Ehlers-Danlos Syndrome - living with chronic pain. Current knowledge of the disease
DOI:
https://doi.org/10.12775/JEHS.2023.19.01.015Keywords
multidisciplinary therapy, joint hypermobility, chronic pain, Ehlers-Danlos syndromeAbstract
Ehlers Danlos Syndrome (EDS) is a group of the most common inherited connective tissue disorders. The main symptoms of this syndrome are excessive skin flexibility, joint hypermobility and blood vessels fragility. The diagnosis is based on clinical symptoms, but to confirm the type of EDS, it is necessary to identify the collagen-encoding gene or protein interacting with it. The group of Ehlers and Danlos diseases include fourteen types, the most common are classic, vascular, hypermobile, arthrochalasis, kyphoscoliotic and dermatosparaxis. [15] Connective tissue plays a key role in the process of movement, constituting the main component of bones, joint cartilage, tendons, ligaments and intervertebral discs. In addition, connective tissue is a part of every internal organ including the intestines and parenchymal organs and the cardiovascular system.[19] For this reason, patients with EDS show symptoms of many diseases, including respiratory, muscular, skeletal and vascular. Women suffering from EDS often struggle with complications during their pregnancies. Psychological and emotional issues are also common.[6] However, the most noticeable and debilitating symptom of EDS is pain, which is often severe and chronic. The pain occurs in approximately 90% or more of EDS patients.[8] Successful pain management in patients with EDS is a major challenge for specialists. The treatment involves non-steroidal anti-inflammatory drugs, acetaminophen, opioids and physiotherapy. Also marijuana, traditional chinese treatments, herbal remedies are considered to reduce the severity of the symptoms. [9] During the creation of this article, the authors analyzed the clinically relevant knowledge of EDS treatment and management based on research published on Pubmed.
References
Kenneth Yan, David Hou, Lisa Bolden , Jacquelyn R Laing , Gerald Berke Laryngeal Manifestations of Ehlers-Danlos Syndrome 2022 Nov 21;S0892-1997(22)00344-7. doi: 10.1016/j.jvoice.2022.10.018.
Jade I Basem, Tiffany Lin, Neel D Mehta A Comprehensive Review: Chronic Pain Sequelae in the Presence of Ehlers-Danlos Syndrome Curr Pain Headache Rep. 2022 Dec;26(12):871-876. doi: 10.1007/s11916-022-01093-z. Epub 2022 Nov 25.
Pranathi Ari Gullapalli, Saba Javed Multidisciplinary chronic pain management strategies in patients with Ehlers-Danlos syndromes Pain Manag. 2023 Jan;13(1):5-14. doi: 10.2217/pmt-2022-0050. Epub 2022 Oct 28.
Delfien Syx, Inge De Wandele, Lies Rombaut, Fransiska Malfait Hypermobility, the Ehlers-Danlos syndromes and chronic pain Clin Exp Rheumatol. 2017 Sep-Oct;35 Suppl 107(5):116-122. Epub 2017 Sep 28.
Kiley C Whalen Wilson Crone Multidisciplinary Approach to Treating Chronic Pain in Patients with Ehlers-Danlos Syndrome: Critically Appraised Topic J Pain Res. 2022 Sep 13;15:2893-2904. doi: 10.2147/JPR.S377790. eCollection 2022.
Howard P Levy, Margaret P Adam, Ghayda M Mirzaa, Roberta A Pagon, Stephanie E Wallace, Lora JH Bean, Karen W Gripp, Anne Amemiya Hypermobile Ehlers-Danlos Syndrome In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993.2004 Oct 22 [updated 2018 Jun 21].
Fransiska Malfait, Richard Wenstrup, Anne De Paepe, Margaret P Adam, Ghayda M Mirzaa, Roberta A Pagon, Stephanie E Wallace, Lora JH Bean, Karen W Gripp, Anne Amemiya Classic Ehlers-Danlos Syndrome In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993.2007 May 29 [updated 2018 Jul 26].
Zhengyang Zhou, Abhitej Rewari , Harsha Shanthanna Management of chronic pain in Ehlers-Danlos syndrome: Two case reports and a review of literature Medicine (Baltimore). 2018 Nov;97(45):e13115. doi: 10.1097/MD.0000000000013115.
