What are the recommended non-pharmacological management strategies for patients with joint hypermobility experiencing pain?

For patients with joint hypermobility who are experiencing pain, the recommended non-pharmacological management strategies include:

• Encouraging normal healthy physical activity and providing information about hypermobility to support understanding and self-management.
• Referral to community-based allied health professionals such as physiotherapists, podiatrists, or occupational therapists with paediatric expertise is appropriate when pain is present but without severe functional impairment or red flag features.
• Physiotherapy interventions focusing on therapeutic exercise, including local muscle strengthening and general aerobic fitness, to improve joint stability and reduce pain.
• Education and advice on pacing activities to avoid overuse and injury, and on strategies to manage symptoms and maintain function.
• Use of assistive devices such as splints, braces, or orthotic supports may be considered to reduce joint load and improve stability if clinically indicated.
• Monitoring and reassessment to identify any progression of symptoms or development of complications that may require specialist referral.

Referral to specialist services (e.g., paediatric rheumatology) is advised if there are red flag features, severe pain, significant functional impairment, or signs suggestive of an underlying connective tissue disorder.

These approaches aim to manage pain and improve function through non-drug means, emphasising physical activity, education, and supportive therapies tailored to the individual's needs and symptom severity ¹.