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EDS and rheumatism can cause similar symptoms, but the cause of the problems is different. EDS is about weaker connective tissue that makes the joints hypermobile and unstable, while rheumatism is an inflammatory disease in which the immune system attacks the joints.
If you have long-term joint pain without knowing why, a first step can be to find out if there are signs of inflammation. This can help you get closer to an explanation and the right type of treatment.
Why EDS and rheumatic disease are often confused
It is common for people with long-term joint pain to start wondering whether it could be rheumatic disease. At the same time, there are other conditions that can cause similar symptoms, and one of them is Ehlers-Danlos syndrome, EDS. Since both conditions can cause pain, stiffness, and fatigue, it is easy to think they are the same thing or closely related.
What mainly makes them easy to confuse is that the symptoms are often noticeable in the joints and can affect daily life in similar ways. But the underlying causes are completely different. EDS is a condition that affects the connective tissue, while rheumatic disease involves inflammation that occurs when the immune system attacks the body’s own tissues.
What is EDS?
EDS is a congenital condition that affects the body’s connective tissue, meaning the tissue that provides support and stability to structures such as the joints, skin, and organs. When the connective tissue is weaker than normal, the joints often become more mobile and less stable.
This can make the body more prone to strain, which in turn can lead to pain. Many people also experience their joints as unstable, twisting incorrectly, or not quite holding together as they should. The severity of symptoms varies from person to person, but common features include hypermobility, recurrent joint pain, and a feeling that the body is fragile or hard to rely on.
What is rheumatic disease?
Rheumatic disease is a collective term for several conditions in which the immune system causes inflammation, often in the joints. This leads to swelling, stiffness, and pain, and can sometimes also affect other parts of the body.
Unlike EDS, this is therefore not about hypermobility or instability, but about an inflammatory process. As a result, the symptoms often present differently. Many people with rheumatic disease describe their joints as feeling stiff for a long time in the morning, being swollen or warm, and the pain remaining even at rest.
Key differences between EDS and rheumatic disease
The most important difference between EDS and rheumatic disease is what causes the symptoms. In EDS, the problems are due to weaker connective tissue, which makes the joints hypermobile and unstable. The pain is often linked to strain, movement, or the joint ending up in a position that the body cannot fully stabilize. The joints may feel loose and sometimes give way.
In rheumatic disease, the symptoms are instead caused by inflammation. The joints then often become swollen, warm, and stiff, and the pain is usually more persistent. It may be present even when the body is at rest. Another difference is that inflammation associated with rheumatic disease is often visible in blood tests, whereas inflammatory markers in EDS are usually normal.
Inflammation or hypermobility – how the difference may feel
One way to understand the difference is to look at how the symptoms behave over time. In inflammatory conditions, such as rheumatic disease, stiffness is often most noticeable in the morning and may last a long time before the body feels mobile again. The joints may also feel swollen, tender, and warm, and the pain is not always related to how much you have been moving.
In EDS, the pain is more often related to strain. It may occur after a day of high activity, repeated movements, or static load. Many people also describe a clear feeling of instability, as if the joints do not quite stay in place. Symptoms can therefore vary greatly from day to day depending on how the body has been used.
Which tests can help you get answers?
Because the symptoms can resemble each other, it is often valuable to supplement with tests to understand what may be causing them. If rheumatic disease is suspected, blood tests are often used to show whether there is inflammation in the body, such as CRP and ESR. In some cases, HLA-B27 is also analyzed, as it may be linked to certain rheumatic diseases.
Rheumatism Health Check measures both high-sensitivity CRP and antibody levels associated with joint pain, which may provide an indication of whether the symptoms could be caused by, for example, rheumatoid arthritis.
If EDS is suspected, the assessment looks different. The diagnosis is mainly made through a clinical evaluation of joint mobility, symptoms, and medical history. Blood tests are primarily used to rule out other causes of the symptoms rather than to confirm EDS.
When should you suspect EDS?
If your joints are unusually mobile, often feel unstable, or are easily injured during strain, this may suggest EDS. This is especially true if the symptoms have been present for a long time and if you do not have clear signs of inflammation.
When should you suspect rheumatic disease?
If, instead, your joints are swollen, warm, or stiff for extended periods, especially in the morning, this may point more toward an inflammatory joint disease. Symmetrical symptoms, for example in both hands, are also common in rheumatic disease.
Can you have both?
It is uncommon, but it does happen that a person has both hypermobility and an inflammatory joint disease. That is why it is important not to draw conclusions too quickly based on individual symptoms, but instead to investigate the symptoms properly.
