Joint Hypermobility: What Are the Signs, and Is Being "Double Jointed" a Problem?
Joint hypermobility means your joints move further than the normal range. Many people live with it comfortably. For some, though, it causes pain, tiredness and repeated injuries. A standing whole-body scan can show how hypermobile joints affect your overall alignment. It reveals compensations that scans taken lying down often miss.
Key points
- Hypermobility is common in adults and is usually inherited. It is not always a problem, but it can cause pain.
- The Beighton score is a simple clinical test used to check how flexible your joints are.
- Pain from hypermobility often appears away from the joint that is too flexible, because other areas compensate.
- A standing whole-body EOS scan shows your skeleton under load, so compensation patterns become visible.
- Management focuses on strengthening, not stretching. Accurate imaging helps guide that plan.
What is joint hypermobility?
Joint hypermobility is the ability to move one or more joints past the range most people have. You may know it as being "double jointed". Your ligaments, the tough bands that hold joints together, are more elastic than average. This lets the joint bend, straighten or rotate further than expected.
Hypermobility exists on a spectrum. At one end, a single bendy thumb causes no trouble at all. At the other end, looseness across many joints can lead to chronic pain, dislocations and fatigue. When symptoms become significant, clinicians may use the term hypermobility spectrum disorder (HSD). In more complex cases, they may consider conditions such as Ehlers-Danlos syndrome (hEDS).
What are the symptoms of joint hypermobility in adults?
The most common symptoms are joint pain, a feeling of instability and muscles that tire easily. Not everyone with flexible joints has problems. When symptoms do appear, they can affect daily life in ways that are easy to dismiss or blame on something else.
Dull pain in the knees, hips, back or shoulders, often worse after activity or at the end of the day.
Joints that feel wobbly or unsupported, sometimes buckling under load without warning.
Sprains, strains and tendon problems that keep coming back, even from minor activities.
Muscles work overtime to steady loose joints. This leads to tiredness that rest alone does not fix.
Noisy joints that click, pop or crack often during normal movement.
A note about urgent symptoms. If you have sudden numbness, weakness in a limb, or loss of bladder or bowel control along with joint problems, please seek urgent medical help from your doctor or your nearest emergency department. These symptoms need immediate assessment.
What causes joint hypermobility?
Joint hypermobility is usually inherited. The genes that build collagen, the protein that gives ligaments, tendons and skin their structure, make a slightly more elastic version. This is by far the most common cause.
Runs in families. Collagen variation makes connective tissue stretchier throughout the body.
Some people have shallower joint sockets, which allow a wider range of movement.
Low muscle tone means joints rely more on ligaments than on muscles for support.
What is the Beighton score test?
The Beighton score is a simple clinical screening tool. A clinician checks nine points across your body. These include bending your little finger back, touching your palms flat to the floor and hyperextending your elbows and knees. In adults, a score of five or more out of nine suggests generalised hypermobility. It is a starting point, not a full diagnosis on its own.
How does standing imaging help assess hypermobile joints?
Standing whole-body imaging captures your skeleton while it carries your full weight. This matters because hypermobile joints behave differently under load than when you are lying down and relaxed. On a scanning couch, your muscles switch off and loose joints settle into a neutral position. This hides misalignment and compensations.
Your body is a connected chain from your feet to your head. If one joint is too loose, the joints above and below it adjust to keep you upright. A wobbly knee might make your hip tilt. A tilted hip might push your lower back into an extra curve. This is why pain in hypermobility often shows up in a different place from the joint causing the problem.
An EOS scan captures your entire skeleton, from your head to your feet, in a single standing image with about 90% less radiation than a standard X-ray, around ten times less. The result is a full picture of how your joints, spine, hips and legs line up together in real-life conditions. This gives your clinician the information to understand where the instability starts and what is compensating for it.
Wondering whether your joint pain could be an alignment problem? Talk it through with us for free before you plan any travel to London.
Book a free video consultationHow is joint hypermobility managed?
Management focuses on building strength and stability around loose joints, not on stretching them further. The right approach depends on knowing exactly which joints are affected and how your body is compensating. That is why accurate imaging matters.
- Targeted strengthening. Physiotherapy programmes that build muscle support around hypermobile joints are the cornerstone of management.
- Pacing activity. Balancing rest and movement prevents flare-ups. Too much rest weakens muscles, while too much activity overloads joints.
- Understanding your alignment. Knowing where your skeleton is out of line helps your physiotherapist or specialist design a programme for your actual problem, not a guess.
- Pain management strategies. These may include changing how you load your joints, supportive taping or working with a pain specialist.
ScanAlign does not provide treatment. It provides the diagnostic imaging that helps your treating clinician see the full picture. You do not need a referral from your doctor, and you can take your images back home to any specialist or therapist you choose.
Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
When MRI is the better option. EOS is excellent at showing bones, joints and whole-body alignment. If your clinician suspects soft-tissue damage, disc problems or nerve involvement, MRI is usually the better tool for those structures. The two types of imaging often complement each other.
Frequently asked questions about joint hypermobility
Not necessarily. Many people with flexible joints have no pain or problems at all. It becomes a concern when looseness leads to pain, instability, fatigue or frequent injuries.
A clinician usually uses the Beighton score and takes a detailed history of your symptoms. They may also check how elastic your skin is and look for signs of related connective tissue conditions. Imaging helps reveal the structural effects of hypermobility.
Yes. When joints in the spine are too flexible, the muscles around them work harder to keep you stable. This can cause aching in the lower back. Loose hips or knees can also shift spinal alignment, adding more strain. You can learn more about how spinal alignment is assessed.
Joint flexibility often decreases naturally with age. However, the effects of years of compensating, such as joint wear, muscle imbalances and posture changes, can become more noticeable over time.
When you lie down, gravity no longer pulls on your joints and your muscles relax. Misalignment and compensations that exist when you stand and walk disappear on the couch. A standing scan shows how your skeleton actually behaves under your body weight.
Yes. An EOS scan uses about 90% less radiation than a standard X-ray, around ten times less. You can find more detail on the safety and FAQs page.
No. ScanAlign accepts self-referrals. You can book directly without seeing your doctor first. A free video consultation helps confirm whether a scan is right for you before you travel.
The price for patients travelling from abroad is confirmed during the free video consultation. You can also visit the FAQs and cost page.
Absolutely. Hypermobility can affect any joint. The hips and knees are common problem areas because they carry so much weight. A whole-body standing scan shows how all these joints relate to each other. You can read more about hip alignment assessment or knee alignment.
Generally, no. Stretching joints that are already too flexible can make instability worse. The focus should be on strengthening the muscles around those joints. A specialist or physiotherapist can advise on the right programme for you.
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- NHS. "Joint hypermobility." nhs.uk. Available at: nhs.uk/conditions/joint-hypermobility.
- Castori M, et al. "A framework for the classification of joint hypermobility and related conditions." American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 2017; 175(1): 148–157.
- The Ehlers-Danlos Society. "What is HSD?" Available at: ehlers-danlos.com.
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.