Generalized joint hypermobility and neck pain: Prevalence and functional correlates from a community-based sample

Background: Generalized Joint Hypermobility (GJH) is central to hypermobility disorders and common in the general population, yet its role in neck pain and function remains unclear. This study examined relationships among GJH, neck pain burden (pain and disability), and neck function (range of motion [ROM] and strength). Methods: Adults attending a large state fair completed GJH assessments (Beighton Score, Five-Part Questionnaire) and a neck pain survey. A subset also completed neck function testing and the Neck Disability Index. Multivariable regression evaluated associations among GJH, neck pain burden, and neck function, including interaction effects between GJH and neck pain burden. Findings: 555 participants (336 female/ 219 male) were enrolled. GJH prevalence was higher in females (23.5%) than males (6.8%). Due to small number of males with GJH (n = 15), subgroup and regression analyses were limited to females. Neck pain prevalence was greater in females with GJH than without GJH (24.1% vs 16.0% | n = 366). Among 182 females completing function testing (71 GJH, 111 non-GJH), regression analyses controlling for age, BMI, and neck pain burden showed GJH was associated with greater multi-directional ROM and strength. Significant interactions indicated that associations between disability and function differed according to hypermobility status. Interpretation: Females with GJH had a higher prevalence of neck pain and demonstrated greater ROM and strength than those without GJH. Interactions suggest GJH modifies the relationship between disability and function, supporting the concept that hypermobility may represent a distinct neck pain phenotype. Findings should be interpreted within this relatively healthy community-based cohort.