Eva – (Hypermobility)

Case history

Eva is a 40 y/o carer and single mum who presented to the clinic with a collection of symptoms ranging from general muscular aches and pains, fatigue, sleeping problems, irritable bowel syndrome and mood swings. The main focus for her was her neck and mid back pain that had fluctuated in severity over a 5-year duration and for which she was currently taking Codeine on a daily basis. (Codeine is an opiate used to treat pain and often prescribed when the effects of paracetamol, ibuprofen and other non-prescribed painkillers don’t work.) 


On assessment, there was a marked reduction in his cervical (neck) range of motion. Eva described being diagnosed with general hypermobility when previously being assessed in her home country of Spain. Her physical findings were consistent with this as her flexibility and range of motion were both on the higher end of the function. She had subtle soft tissue changes in her neck and mid-back where she was describing her symptoms. She appeared to be hypersensitive and was muscle guarding with even the slightest palpation. Her respiratory pattern was shallow as she was chest breathing.  


Eva seemed to be in a heightened stress state and had a lot going on in her life at the time. An accumulation of work, home and national (pandemic) stresses had her in a sympathetic dominant state which was contributing to and correlated with the pattern of her symptoms. Both her posture and breathing patterns were affecting her neck and shoulder musculature, affecting the area of complaint and this was directly related to the level of stress she was experiencing.


Advice was given to take time to manage her stresses and respond to her body’s communications of distress. Her treatment recommendation was a short course of weekly treatment consisting mostly of manual therapy and dry cupping. She was guided on conscious breathing and mindful practice. Our main aim was to initiate a state of relaxation, rest and help her practice this herself. 


Eva responded well to her care and took on board the advice given. Due to her personal circumstances, she did not maintain the weekly consistency of her program but did complete the course.


Her outcomes were positive as she learnt to understand what her body was doing. She stopped repeatedly going to the GP for each symptom she had after realising that the majority of the complaints were related and linked back to her stress levels. This approach resulted in her no longer requiring the medication she was on and provided her more of an active role in her health management.


Much of the burden on health care systems such as the NHS is from symptom management, which in many instances is the resultant effect of not understanding the interconnected nature of human body systems. Stress and its many effects, if better understood by both patients and physicians, could be better managed and understood as the root cause of many patient visits and GP presentations. Gaining a better understanding of the functional implications of stress can empower patients to take active measures in their health management instead of repeatedly visiting equally frustrated GP’s for symptom management. Sympathetic overload is a poorly understood and hugely overlooked cause of multisystem dysfunction and requires much more attention and awareness than it currently receives.