Chronic Pain, Chronic Fatigue, Joint Hypermobility & Neurodivergence: Could There Be a Connection?

If you live with chronic pain or chronic fatigue, you may have noticed other traits or symptoms that seem unrelated—difficulty with sensory processing, executive functioning, attention, social communication, or other characteristics associated with neurodivergence.

But what if these conditions are more connected than we previously understood?

A recent study explored the relationship between neurodivergence, joint hypermobility, chronic pain, and chronic fatigue—and the findings raise some important questions for both patients and healthcare practitioners.

Could Joint Hypermobility Be the Missing Link?

Neurodivergent traits are commonly reported among people living with chronic pain and chronic fatigue. Researchers wanted to better understand why these conditions may overlap.

Interestingly, the study found that joint hypermobility may act as a mediator between neurodivergence and chronic pain and chronic fatigue.

In other words, joint hypermobility may be one piece of the puzzle connecting these seemingly separate experiences.

This is particularly interesting because hypermobility is not always obvious. Someone doesn’t necessarily need to be able to perform extreme “party tricks” with their joints to have clinically relevant hypermobility. Hypermobility can present in many different ways and may be overlooked during routine medical evaluations.

What About “Hidden” Neurodivergence?

Another important consideration is how neurodivergence was identified in the study.

Participants were identified as likely autistic and/or likely to have ADHD, rather than having a confirmed clinical diagnosis.

This distinction matters.

Many adults—particularly those who have developed strong coping or masking strategies—may go through years without recognizing that they are neurodivergent. Barriers to assessment and diagnosis can include limited access to specialists, cost, long waitlists, stigma, and a lack of recognition of how neurodivergence can present differently across individuals.

This raises the possibility of a population of people with “hidden” or unrecognized neurodivergence who are simultaneously navigating chronic pain, fatigue, and other physical symptoms.

What Does This Mean for Healthcare Practitioners?

These findings raise an important question:

How can practitioners become better informed about neurodivergence screening when working with patients experiencing chronic pain and chronic fatigue?

Screening does not mean assuming that every patient with chronic pain is autistic or has ADHD.

Instead, it means recognizing that neurodivergence may be relevant to the patient’s overall clinical picture and understanding when additional screening, education, or referral may be appropriate.

It also encourages practitioners to look beyond a single diagnosis and consider how sensory processing, communication styles, executive functioning, autonomic regulation, movement patterns, and other factors may influence a patient’s experience of pain and fatigue.

Should We Be Screening for Hypermobility?

One of the biggest questions I take away from this research is whether joint hypermobility screening should become a more routine part of evaluating people with chronic pain, chronic fatigue, and suspected neurodivergence.

I believe it deserves consideration.

Joint hypermobility can influence proprioception, joint stability, muscle workload, movement strategies, and potentially the way someone experiences and responds to physical stress.

Identifying hypermobility may therefore provide practitioners with another piece of information when developing an individualized treatment plan.

Rather than treating chronic pain or chronic fatigue in isolation, we can begin asking:

What else might be contributing to this person’s symptoms?

A More Connected Approach to Chronic Pain

Chronic pain and chronic fatigue are complex experiences. They rarely fit neatly into one diagnostic category.

The emerging relationship between neurodivergence and joint hypermobility gives us another reason to take a broader, more individualized approach to assessment and treatment.

For practitioners, this may mean becoming more comfortable recognizing neurodivergent traits, understanding appropriate screening tools, and considering joint hypermobility when clinically relevant.

For patients, it may mean finally having a framework that connects symptoms that previously felt completely unrelated.

There is still much more to learn.

But research like this encourages us to move away from looking at symptoms in isolation and toward understanding the interconnected systems that may contribute to chronic pain and fatigue.

Questions for Practitioners

• How comfortable are you screening for neurodivergent traits in patients with chronic pain or fatigue?
• Do you routinely assess for joint hypermobility?
• Could identifying hypermobility or neurodivergence change your treatment approach?
• How can we reduce barriers to appropriate neurodivergence assessment and diagnosis?

Understanding these connections may be an important step toward providing more individualized and effective care for people living with chronic pain and chronic fatigue.

Read the study & See References: PubMed – Chronic pain, chronic fatigue, neurodivergence and joint hypermobility