Expert: J.R. Strecker, B.S., D.C. - 11/3/2008

Question
Background information: After an ankle and wrist sprain at age 12 that didn't heal, I began having joint pain in other places as well (e.g. cervical, lumbar spine).  Was evaluated for many things by rheumatologists, but nothing concrete panned out (including arthritis, lupus, lyme).  In my 20s I received a fibromyalgia diagnosis, and since then have considered my pain to be a pain dysregulation disorder.  
However, in my early 30s, MRIs of my back revealed multiple disc dessication and herniations, culminating in a cervical disc shattering (no trauma) that required immediate surgery due to spinal impingement.   Now, 2 years post cervical fusion, while the cerivical problems have eased, I have been noticing a lot of "clicking" and "popping" of my joints with pain (shoulders, hips, thoracic spine, big toe joint, ankle spraining).  A sports medicine doctor diagnosed me with hip joint instability and did prolotherapy on me.  I don't know whether it was the prolo or just time, but one side of the hip got worse and an MRI revealed bursitis.
Sorry for the lengthy history, but I guess what I'm wondering is whether, even though my general lab values have been normal, I might have some systemic problem with my tendons or ligaments such that my joints aren't stable enough and the resulting pain and "spraining" I experience is a result of that "laxity".   Is there such a systemic thing and if so, what kind of doctor should I go to in order to evaluate me for it?  I live in the NYC area.
Much appreciation.

Answer
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Hello C.,

Your case is too involved for me to comment on your situation specifically.  But in answer to your question, there are disorders that affect joint laxity systemically.  They are classified as connective tissue disorders.  You can use an Internet search engine to learn more about the different types of connective tissue disorders.  They are classified in many ways and are genetically based.  Connective tissues are found everywhere in the body.  In a connective tissue disease, the body's connective tissues lack the tensile strengths found in people without the disorder.  The results are wide-ranging, and each disorder can have vastly varying degrees of severity.  One of the most common symptom is joint laxity.  Some people have hypermobile joints; other people have more serious signs and symptoms.

Please keep in mind I am not diagnosing you as having a connective tissue disorder.  A diagnosis can only be made by a doctor who evaluates you.  Regarding which doctor to go to for an evaluation, the doctor who performed your prolotherapy probably is a good start, as this is sometimes a procedure for connective tissue disorder patients.  This doctor may have performed this treatment based on speculation of a connective tissue disorder.  I would suggest to start with the doctor who performed this procedure and mention your concern for your joint laxity.  In addition, ask what other specialists he/she may be able to refer you to  or if there are other treatment options he/she can recommend for your situation.

In summary, I would say connective tissue disorders are most commonly the culprits for systemic joint instabilities.  This will give you a good place to start talking with your doctor and researching online.  I hope this helps a bit.  Again, please do not take this as a diagnosis, but rather as educational information for you to discuss with your doctor.

Best of luck!
Dr. J.R. Strecker, D.C.