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If you’ve ever been told you’re hypermobile, you might have felt a sense of relief at finally having a name for your symptoms and ongoing struggles.
However, what if that diagnosis isn’t right?
What if the constant pain, fatigue, and joint issues that you’re dealing with, aren’t actually due to EDS at all?
Hypermobility and EDS are very often misunderstood, even by medical professionals. And it’s not just about being extra flexible, and it’s certainly not always harmless. But here’s the kicker: there are several other conditions that can look a lot like hypermobility and EDS, which can lead to misdiagnosis, delayed treatment, and a whole lot of unnecessary frustration for the patient. Some conditions share joint laxity, while others mimic the pain, fatigue, and instability that can come with hypermobility spectrum disorders or hypermobile Ehlers-Danlos syndrome.
Misdiagnosis matters. If you’ve been given a hypermobility diagnosis but something still doesn’t feel quite right, it’s worth taking a closer look.
In this article, we’ll break down the conditions most commonly mistaken for hypermobility, what makes them different, and how to push for the right diagnosis. Because getting the right answers means getting the right care: and that can make all the difference.
The diagnosis of hypermobility may have brought a sense of relief to those who have experienced it. But suppose that prognosis is incorrect. What if your hypermobility or Ehlers Danlos syndrome isn’t the real cause of your chronic pain, exhaustion, or joint problems?
Understanding Hypermobility and Misdiagnosis
Hypermobility is often treated as a simple trait, like having curly hair or being able to roll your tongue. Some people can bend their fingers back further than usual, do the splits with ease, or have looser joints than others. That’s general hypermobility, and for many, it doesn’t cause any problems. But for others, hypermobility is just the tip of the iceberg, hiding a much bigger issue beneath the surface.
This is where things start to get complicated. Joint hypermobility on its own isn’t a medical condition. It only becomes a problem when it comes with pain, instability, frequent injuries, or systemic symptoms affecting the rest of the body. That’s when we enter the realm of hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS). These conditions go far beyond just being extra flexible. They can impact everything from digestion and circulation to chronic pain and fatigue.
The problem is, many doctors don’t make this distinction. They see flexibility and assume it’s harmless, missing the underlying condition entirely. Others misdiagnose hypermobility-related symptoms as something else, fibromyalgia, chronic fatigue syndrome, anxiety—without ever considering that hypermobility could be part of the picture.
The Difference Between General Hypermobility and Hypermobility Disorders
Not all hypermobility is the same. Some people are naturally more flexible due to their genetic makeup. They might be able to move their joints beyond the typical range without any issues. This type of hypermobility, often seen in gymnasts, dancers, and athletes, isn’t a disorder. It’s simply a variation in how their connective tissue functions.
Hypermobility disorders, on the other hand, come with a cost. If your flexibility is paired with joint pain, frequent subluxations or dislocations, fatigue, or widespread body pain, it’s no longer just a trait—it’s a sign of something more serious.
The two main hypermobility-related conditions are:
Hypermobility Spectrum Disorder (HSD) – A broad category for those who experience pain, instability, and other symptoms due to hypermobility but don’t meet the criteria for a specific connective tissue disorder like EDS.
Hypermobile Ehlers-Danlos Syndrome (hEDS) – A genetic connective tissue disorder that includes hypermobility, but also affects skin, blood vessels, and the nervous system. hEDS is more severe than HSD and often comes with symptoms like easy bruising, poor wound healing, gastrointestinal issues, and autonomic dysfunction.
So, while general hypermobility is just about joint flexibility, HSD and hEDS involve widespread issues throughout the body. That’s a critical distinction that often gets overlooked.
Why Joint Hypermobility Alone Isn’t Always the Full Picture
Many people with hypermobility disorders spend years—sometimes decades—searching for answers. They’re told their symptoms are unrelated, that their pain is due to poor posture, or that they’re just anxious. The problem is, most medical professionals don’t receive much training in connective tissue disorders. If they see joint hypermobility but no obvious connective tissue damage, they often assume it’s nothing serious.
But hypermobility disorders don’t just affect the joints. They can cause:
- Chronic pain and fatigue – Due to joint instability, muscle overuse, and nervous system dysfunction
- Frequent dislocations or subluxations – Because of loose connective tissue that struggles to hold joints in place
- Digestive issues – Including bloating, constipation, and irritable bowel syndrome (common in hEDS)
- Circulatory problems – Like dizziness when standing, linked to autonomic dysfunction and conditions like POTS
- Skin fragility and poor healing – Especially in EDS, where collagen abnormalities affect wound healing
This is why simply looking at how flexible someone is doesn’t tell the full story. Someone can have hypermobility without having a disorder, just as someone can have a hypermobility disorder without being noticeably flexible.
