Joint Hypermobility & Migraine: A Possible Link
Researchers may have uncovered some new clues about the causes of Migraine by observing that patients with joint hypermobility disorders (extreme flexibility / double jointedness) are more likely to experience Migraine Disease. Female patients with a diagnosis of a joint hypermobility disorder were three times more likely to also live with migraine disease than the control group.
What is joint hypermobility?
Joint hypermobility is an inherited condition. Patients with this type of disorder experience extreme flexibility in their joints and musculoskeletal symptoms such as pain, joint instability and myalgia (muscle pain), but do not have any kind of rheumatologic disorder (i.e. arthritis).
Somewhere between 10-15% of the population live with joint hypermobility disorders, and as many as 85-90% of those patients are female. Ehlers-Danlos Syndrome is one type of joint hypermobility disorder.
Doctors and researchers have observed that joint hypermobility disorders share a common disease process with conditions like Irritable Bowel Syndrome, depression, fibromyalgia, sleep disorders, anxiety disorders and Migraine. Researchers have observed the comorbid presence of Migraine and joint hypermobility in past studies. The author of this study, Dr. Vincent Martin, University of Cincinnati College of Medicine, had observed that many of his joint hypermobility patients also suffered from Migraine; he personally lives with both conditions. He wanted to examine the possible correlation using the correct diagnostic criteria for both conditions.
Finding the link
Martin believes both joint hypermobility disorders and Migraine share roots of being related to collagen. Collagen is a protein that connects joints and tissues. His hypothesis is that if collagen is too elastic it leads to overly flexible joints and stretchy blood vessels. The notion that Migraine originates in the blood vessels is an older theory that has gone out of fashion in recent years with the awareness that it's actually a neurological condition. But we do know that expanding and contracting blood vessels are part of the Migraine process. Perhaps elastic collagen makes those of us with Migraine more susceptible to this process.
There are some key strengths and limitations to this study. Its strengths include the fact that diagnosis of the joint hypermobility disorders was done by a geneticist with special expertise in diagnosing and treating joint hypermobility disorders. Further, this is the first study of the possible connection between these conditions that used the International Headache Society ICHD-2 diagnostic criteria for diagnosing patients with Migraine.
Limitation in research
Key limitations include the fact this was a small study, which limits the accuracy of the observations. Another limitation is that participants were patients at a connective tissue clinic, which may have skewed the results toward a population more likely to have comorbid conditions than the population at large. The researchers were unable to gather data about comorbid conditions other than Migraine, which left them unable to control for any of the other conditions commonly observed in patients with joint hypermobility disorders (i.e. anxiety disorders, sleep disorders, IBS, TMJ). Larger studies that build on the use of proper diagnostic criteria for both conditions and that control for other possible comorbid conditions that might affect the correlation between joint hypermobility and Migraine will be necessary in the future.
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