Neurodiversity & Musculoskeletal pain

Increased incidence of musculoskeletal pain in people with neurodiversity

Over the past decade, there is an increasing awareness and understanding that people with neurodiversity (and in particular autistic traits) are more likely to develop musculoskeletal pain than the neurotypical population. The reasons for this are not fully understood. However it has been observed in multiple studies that people with ADHD or Autism are more likely to also have hypermobility of the joints (or other tissues), fibromyalgia (chronic, widespread muscle pain), headaches, irritable bowel syndrome or other digestive issues. In addition, because of sensory processing difficulties, many neurodivergent people simply experience the sensations of the body in a very different way to other people. One study, reviewing the evidence and prevalence of pain in neurodivergent people has argued that hypermobility and pain are actually aspects of autism.

Our expertise at Evidence-Based Therapy Centre

Because of the multi-disciplinary nature of our service at Evidence-Based Therapy Centre, our musculoskeletal physiotherapists are knowledgeable and experienced in this area. Both Eoin Ó Conaire & Nigel Plummer are skilled at assessing these presentations and are aware of the nuances of neurodiversity and persistent pain. An example of one common presentation that we see, is somebody who has autism (diagnosed or self-diagnosed) mentions to their therapist that they have pain in their shoulder and neck muscles that often develops into a headache. They then have an assessment with one of our physiotherapists who diagnoses hypermobility of the joints. This is where the ligaments that support the joints are “stretchier” than average. Because of this extra movement at the joints, the person’s muscles have to work harder to stabilise the joints. If they are not strong enough to do this, they become fatigued and develop tension and pain. Strategies to relieve the tension and improve the muscle strength can often provide very effective long-term relief from the pain and headaches.

How can you tell if you have hypermobility?

Sometimes it is very obvious that you have hypermobile joints – you may have been described as double-jointed as a child and can easily place your limbs into positions that other people find difficult. Often it is not so obvious. However if your knees and / or elbows hyperextend (go more than straight) or if you can push your thumb to touch the inside of your wrist, then you probably have hypermobile joints. The Beighton Score is a quick test that physiotherapists carry out to screen for hypermobility and is demonstrated in the picture below.

The pros and the cons of being hypermobile

It is important to note that having hypermobility does not necessarily mean that you will develop pain. In fact there are many positive things about being able to get your limbs in positions that other people find difficult. For example, it is a big advantage in dance, gymnastics, swimming, martial arts and many other sports and the performing arts. However there is an increased incidence of pain or injury in people with hypermobility. This is because the muscles have to be stronger and more efficient than the average person’s so as to compensate for the stretchy ligaments. If the muscles are not strong enough, this can lead to musculoskeletal pain. Thankfully, this is something that can often be helped with a targeted physiotherapy programme.

If you have neurodiversity and also have musculoskeletal pain then perhaps you would benefit from a physiotherapy assessment with one of our physiotherapists.

To book an appointment, you can call the clinic on 091 727777 or get in touch via the contact page.