Compression garment use may reduce pain in hypermobile EDS, HSD: Study
Treat response associated with longer time wearing prescribed clothing
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Compression garments are well tolerated and may reduce pain and the use of pain medications in people with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD).
That’s according to a recent study, which demonstrates that treatment response, reported in 80% of participants, was associated with a longer time spent wearing the prescribed garments.
The study also demonstrated that HSD patients, for whom compression garments are not usually reimbursed, may experience benefits similar to those seen in hEDS, meaning that “reimbursement policies might therefore warrant reevaluation,” researchers wrote.
The study, “Compression garments in hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders: a retrospective cohort study,” was published in BMC Musculoskeletal Disorders.
Compression garments sometimes used as add-on treatment in hEDS
Hypermobile EDS is the most common type of EDS, a group of connective tissue disorders characterized by symptoms such as joints that move beyond the normal range of motion (hypermobile) and frequent joint dislocations.
Both hEDS and HSD commonly lead to chronic pain, chronic fatigue, impaired proprioception (the body’s sense of its position in space), and lower quality of life. Although the clinical presentation of HSD is similar to that of hEDS, it doesn’t meet the same diagnostic criteria.
Compression garments are sometimes used as a nonpharmacological, add-on treatment for patients with hEDS to reduce pain and improve stability and balance.
“However, scientific data remain limited in hEDS and nearly [nonexistent] in patients with HSD,” the researchers wrote.
To learn more, a team of researchers at Amiens University Medical Center in France analyzed the use of compression garments by 13 adults with hEDS and seven with HSD. Participants were primarily women (85%) with a mean age of 39.2 years.
Most had a family history of hypermobility (70%), and half or more had repeated sprains, joint dislocations, and altered proprioception. Median duration of pain was seven years. All had peripheral pain syndrome, which happens when the nerves outside of the brain and spinal cord are damaged.
Garments poorly tolerated, discontinued by 25% of patients
There were no significant differences in clinical features between hEDS and HSD participants, except that a higher percentage of patients with hEDS exhibited altered visceral proprioception, or the perception of internal bodily sensations (84.6% vs. 14.3%).
Compression garments were more frequently prescribed to the limbs (95%) and the trunk (90%). They were used for a mean of 8.3 hours daily. Fifteen participants (75%) adhered to a prescribed physical therapy program.
The garments were poorly tolerated or discontinued by five patients (25%). Intolerance was significantly associated with the absence of clinical benefit. Almost half (45%) of the patients experienced an “on-off” effect, meaning a rapid reduction of pain when the garment was put on, followed by no relief upon its removal.
The clinical efficacy of compression garments was determined by a composite measure, defined as the presence of at least one of four outcomes: a perceived decrease in pain, lower use of pain medications, less fatigue, and improvement in quality of life.
These preliminary observations suggest that sustained use of [compression garments] favors better clinical outcomes, although this hypothesis requires confirmation.
At a follow-up performed after a mean of 4.4 months, 80% of patients reported less pain, and 53.8% experienced a decrease in the use of pain medications. Additionally, 40% reported an improvement in their quality of life, 60% reported a stable quality of life, and 15% experienced a reduction in fatigue. The proportion of patients achieving key outcomes was similar between the hEDS and HSD groups.
Overall, 80% of the participants responded to treatment, meaning they met at least one of the composite outcome’s items. These patients had a significantly higher body mass index, a measure of body fat based on height and weight, and wore compression garments for longer periods compared with non-responders. These groups did not differ in age, pain duration, adherence to physiotherapy, or Beighton score, which is used to measure joint hypermobility.
“The time per day wearing [compression garments] was a strong predictor of a treatment response … and thus highlighted the importance of treatment adherence,” the researchers wrote. “These preliminary observations suggest that sustained use of [compression garments] favors better clinical outcomes, although this hypothesis requires confirmation.”
The sciensists also noted a study limitation. Most participants had undergone and often continued using long-term physiotherapy or rehabilitation programs before using compression garments, which may have contributed to the observed benefits, “making it difficult to attribute the observed effects solely to the use of [compression garments].” As a result, “our findings should be interpreted as associations, rather than evidence of causality,” they added.
