Fibromyalgia & hEDS/HSD
Fibromyalgia and Hypermobility: Overlap, Not Just Misdiagnosis
None of us writing this are doctors. This page collects what the published research actually says about the overlap between fibromyalgia and hEDS/HSD, so you have something concrete to bring to your own doctor.
If you have been diagnosed with fibromyalgia, hEDS or HSD, or both, and the symptom lists feel like they blur together, that is not confusion on your part. The two conditions genuinely overlap in a documented, measured way - and understanding which symptoms belong to which diagnosis, if either, can change what treatment actually gets tried.
How Often Do Fibromyalgia and hEDS/HSD Co-Occur?
A 2023 study out of an EDS clinic retrospectively examined intake data from 733 patients. Of those, 56.5% (414 people) were diagnosed with both hEDS/HSD and fibromyalgia, 23.8% (167 people) had hEDS/HSD alone, 13.3% (98 people) had fibromyalgia alone, and 7.4% (54 people) had neither diagnosis despite being seen at the clinic.
The important caveat: this is a clinic sample, meaning everyone in it was already being evaluated for hEDS/HSD at a specialty clinic. It tells you how often the two diagnoses overlap among people already in that pipeline, not what percentage of the general population with fibromyalgia also has hEDS/HSD, or vice versa. Still, a rate above one in two within this specific clinical population is a real, substantial finding.
What Actually Separates the Two Conditions?
The study compared 40 self-reported symptoms and comorbidities across groups and found something specific: people with fibromyalgia alone and people with hEDS/HSD plus fibromyalgia reported very similar symptom patterns to each other - joint pain, hand pain when writing or typing, brain fog, activity-limiting joint pain, allergy or atopy, and headache were the top issues in the fibromyalgia-only group.
What distinguished the hEDS/HSD-plus-fibromyalgia group specifically was five issues: subluxations (partial joint dislocations), sprains and similar joint injuries, having to stop playing sports due to injury, poor wound healing, and migraine. People with hEDS/HSD alone, without fibromyalgia, reported far fewer symptoms and comorbidities overall than those with both. In practical terms: subluxations, poor wound healing, and joint injury history are the signals that point toward a connective tissue component being present, not just fibromyalgia on its own.
What to do with this
If you have a fibromyalgia diagnosis and also experience joint subluxations, unusually slow wound healing, or a pattern of joint injuries that led you to stop physical activity, this research suggests those specific signs are worth raising with a doctor as possible evidence of an underlying connective tissue component, not just fibromyalgia. Conversely, if you have hEDS/HSD and are also dealing with widespread pain, brain fog, or fatigue beyond what your joints alone would explain, a fibromyalgia evaluation is a reasonable next step rather than assuming everything traces back to your joints.