Standing up should not be complicated. For someone with POTS, it can trigger a racing heart, dizziness, brain fog, and a wave of exhaustion that lingers for the rest of the day. After a diagnosis, the next question is almost always the same one: okay, so who actually treats this?
POTS, short for Postural Orthostatic Tachycardia Syndrome, is complex enough that no single specialist covers all of it. Understanding who does what, and where nervous system focused care fits into that picture, makes it a lot easier to know where to turn next.
What POTS Actually Involves
POTS is a condition of the autonomic nervous system, the part of the body that quietly manages your pulse, your blood flow, your digestion, and how your body handles heat and cold, all without you ever thinking about it. In POTS, that system does not regulate blood flow properly when a person moves from lying or sitting to standing, causing the heart rate to spike and bringing on dizziness, lightheadedness, fatigue, brain fog, and sometimes fainting.
Estimates suggest POTS affects between one and three million Americans, most of them women, and signs often first appear during the teenage years or early adulthood. Despite how common it is, POTS is still widely misunderstood, and many people cycle through several providers before landing on an accurate diagnosis. For a teenager already navigating school, friendships, and everything else that comes with adolescence, that extra layer of confusion can be exhausting on top of the signs themselves.
The Medical Side of Care
Cardiologists and neurologists are usually the specialists who diagnose POTS and manage it medically. Their approach typically combines medications, beta blockers to steady heart rate, medications to support blood volume, or others aimed at specific signs, with lifestyle guidance like increased salt and fluid intake, compression garments, and a gradual, structured exercise program.
This kind of care plays a real role for a lot of people living with POTS, and many find genuine relief through it. It tends to focus on managing signs day to day rather than addressing what caused the autonomic nervous system to lose its regulation in the first place, which is often where families start looking for something more. A cardiologist rules out heart conditions that overlap with POTS signs, which is an important step. A neurologist looks at how the nervous system is regulating more broadly. Both roles matter, and neither one is designed to look specifically at the physical tension that can be interfering with that regulation at the source.
Where Nervous System Focused Chiropractic Care Fits
This is where our doctors come in, adding the nervous system piece to a POTS care team. Subluxation, tension in the upper neck and spine that interferes with nervous system signaling, can play a real role in how well the autonomic nervous system is able to regulate heart rate and blood pressure when a person changes position.
Think of the autonomic nervous system as having a gas pedal and a brake. In POTS, the gas pedal tends to stay engaged even when the body should be settling into a calmer state. Gentle work at the upper neck, where the vagus nerve, the body's main calming pathway, begins its route through the body, can help that brake engage more fully.
What Care Looks Like With Our Doctors
We start with a full history: when signs began, what has already been tried, and how they show up day to day. From there, INSiGHT neurological scanning, thermal, heart rate variability, and sEMG, gives us objective data on how the autonomic nervous system is actually functioning, rather than relying on symptoms alone.
Using Koren Specific Technique and Talsky Tonal Chiropractic, our doctors apply light, nervous system focused contacts, no cracking, popping, or twisting, at the areas the scans point to, most often the upper neck and mid back. This works as one part of a broader care team, alongside whatever a cardiologist or other specialist has already put in place.
Everyday Habits That Support the Same Goal
- Steady hydration and salt intake through the day, spread out rather than all at once
- Compression garments for the legs during long periods of standing
- Rising slowly from lying or sitting, giving the body a moment to adjust before standing fully
- Gentle, recumbent style movement, building activity gradually rather than pushing through exhaustion
These habits work well alongside nervous system care, supporting the same goal of a body that regulates more easily as it moves through the day. Each one supports a different piece of the same picture. Each piece tends to support the others rather than standing in for them.
What Parents and Patients Often Notice
People often describe more steady energy through the day, fewer dizzy spells with position changes, and a better tolerance for standing or light activity. Some notice a difference within the first several visits, while more established patterns take longer, steadier care to shift. Our doctors track progress with repeat scanning so the plan can adjust as the nervous system responds, and we stay in communication with the rest of your care team as that progress unfolds.
Where to Go From Here
If you are trying to figure out who belongs on your POTS care team, nervous system focused chiropractic care is worth including alongside the cardiologists and other specialists already involved. You can read more about how we approach POTS and dysautonomia, or get our free guide on the nervous system side of these signs. When you are ready, you can schedule a consultation with our doctors in Royal Oak, or call us at (248) 616-0900.
