{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:25:25Z","timestamp":1793060725780,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Female chronic pelvic pain is estimated to affect up to 24% of adult women, many of whom have a component of myofascial pelvic pain. Although an association of joint hypermobility and pelvic pain has been hypothesized, limited data are available that estimate the prevalence of joint hypermobility in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the prevalence of generalized hypermobility spectrum disorder (G\u2010HSD) among female patients with chronic myofascial pelvic pain and examine the association between G\u2010HSD and other frequent pelvic pain\u2010associated complaints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral center within a university\u2010affiliated public health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Adult women who were diagnosed with myofascial pelvic pain during a 1\u2010year period (n = 77 with G\u2010HSD and n = 241 without G\u2010HSD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were abstracted via chart review of patients meeting inclusion criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>The primary outcome of this study was the prevalence of G\u2010HSD among patients with persistent myofascial pelvic pain. Secondary outcomes included the prevalence of dyspareunia, provoked vestibulodynia, stress urinary incontinence, irritable bowel syndrome, hip pain, low back pain, and fibromyalgia in patients with persistent myofascial pelvic pain with and without G\u2010HSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010four percent (N\u2009=\u200977; 95% CI: 19.6, 29.4) of myofascial pelvic pain patients also met criteria for G\u2010HSD. After adjusting for confounders, the odds in favor of having G\u2010HSD was 3.55 higher (95% CI: 1.50, 8.40) (<jats:italic>P<\/jats:italic>\u2009=\u2009.004) in females with dyspareunia; 7.46 higher (95% CI: 2.41, 23.1) (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) with low back pain; 3.76 higher (95% CI: 1.35, 10.5) (<jats:italic>P<\/jats:italic>\u2009=\u2009.02) with stress urinary incontinence; 4.72 higher (95% CI: 2.00, 11.2) (<jats:italic>P<\/jats:italic> &lt; .001) with irritable bowel syndrome; and 3.12 higher (95% CI: 1.36, 7.13) (<jats:italic>P<\/jats:italic>\u2009=\u2009.007) with hip pain. There was no significant association identified between provoked vestibulodynia or fibromyalgia and G\u2010HSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The estimated prevalence of G\u2010HSD is higher in chronic myofascial pelvic pain patients than in the general population with statistically significant associations with several comorbid conditions. Characterizing these associations is the first step in developing effective, evidence\u2010based screening recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12131","type":"journal-article","created":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T06:49:25Z","timestamp":1549522165000},"page":"1193-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Joint Hypermobility among Female Patients Presenting with Chronic Myofascial Pelvic Pain"],"prefix":"10.1002","volume":"11","author":[{"given":"Julie","family":"Hastings","sequence":"first","affiliation":[{"name":"Division of Advanced Gynecology, Department of Obstetrics and Gynecology Dignity Health Medical Group, St. Joseph's Hospital  Phoenix AZ"},{"name":"University of Arizona College of Medicine  Tucson AZ"},{"name":"Creighton University School of Medicine, Phoenix Regional Campus  Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeri E.","family":"Forster","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Colorado School of Medicine  Denver CO"},{"name":"Rocky Mountain Mental Illness, Research and Clinical Center, Rocky Mountain Regional VA Medical Center  Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Witzeman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Denver Health Medical Center  Denver CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-6-177"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00465.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2014.04.003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2009.01.003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2007.06.004"},{"issue":"9","key":"e_1_2_6_7_1","first-page":"1200","article-title":"Laparoscopic findings in women with chronic pelvic pain","volume":"86","author":"Newham AP","year":"1996","journal-title":"S Afr Med J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200312000-00004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001422"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30414-X"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2009.00758.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2016.162"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000098"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1586262"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2014.04.004"},{"issue":"2","key":"e_1_2_6_16_1","first-page":"239","article-title":"Joint hypermobility syndrome: inherited disorder of collagen synthesis","volume":"13","author":"Child AH","year":"1986","journal-title":"J Rheumatol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.12.026"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31539"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/79.6.591"},{"key":"e_1_2_6_20_1","unstructured":"What is HSD? 2018.https:\/\/www.ehlers-danlos.com\/what-is-hsd\/. 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