Pain intensity in anatomical regions in relation to psychological factors in hypermobile Ehlers-Danlos syndrome.

Abstract

Objectives: Hypermobile Ehlers-Danlos syndrome (hEDS) is a multisystemic disorder in which pain and psychological symptoms appear to be highly interrelated. We investigate the relationships between pain intensity, pain location, and psychological distress in patients with hEDS.

Methods: The study sample in this cross-sectional study comprised patients with diagnosed hEDS (n = 81) aged 18-67 years, with a mean age of 39.5. Sociodemographic information was collected using a questionnaire. Pain intensity was measured using the numeric rating scale, depressive symptoms with the Beck Depression Inventory, and pain-related anxiety with the Pain Anxiety Symptoms Scale. The interrelations between pain intensity and psychological factors were analysed for each of the following anatomical regions: head, neck, upper extremities, chest, back, abdomen, and lower extremities.

Results: The results show that pain was intense and occurring in multiple anatomical regions. Pain intensity was related to depressive symptoms and pain anxiety, with the strength of the relationship varying across different anatomical regions. Specific findings were that strongest associations of depressive symptoms and pain intensity were in the abdomen and lower extremities. In contrast, pain in the upper extremities did not relate to depressive symptoms or pain anxiety.

Conclusion: This is the first study on patients with hEDS that elucidates the multisite pain symptoms and their interrelation to psychological symptoms. The total burden of pain can be considered a strong contributing element to the results found in our study. These factors should be considered when treating patients with hEDS.