Related Experiment Video
Updated: May 22, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Hypermobility and musculoskeletal pain in children: a systematic review
G McCluskey1, E O'Kane, D Hann
1Queen's University Belfast, School of Medicine, Dentistry and Biomedical Sciences, Belfast, Northern Ireland, UK.
Insights
Hypermobility in children shows no link to joint pain in European populations. However, a significant association between hypermobility and musculoskeletal pain was found in Afro-Asian children, though heterogeneity remains a factor.
Area of Science:
- Pediatric rheumatology
- Musculoskeletal health
- Epidemiology
Background:
- Joint hypermobility is a common condition in children.
- Its association with musculoskeletal pain requires further investigation.
- Existing evidence is varied, necessitating a comprehensive review.
Purpose of the Study:
- To systematically review and synthesize evidence on the association between hypermobility and musculoskeletal pain in pediatric populations.
- To identify potential regional differences in this association.
Main Methods:
- Systematic literature review of observational studies using PubMed, EMBASE, NHS Evidence, and Medline.
- Inclusion of studies on children, excluding specialist groups.
- Pooled odds ratios (ORs) calculated using random effects models; heterogeneity assessed via chi-squared tests.
Main Results:
- Fifteen studies met inclusion criteria; 13 were included in statistical analysis.
- High overall heterogeneity (I(2) = 72%) initially limited interpretation.
- Subgroup analysis revealed no association in European studies (I(2) = 8%) but a significant association in Afro-Asian studies (I(2) = 65%).
Conclusions:
- No clear association between hypermobility and joint pain in European children.
- A notable association exists in Afro-Asian children, though heterogeneity warrants caution.
- Further research is needed to clarify the impact of ethnicity, environment, and study design on these findings.
Objective:
To examine the evidence of an association between hypermobility and musculoskeletal pain in children.
Methods:
A systematic review of the literature was performed using the databases PubMed, EMBASE, NHS Evidence, and Medline. Inclusion criteria were observational studies investigating hypermobility and musculoskeletal pain in children. Exclusion criteria were studies conducted on specialist groups (i.e. dancers) or hospital referrals. Pooled odds ratios (ORs) were calculated using random effects models and heterogeneity was tested using χ(2)-tests. Study quality was assessed using the Newcastle-Ottawa Scale for case-control studies.
Results:
Of the 80 studies identified, 15 met the inclusion criteria and were included in the review. Of these, 13 were included in the statistical analyses. Analysing the data showed that the heterogeneity was too high to allow for interpretation of the meta-analysis (I(2) = 72%). Heterogeneity was much lower when the studies were divided into European (I(2) = 8%) and Afro-Asian subgroups (I(2) = 65%). Sensitivity analysis based on data from studies reporting from European and Afro-Asian regions showed no association in the European studies [OR 1.00, 95% confidence interval (CI) 0.79-1.26] but a marked relationship between hypermobility and joint pain in the Afro-Asian group (OR 2.01, 95% CI 1.45-2.77). Meta-regression showed a highly significant difference between subgroups in both meta-analyses (p < 0.001).
Conclusion:
There seems to be no association between hypermobility and joint pain in Europeans. There does seem to be an association in Afro-Asians; however, there was a high heterogeneity. It is unclear whether this is due to differences in ethnicity, nourishment, climate or study design.
Related Concept Videos
01:28Disorders of the Skeletal Muscle
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:07Development of the Limb Synovial Joints
The mesenchymal stem cells differentiate into chondrocytes that form the hyaline cartilage, and later the cartilaginous model of the bone. This model further transforms into a bone. This process is known as endochondral ossification.
During development, the limbs...