Ehlers Danlos syndrome and osteopathy
What is Ehlers Danlos syndrome?
Ehlers-Danlos Syndrome (EDS) is an inherited disorder that affects connective tissue.
They are characterized by 3 main signs:
- Joint hyperlaxity: more precisely, we speak of Generalized Articular Hypermobility (GAH)
- Hyper elasticity of the skin
- Fragility of connective tissue
These diseases are mainly due to abnormalities within the extracellular matrix (biosynthesis and/or structure of proteins).
Connective tissues:
These are the tissues of the body that have the purpose of supporting and protecting the other tissues of the body by providing nutrients and eliminating waste.
Prevalence of Ehlers Danlos
These pathologies are rare but affect about 1 in 5000 people.
Ehlers Danlos Syndrome Clinic
The main features that point to Ehlers Danlos syndrome are:
- Joint hyperlaxity
- Joint pain
- Multiple sprains
- Multiple / recurrent dislocations
- Scoliosis
- Hematoma and wound healing disorders
- Significant fatigability
However, other clinical signs are defined in each subtype of Ehlers Danlos.
Diagnosis of Ehlers Danlos
Anamnesis
The diagnosis is first of all guided by the personal anamnesis (questioning) (history, pain, etc.) but also family.
Elimination of other pathologies
The diagnosis is also made by eliminating other bone, muscle and rheumatological pathologies.
Joint hyperlaxity test: Breighton score
Joint hyperlaxity or Generalized Articular Hypermobility (GAH) is detected by the Breighton score.
Breighton score calculation :
Tests:
- / 2 : Elbow extension : positive if greater than 10°.
- / 2 : Contact of the thumb on the forearm : positive if contact is possible
- / 2 : Finger extension : positive if greater than 90
- / 2 : Knee extension : positive if greater than 10°.
- / 1: Place your hands flat on the ground with your knees straight
The diagnosis of GAG is made when 5 or more out of 9 are scored on the tests.
However, a nuance must be made: a child is more flexible than an adult, so there is an over-diagnosis in children and an under-diagnosis in adults...
Genetic / molecular diagnosis:
Except for the Hypermobile SED type, genetic and molecular analysis allows the diagnosis to be made.
The different types of Ehlers Danlos Syndrome :
A classification, established in 2017, highlights 17 types of Ehlers Danlos syndromes.
- AEBP1
- Fragile Cornea Syndrome: BCS
- Arthrochalastic SED: SEDa
- SED Classic: SEDc
- SED Classic-like: SEDcl
- Cardio-vascular SED : SEDcv
- Dermatosparaxial SED: SEDd
- SED Hypermobile : SEDh
- Cyphoscoliotic SED: SEDk
- Myopathic EDS: mEDS
- Musculocontractural EDS: mECS
- Periodontal SED : SEDp
- SED Spondylodysplastic : SEDsp
- Vascular EDS: vEDS
Treatment and management:
There is no treatment as such for Ehlers Danlos syndromes.
Treatment consists of preventing skin damage, pain and functional disorders. To do this, multidisciplinary management is currently the only option to support and improve the quality of life of patients.
Osteopath and Ehlers Danlos syndrome
The goal of osteopathy, again in parallel with other approaches, is to :
- Remove all dysfunctions that may increase the patient's pain
- Advise the patient on his lifestyle habits, exercises according to the observed mechanical disorders in order to avoid the recurrence of his problem but also to prevent
Beware, some osteopathic techniques are contraindicated when treating a patient suffering from Ehlers Danlos syndrome.
The application of kinesiology bands (K-tape, K-taping, etc.) also helps to relieve the patient. Your osteopath can also apply them during the consultation.
Adapted physical activity helps in EDS but here again it is necessary to dose: too much sport will cause damage to the connective tissue and if you don't do enough, the muscles will not do their role as guardian of the joints.
Do not hesitate to ask your osteopath, physiotherapist, etc. for advice.
Marie Messager
Osteopath D.O
2 rue Alexis de Tocqueville
78000 Versailles
