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

For patients with joint hypermobility experiencing pain, the recommended non-pharmacological management strategies focus on individualized therapeutic exercise, education, and support to improve joint stability and reduce pain. Therapeutic exercise should be tailored to the patient's needs, including local muscle strengthening and general aerobic fitness, to enhance joint support and function. Patients should be advised that initial increases in joint pain when starting exercise are common but regular, consistent exercise leads to long-term benefits such as reduced pain and improved quality of life. Supervised exercise sessions and combining exercise with education or behaviour change programmes, including pain coping skills and goal-setting, are recommended to support adherence and effectiveness.

Manual therapy (such as joint mobilisation or soft tissue techniques) may be considered alongside therapeutic exercise, particularly if the hypermobility affects larger joints like hips or knees, but should not be used alone. Occupational therapy referral is advised to provide advice on assistive devices and adaptations to daily activities to reduce joint strain and improve function. This may include splints, braces, or aids to reduce bending and joint load.

Weight management should be supported if the patient is overweight, as weight loss can reduce joint pain and improve function. Additionally, referral to physiotherapy or local musculoskeletal teams for individualized management plans is recommended. Psychosocial support and education about pacing activities and managing flare-ups are also important components of care.