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Understanding Ehlers-Danlos Syndrome (EDS): Symptoms, Diagnosis, and Supportive
Treatment Options
By Matthew Terzella, MD
Board-Certified in Physical Medicine & Rehabilitation
Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders that affect the way the body produces collagen, the protein that helps provide strength and structure to skin, ligaments, blood vessels, and joints. Because collagen plays such an important role throughout the body, EDS can impact multiple systems and create a wide range of symptoms, from joint instability to chronic pain to fatigue and autonomic nervous system issues.
At Piedmont Physical Medicine & Rehabilitation (PPMR) in Greenville, SC, we care for many patients living with EDS and Hypermobility Spectrum Disorders (HSD). Our goal is always to help you understand what’s happening in your body and develop a treatment approach that supports your comfort, function, and quality of life.
What Is Ehlers-Danlos Syndrome?
Ehlers-Danlos Syndrome refers to a group of genetic conditions that affect how the body builds and maintains connective tissue. Because connective tissue supports joints, skin, organs, vessels, and more, people with EDS often experience joint instability, tissue fragility, and increased laxity or flexibility.
EDS is lifelong, but symptoms and severity vary significantly from person to person. Some people experience mainly joint pain and instability, while others may have more systemic involvement.
Early recognition, education, and supportive care can make a meaningful difference in quality of life.
Common Symptoms of Ehlers-Danlos Syndrome
While symptoms differ by individual and EDS type, some common features include:
Musculoskeletal symptoms
Hypermobile or “double-jointed” joints
Frequent sprains, strains, or dislocations
Chronic joint or muscle pain
Muscle fatigue and weakness
Poor proprioception (awareness of joint position)
Skin and soft tissue
Soft, stretchy, fragile, or easily bruised skin
Slow or complicated wound healing
Visible scarring
Autonomic & systemic involvement
Lightheadedness or fainting
Heart rate or blood pressure instability
Gastrointestinal symptoms
Temperature regulation challenges
Fatigue and sleep disturbance
These symptoms may overlap with conditions such as Postural Orthostatic Tachycardia Syndrome (POTS) and dysautonomia, which commonly coexist with hypermobility disorders.
Types of Ehlers-Danlos Syndrome
There are thirteen recognized types of EDS. The most common include:
Hypermobile EDS (hEDS)
Most frequently diagnosed type
Characterized by joint hypermobility, instability, and pain
Diagnosis is clinical (no single confirmatory genetic test yet)
Classical EDS
Skin hyperextensibility and fragile tissue
Joint laxity and scarring
Vascular EDS (vEDS)
Rare but serious
Affects blood vessels and internal organs
Requires specialized medical monitoring
Other rare types may involve skeletal, periodontal, or dermal features. Because presentation varies widely, individualized evaluation is essential.
How PPMR Supports Patients Living With EDS
At Piedmont Physical Medicine and Rehabilitation in Greenville, SC, we recognize that no two people experience Ehlers-Danlos Syndrome the same way.
Our approach centers on:
✔ listening
✔ educating
✔ supporting stability and comfort
✔ coordinating care when appropriate
We focus on conservative, regenerative, and supportive treatment plans that align with your goals and daily life.
Treatment Options Available at PPMR
Our care plans are customized and can include:
Regenerative Injection Therapies
These are designed to help support soft-tissue stability in lax or painful joints:
Prolotherapy — stimulates healing in ligaments and tendons to help improve joint stability
Platelet-Rich Plasma (PRP) injections — uses your own platelets to help support tissue repair and function
These treatments may be helpful for patients with chronic joint pain or recurrent soft-tissue injury related to hypermobility.
Pain Management & Targeted Nerve Blocks
When appropriate, we may recommend:
diagnostic or therapeutic nerve blocks
targeted injections for pain relief
strategies to calm overactive pain pathways
These options are carefully selected to reduce pain while supporting functional goals.
Support for Dysautonomia & POTS Symptoms
Many EDS patients also experience autonomic nervous system instability. While PPMR does not replace cardiology or neurology care, we can:
help identify symptom patterns
support conservative management strategies
coordinate with specialists as needed
Coordinated, Collaborative Care
EDS often benefits from a team-based model. We can collaborate with:
cardiology
specialized physical therapy
allergy & immunology
neurology
gastroenterology
and other specialists as needed
Our goal is to help ensure nothing gets overlooked and that your care feels integrated and supportive.
A Patient-Centered Philosophy
We believe deeply in shared decision-making. That means:
you are heard
your goals matter
your comfort matters
your plan is built with you, not just for you
Our aim is to help you live as fully and comfortably as possible — not to force you into a box.
If You’re Living With Ehlers-Danlos Syndrome, You Don’t Have to Do It Alone
EDS can be complex — but you deserve a care team that understands that complexity and meets you with compassion.
At Piedmont Physical Medicine & Rehabilitation, Dr. Matthew Terzella and our team provide patient-centered, regenerative-focused, thoughtful care for people navigating chronic pain and hypermobility disorders.
If you’re seeking clarity, support, or conservative treatment options — we’re here to help.
📞 Contact our office at 864-235-1834 to schedule an appointment and learn whether our approach may be right for you.
Frequently Asked Questions About EDS
EDS is genetic and lifelong. Treatment focuses on support, stability, pain reduction, and function — helping you live better with your condition.
Joint hypermobility means that a person’s joints have a greater range of motion than is expected or usual. Some people have joint hypermobility that does not cause them pain or other issues. However, some people with joint hypermobility also have joint instability. Joint instability occurs when the bones of a joint aren’t held in place securely. This can lead to joint subluxations, dislocations, sprains, and other injuries. Joint instability can cause both acute and chronic pain and interfere with daily life.
Joint hypermobility is observed throughout the body in most types of EDS, but hypermobility may be limited to the hands and feet in some types. Although joint hypermobility is observed across all types of EDS, not everyone with a type of EDS has joint hypermobility.
No. Some people have generalized joint hypermobility without systemic features. Evaluation helps clarify the difference.
For some patients, prolotherapy or PRP may support joint stability and reduce pain related to ligament laxity. Treatment decisions are always individualized.
Each type of EDS is associated with different symptoms and characteristics. Some symptoms are common across all types of EDS, such as joint hypermobility, pain, and fatigue. Other symptoms are only observed in specific types of EDS. Even within the same type of EDS, people can experience very different symptoms from each other.
There are also many other medical conditions that are often seen in people with EDS, including types of dysautonomia and mast cell diseases.
No. Presentation varies widely. Many people live full, active lives with proper support.
The Ehlers-Danlos syndromes can be passed on from parent to child. Each type of EDS is inherited in either a dominant or recessive inheritance pattern.
A dominant inheritance pattern means that just one copy of a genetic variant (passed down from one parent) is needed to inherit the condition. If a person has a condition with a dominant inheritance pattern, each of their children will have a 50% chance of inheriting the condition. A recessive inheritance pattern means that a person must inherit two copies of the genetic variant (one from each parent) in order to have the condition.
A person may be the first one in their family to have a type of EDS. This is called a de novo mutation.
Movement is important — but should be guided, controlled, and protective. We frequently coordinate with specialized physical therapists.
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