture, relaxation techniques).
◦ Neuropathic modulators are often poorly tolerated.
Conclusion
Pain in Ehlers-Danlos syndrome is a complex and disabling symptom. Individualized
management and in-depth research are essential to improve patients’ quality of
life. Greater awareness among healthcare professionals and advances in
understanding pathophysiology could transform the management of this condition.
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