How Doctors Diagnose Hypermobility, and Where Things Go Wrong
The process of diagnosing a hypermobility disorder should be thorough. It typically involves:
The Beighton Score: A basic test that measures how flexible specific joints are. A higher score suggests joint hypermobility, but it doesn’t diagnose a disorder on its own.
Symptom History: Looking at pain levels, joint instability, frequent injuries, and systemic symptoms.
Family History: Since conditions like hEDS tend to run in families, genetic patterns can offer clues.
Clinical Criteria for hEDS: The 2017 criteria outline specific signs that must be met for an hEDS diagnosis.
Where things go wrong is that many doctors stop at the Beighton Score. If someone doesn’t score high enough, they’re often dismissed—even if they have all the other symptoms of a hypermobility disorder. Others might diagnose HSD or hEDS based on flexibility alone, without looking at systemic issues.
The lack of genetic testing for hEDS also complicates things. Unlike other types of EDS, which can be confirmed with genetic testing, hEDS is a clinical diagnosis, meaning it relies entirely on symptoms and physical examination. That leaves room for misdiagnosis or missed diagnosis altogether.
This is why so many people with hypermobility disorders are first diagnosed with something else, fibromyalgia, arthritis, chronic fatigue syndrome, or even anxiety, before they finally get the right answer.
Hypermobility on its own isn’t necessarily a problem. But when it comes with pain, instability, fatigue, and other systemic symptoms, it’s more than just flexibility: it’s a disorder that needs to be recognized.
The problem is, many doctors don’t know what to look for. They rely too much on flexibility tests, overlook systemic symptoms, and often misdiagnose or dismiss patients entirely. That’s why it’s so important to understand the difference between general hypermobility and hypermobility disorders—because getting the right diagnosis is the first step toward getting the right treatment.
Conditions That Can Be Mistaken for Hypermobility
Getting a hypermobility diagnosis can feel like an answer: until the pieces don’t quite fit. Maybe you’ve been told you have hypermobile Ehlers-Danlos syndrome or Hypermobility Spectrum Disorder, but your symptoms go beyond what’s expected. Or maybe you’ve struggled with pain, fatigue, or joint instability for years, only to be dismissed as “just flexible.” The truth is, hypermobility isn’t always the right diagnosis.
There are plenty of conditions that mimic hypermobility, some involve actual joint laxity, while others share the pain, fatigue, and systemic issues often seen in hypermobility disorders. And because so many of these conditions overlap, misdiagnosis is common.
So, what else could be going on? Here are the most common conditions that can be mistaken for hypermobility and what makes them different.
Hypermobility Spectrum Disorders (HSD) vs. Other Conditions
HSD is often given as a catch-all diagnosis for anyone with hypermobility and pain, but that doesn’t mean it’s always the right one. Since HSD lacks a genetic marker and doesn’t come with the more severe systemic features seen in hEDS, it can look a lot like other musculoskeletal or pain conditions.
The biggest issue? Many people diagnosed with HSD may actually have hEDS, inflammatory conditions, or even neurological disorders that were missed. If your symptoms seem to be progressing, include widespread pain beyond the joints, or come with autonomic or gastrointestinal issues, it’s worth taking another look.
Hypermobile Ehlers-Danlos Syndrome (hEDS) vs. Other Conditions
hEDS is the most commonly diagnosed connective tissue disorder, but it’s also the only type of EDS without a genetic test. That means it’s diagnosed purely based on symptoms, which leaves a huge margin for error. Many conditions—including autoimmune disorders, fibromyalgia, and even anxiety—can look like hEDS, leading to misdiagnosis.
If you’ve been diagnosed with hEDS but have severe bruising, skin that scars abnormally, or vascular symptoms, another type of EDS (like vascular EDS) might be more likely. On the other hand, if you have widespread body pain, chronic fatigue, and cognitive issues but don’t meet the criteria for joint instability, something like fibromyalgia or chronic fatigue syndrome might be the real issue.
Marfan Syndrome
Marfan syndrome is another genetic connective tissue disorder that can look a lot like hEDS. Both involve joint hypermobility, but Marfan syndrome comes with distinct physical features:
- Tall stature with disproportionately long arms, legs, fingers, and toes
- Chest abnormalities like pectus excavatum (a sunken chest)
- Heart issues, particularly aortic dilation or mitral valve problems
Unlike hEDS, Marfan syndrome has a known genetic cause—mutations in the FBN1 gene—and doctors can confirm it with a genetic test. If you have significant cardiovascular symptoms along with hypermobility, it’s worth asking about Marfan syndrome.
Osteogenesis Imperfecta (Brittle Bone Disease)
Osteogenesis imperfecta (OI) is a disorder that affects collagen production, just like EDS, but it primarily affects the bones. While people with OI can have joint hypermobility, the key sign is fragile bones that fracture easily, often from minor trauma.
