Chen, Grant, Olver, James S, Kanaan, Richard A · Journal of psychosomatic research · 2021 · DOI
This review looked at whether people with ME/CFS and similar conditions have more flexible or hypermobile joints than other people. Researchers examined 11 studies comparing joint flexibility in people with ME/CFS, fibromyalgia, and similar conditions to healthy controls. They found that people with these conditions were about three times more likely to have joint hypermobility, though the quality of the studies varied.
Joint hypermobility is a treatable condition that may contribute to symptoms in ME/CFS and related functional somatic syndromes. Understanding the relationship between these two conditions could lead to better diagnostic approaches and targeted physical management strategies for some ME/CFS patients.
This study does not prove that joint hypermobility *causes* ME/CFS or that treating hypermobility will resolve ME/CFS symptoms. The association is correlational, not causal, and the poor quality of most included studies means findings require confirmation with higher-quality research before being generalized to all ME/CFS populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Chen, Grant, Olver, James S, & Kanaan, Richard A (2021). Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2021.110556
BibTeX
@article{mecfsatlas-chen-2021-functional-somatic,
author = {Chen, Grant and Olver, James S and Kanaan, Richard A},
title = {Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis.},
journal = {Journal of psychosomatic research},
year = {2021},
doi = {10.1016/j.jpsychores.2021.110556},
note = {PubMed: 34237584},
url = {https://www.mecfsatlas.com/evidence/chen-2021-functional-somatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/chen-2021-functional-somatic
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