Jessica S Demes, Bryan McNair , Matthew R G Taylo Use of complementary therapies for chronic pain management in patients with reported Ehlers-Danlos syndrome or hypermobility spectrum disorders Am J Med Genet A. 2020 Nov;182(11):2611-2623. doi: 10.1002/ajmg.a.61837. Epub 2020 Sep 10.
Carolina Baeza-Velasco, Antonio Bulbena , Roberto Polanco-Carrasco , Roland Jaussaud Cognitive, emotional, and behavioral considerations for chronic pain management in the Ehlers-Danlos syndrome hypermobility-type: a narrative review Disabil Rehabil. 2019 May;41(9):1110-1118. doi: 10.1080/09638288.2017.1419294. Epub 2018 Jan 22.
Mariia Kumskova , Gagan D Flora , Janice Staber , Steven R Lentz , Anil K Chauhan Characterization of bleeding symptoms in Ehlers-Danlos syndrome J Thromb Haemost. 2023 Jul;21(7):1824-1830. doi: 10.1016/j.jtha.2023.04.004. Epub 2023 Apr 17.
C M Lam , G Wood , M A Birchall Laryngological presentations and patient-reported outcome measures in Ehlers-Danlos syndrome J Laryngol Otol. 2022 Oct;136(10):947-951. doi: 10.1017/S0022215121004072. Epub 2021 Dec 10.
Viviana Guerrieri , Alberto Polizzi , Laura Caliogna , Alice Maria Brancato , Alessandra Bassotti , Camilla Torriani , Eugenio Jannelli, Mario Mosconi, Federico Alberto Grassi, Gianluigi Pasta Pain in Ehlers-Danlos Syndrome: A Non-Diagnostic Disabling Symptom? Healthcare (Basel). 2023 Mar 24;11(7):936. doi: 10.3390/healthcare11070936.
Nada Alrifai, Laith Alhuneafat, Ahmad Jabri, Muhammad Umar Khalid, Xiarepati Tieliwaerdi, Fares Sukhon 4, Nour Hammad, Ahmad Al-Abdouh , Mohammed Mhanna , Aisha Siraj , Tarun Sharma Pregnancy and Fetal Outcomes in Patients With Ehlers-Danlos Syndrome: A Nationally Representative Analysis Curr Probl Cardiol. 2023 Jul;48(7):101634. doi: 10.1016/j.cpcardiol.2023.101634. Epub 2023 Feb 16.
Tyler Miklovic, Vanessa C. Sieg Ehlers-Danlos Syndrome In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.2023 May 29.
Phoebe A Thwaites, Peter R Gibson, Rebecca E Burgell Hypermobile Ehlers-Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know J Gastroenterol Hepatol. 2022 Sep;37(9):1693-1709. doi: 10.1111/jgh.15927. Epub 2022 Jul 20.
Nandan Marathe, Laura-Nanna Lohkamp, Michael G Fehlings Spinal manifestations of Ehlers-Danlos syndrome: a scoping review J Neurosurg Spine. 2022 Aug 19;37(6):783-793. doi: 10.3171/2022.6.SPINE211011. Print 2022 Dec 1.
A Benattia, K Benistan, M Frank, S Boussouar Respiratory manifestations of Ehlers-Danlos syndromes Rev Mal Respir. 2023 Mar;40(3):254-264. doi: 10.1016/j.rmr.2023.01.009. Epub 2023 Feb 4.
https://www.mp.pl/pacjent/reumatologia/choroby/142137,zespol-ehlersa-i-danlosa
Malfait i inni, The 2017 international classification of the Ehlers-Danlos syndromes, „American Journal of Medical Genetics Part C (Seminars in Medical Genetics)”, 175 (C), 2017,
Haus O., Nowa Klasyfikacja Zespołu Ehlersa Danlosa, Prezentacja przedstawiona podczas I Bydgoskiego Spotkania Osób z Zespołem Ehlersa-Danlosa
Fraser C Henderson Sr, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans Neurological and spinal manifestations of the Ehlers-Danlos syndromes Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):195-211. doi: 10.1002/ajmg.c.31549. Epub 2017 Feb 21.
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