Other red flags for OI include:
- Blue sclera (a bluish tint in the whites of the eyes)
- Hearing loss
- Shorter stature and bone deformities
OI can be diagnosed with genetic testing, which can help rule it out if you’ve been misdiagnosed with a hypermobility disorder.
Inflammatory Joint Conditions (Juvenile Arthritis, Rheumatoid Arthritis, etc.)
Inflammatory joint conditions, like juvenile idiopathic arthritis (JIA) or rheumatoid arthritis (RA), can sometimes be mistaken for hypermobility because they cause joint pain, instability, and even laxity. The big difference? Inflammation.
If you have swelling, redness, or warmth in your joints—especially in the morning—then an inflammatory condition is much more likely than a hypermobility disorder. Blood tests for inflammatory markers like CRP and ESR can help determine if your pain is coming from an autoimmune condition rather than joint laxity.
Fibromyalgia
Fibromyalgia and hEDS often get confused because both involve chronic widespread pain, fatigue, and poor sleep. But there’s a key difference:
- Fibromyalgia does not involve joint instability or excessive flexibility
- hEDS does not typically cause tender points in muscles the way fibromyalgia does
Many people with hypermobility are first misdiagnosed with fibromyalgia, especially if doctors don’t check for joint laxity. If you’ve been diagnosed with fibro but feel like your joints are unstable or easily dislocate, it’s worth looking into hypermobility disorders instead.
Loeys-Dietz Syndrome
Loeys-Dietz syndrome is a rare connective tissue disorder that shares features with both hEDS and Marfan syndrome, which makes it easy to misdiagnose. Like Marfan syndrome, it can cause vascular complications, but Loeys-Dietz has some distinctive facial features, including:
- Wide-set eyes (hypertelorism)
- A cleft palate or bifid uvula
- Twisting or abnormal structure in the arteries
Because Loeys-Dietz can lead to life-threatening aneurysms, getting the right diagnosis early is crucial. If you’ve been diagnosed with hEDS or Marfan syndrome but have unusual vascular symptoms, it’s worth asking about genetic testing for Loeys-Dietz.
Benign Joint Hypermobility Syndrome (BJHS)
BJHS used to be a common diagnosis for people with hypermobility and pain, but it’s now considered part of HSD. The difference between BJHS and a full hypermobility disorder like hEDS comes down to systemic symptoms.
If you have:
- Only joint hypermobility and pain, BJHS (or HSD) is the more likely diagnosis
- Additional symptoms like skin fragility, digestive issues, or autonomic dysfunction, hEDS is a stronger possibility
Localized or Peripheral Joint Hypermobility
Not all hypermobility is systemic. Some people have hypermobility in specific joints—often from training, sports, or genetics—without having a connective tissue disorder.
This is common in:
- Dancers and gymnasts
- Athletes with hypermobile shoulders or fingers
- Musicians (violinists, pianists) who develop hypermobility in their hands
The key difference is that these individuals don’t experience widespread pain, fatigue, or systemic issues. If you’re hypermobile but otherwise healthy, a connective tissue disorder is unlikely.
Neuromuscular Disorders
Some neuromuscular disorders can mimic hypermobility because they cause muscle weakness, poor coordination, and joint instability. Conditions like:
- Muscular dystrophies
- Ehlers-Danlos Syndrome with neurological involvement
- Cerebral palsy (in milder cases)
These disorders don’t necessarily involve loose connective tissue but can cause joints to be unstable due to weak muscles. If your hypermobility is paired with significant muscle weakness, poor motor control, or frequent falls, a neuromuscular condition might be worth exploring.
In a nutshell
Hypermobility is tricky because it overlaps with so many other conditions. Some of these involve genuine joint laxity, while others just share the pain and fatigue that often come with hypermobility disorders. If your diagnosis doesn’t feel quite right, or if your symptoms don’t fit the standard hypermobility criteria, keep pushing for answers. The right diagnosis can make all the difference in getting the right care.
FAQ
Can You Develop Ehlers-Danlos Syndrome Later in Life?
No, you can’t suddenly develop Ehlers-Danlos syndrome (EDS) later in life: EDS is genetic, which means you’re born with it. However, just because you’re born with it, it doesn’t mean you will notice the symptoms of eds right away.
Are there other conditions that look like hypermobility disorders?
Yes, and this is where things get tricky. Conditions like Marfan syndrome, Loeys-Dietz syndrome, osteogenesis imperfecta, fibromyalgia, rheumatoid arthritis, and neuromuscular disorders all share some overlapping symptoms. The key is that each one has its own distinct signs and diagnostic criteria.
Why do hypermobility disorders get misdiagnosed so often?
Because they don’t fit neatly into one category. Symptoms like chronic pain and fatigue are often misattributed to fibromyalgia, chronic fatigue syndrome, or even anxiety. Plus, many doctors rely too heavily on the Beighton Score(a test for joint flexibility) and don’t take systemic symptoms into account, leading to missed or incorrect diagnoses.
