title: Increased joint pain after massive weight loss: is there an association with joint hypermobility?
abstract: BACKGROUND
  Obesity is associated with an increased risk of pain in weight-bearing joints. Although pain often decreases after obesity surgery, this is the reverse for some patients. Hypermobility is described as an excessive range of motion in joints and has been suggested to be a possible cause of joint pain. It is not known whether there is an association between increased joint pain after weight loss and hypermobility.
  
  
  OBJECTIVE
  The objective of this study was to investigate whether there is an association between hypermobility and increased joint pain after massive weight loss.
  
  
  METHODS
  University hospital, Sweden.
  
  
  METHODS
  A survey including a screening questionnaire about hypermobility and questions about joint pain was sent to 149 people who had previously undergone bariatric surgery. Ninety-three people (72 women and 21 men) completed the questionnaire.
  
  
  RESULTS
  Nineteen of the respondents fulfilled the criteria for hypermobility. There were no significant differences between the groups with and without hypermobility regarding pain in weight-bearing joints before or after surgery. There was a significant difference between the groups with increased or novel pain in the ankles, shoulders, hands, and feet (P<.05) after the weight loss. Furthermore, the patients with hypermobility had increased or novel pain in a significantly higher number of weight-bearing joints, other joints, and joints in total (P< .05).
  
  
  CONCLUSIONS
  Even with a small sample size, a tendency can be seen for people with hypermobility to experience increased joint pain after weight loss compared with those without hypermobility.
authors.affiliation: Department of Physical Therapy, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Surgery, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: monika.fagevik-olsen@vgregion.se.
authors.forename: Monika
authors.initials: M
authors.lastname: Fagevik Olsén
authors.affiliation: Department of Physical Therapy, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors.forename: Sofie
authors.initials: S
authors.lastname: Brunnegård
authors.affiliation: Department of Physical Therapy, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Sjöström
authors.affiliation: Department of Surgery, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Biörserud
authors.affiliation: Department of Physical Therapy, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Kjellby-Wendt
mesh_terms: D018771:Arthralgia / Q000209:etiology* / Q000503:physiopathology; D050110:Bariatric Surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery; D010149:Postoperative Pain / Q000209:etiology* / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D015431:Weight Loss / Q000502:physiology*
keywords: Bariatric surgery; Generalized joint laxity; Joint hypermobility syndrome; Joint instability; Obesity