Because it can take so long to get a proper diagnosis, understanding and managing life with POTS can be quite challenging.
What is POTS?
Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia making it a condition of the autonomic nervous system (ANS). The ANS is the body’s “autopilot” system acting largely unconsciously, controlling things such as heart rate, digestion, blood pressure, breathing, and other functions. POTS occurs when the ANS doesn’t work as it is supposed to.
No matter the position a person is in—standing, lying flat on their back, sitting or reclining, the ANS helps maintain blood pressure at the proper level. Typically, when you stand, your ANS tells blood vessels in your lower body to constrict. In order to prevent blood from pooling in the legs, the constriction of the blood vessels acts against gravity. This innate response ensures that the brain receives sufficient blood flow to function properly.
Because the ANS does not function normally in POTS, blood vessels do not tighten sufficiently to ensure adequate blood flow to the brain. When there is insufficient blood supply to the brain, a person may feel lightheaded or pass out whenever they stand. Instead, the ANS causes the heart to beat much faster in an attempt to maintain adequate blood supply to the brain.
What does POTS stand for?
Because symptoms of POTS are related to body position and are triggered while standing, the letter “P” stands for postural.
“O,” orthostatic, represents something caused by an upright posture. When you have POTS, your blood vessels fail to respond to signals, causing blood to pool in your lower extremities and insufficient blood flow to the brain and upper body.
“T” stands for tachycardia, a rise in heart rate brought on by the body’s signaling of tightening blood vessels and pumping blood back up. Your heart beats more quickly than usual as a result (usually over 100 beats per minute).
Lastly, “S” stands for syndrome because POTS is a group of symptoms rather than a disease.
How to Identify POTS
Because POTS can present differently in everyone, identifying it can be tricky. However, some of the most typical signs to watch out for are:
- Fainting
- Heart palpitations (noticeable heartbeats)
- Tachycardia upon standing
- Lightheadedness/dizziness with prolonged sitting or standing
- Brain fog or trouble focusing
- Shortness of breath
- Exercise intolerance
- Chronic fatigue
- Tremor and Nausea
What causes POTS?
POTS can be brought on by several different factors or instances. POTS can develop after a pregnancy, major surgery, head injury, trauma, serious infection, viral illness, COVID, or even an autoimmune disease.
Another condition can also trigger POTS. For example, Ehlers-Danlos Syndrome (EDS), a completely different disorder, and POTS frequently coexist. Many POTS patients are thought to get the Syndrome as a result of having EDS. However, It’s important to remember, not all POTS patients have EDS.
How PT can help
POTS is a condition that is growing more common in the United States, with more and more people seeking help every day. At PARR PT, we have over 10 years of experience in exercise physiology creating safe yet effective exercise programs for a variety of conditions.
Our specialized therapy consists of a number of autonomic physical therapy techniques that work to restore the body’s reaction to activity and everyday tasks and help facilitate a mind-body connection. In order to reduce pain and restore normal function, we also apply specific gut physical therapy. This includes manual therapy, nerve balancing, and spinal alignment.
We are experts in appropriately moderating exercise intensity and positioning a person based on the severity of symptoms. Our experience has led to improvements in endurance with day-to-day activities, standing and exercise tolerance. Not only is physical therapy needed to enhance heart function through exercise, but particular manual therapy treatments are necessary for management of the “fight or flight” response in individuals with POTS for longer-lasting outcomes.
Next steps
Oftentimes, patients see multiple physicians over many years before receiving an accurate diagnosis. Finding a clinician that is knowledgeable with dysautonomia is crucial. At PARR PT, we recognize no two people with POTS are affected in the same way, so it’s important to receive individualized care that’s unique to your situation. Although POTS is not life-threatening, it has proven to be life-altering. Don’t be afraid to ask your healthcare provider questions about POTS and seek help when needed.