Positional Orthostatic Tachycardia Syndrome (POTS) – The Upper Neck Connection
Positional Orthostatic Tachycardia Syndrome (aka POTS) can be a debilitating disorder. It is defined by dizziness, faintness, anxiety as well as a host of other symptoms. POTS is a functional neurological disorder that involve the vagus nerve. The vagus nerve is the communication highway for all of the neurological information between your brain and vital organs. It is intimately involved with hormone regulation as well, including the thyroid, adrenal and reproductive glands.
One of the most challenging things about POTS is that there is seldom ever just one thing that causes it. It is often a combination of different things, each contributing to the overall disorder. The reason this is so frustrating for so many people who experience POTS is because their blood tests, brain CT and MRI scans often come back saying that everything looks normal (when clearly something is wrong).
Players Involved with Positional Orthostatic Tachycardia Syndrome
To best appreciate the nature of positional orthostatic tachycardia syndrome, its worth taking a brief moment to consider the players involved.
The vagus nerve exits your brainstem at the very base of your skull through an opening called the jugular foramen. This opening also contains a few other important structures:
- The glossopharyngeal nerve, which controls swallowing, glands and monitors blood pressure
- The spinal accessory nerve, which controls neck movements and posture
- The ascending sympathetic trunk, which controls blood and lymph flow in your brain (and can cause dizziness, anxiety, sweating or even panic attacks)
- The internal carotid artery, which supples two-thirds of blood to your brain
- The internal jugular vein, which is the primary drain for blood from your brain back to your heart.
Now, as all of these structures descend from your head along the front of your upper neck, they are bound on both sides (front-to-back) by two structures:
- The styloid process and its associated ligament, which regulates jaw tension and TMJ function.
- The front parts of the C1-C2-C3 vertebrae, which are collectively known as the upper cervical spine
It is important to appreciate the relationship between these structures because a problem with either your TMJ or your upper neck then can be one of the major factors that contributes toward POTS.
What Causes Positional Orthostatic Tachycardia Syndrome?
In order to understand the nature of POTS (and more importantly what can be done to help), it is essential that we let go of this false belief that we need to just find “the one thing.” Alas, there is not just one thing. Instead, we need to look at the various factors involved as address each of them.
Specifically, we are referring to hormone imbalances that include the thyroid, adrenal and sex glands. The most challenging thing when it comes to hormones is that an imbalance of one will also affect all the others. As a result, it can be very difficult to find the origin of the problem. Nevertheless, some of the common elements that must be considered especially with POTS are your iron, iodine, cobalt, vitamin B9, B12, T3, T4, TSH, cortisol and DHEA levels.
Connective Tissue Disorder
Ehler’s Danos Syndrome is a genetic condition that cause a person’s ligaments to be more flexible than average. While this flexibility in itself is not a problem, it means that it does not take as much physical stress when problems occur with your head, neck or jaw to produce symptoms. Although we cannot change our genes, mast cell activation, which is a hyperactive immune response, typically to mold is a recurring theme. A good probiotic, supplements (N-Acetyl Cysteine, Vitamin D and a quality probiotic) may help to improve symptoms of POTS.
The shape of our skull can also make some people more susceptible to functional neurological disorders like POTS. Contributing factors that can cause brainstem pressure and chiari malformation include a basilar impression, playbasia and a shallow posterior fossa. Although surgery is sometimes the only answer, many people never need to go down that route. They find that working with a good craniosacral therapist and physical therapist who performs vagus nerve stimulation helps.
TMJ and myofunctional disorders can cause your jaw to move abnormally. Not only can this cause clicking, tension, and grinding, it can also pull on the ligament that attaches to that styloid process. As a result, you can experience physical compression of the vagus nerve along with all those other nerves and blood vessels we mentioned earlier (called Eagle’s syndrome). Think of it like having a pebble in your shoe. Even the small bit of physical irritation compounded over a long time can cause lots of problems with the vagus nerve. Here the where a myofunctional therapist plus neuromuscular dentist are often key players in assisting people with POTS.
Upper Neck Misalignment
Your upper neck (aka craniocervical junction) is the only level in your spine that does not have a disc that locks it into place. Therefore, if we ever experience a physical injury that causes the C1-C2-C3 vertebrae to lock into an abnormal position (especially forward like happens when we sit in front of a computer), that can also compress against the vagus nerve and produce symptoms associated with POTS. This is the upper cervical chiropractic side of the equation and where a unique approach known as the Blair technique can help.
Positional Orthostatic Tachycardia Syndrome – A Different Approach
To recap, there is unfortunately no one answer to solving POTS. If it takes a village to raise a child, it takes a team to treat positional orthostatic tachycardia syndrome. Each is an essential element that only works when combined with all the others.
Our role at Clear Chiropractic is to help with the upper neck alignment side of the equation. The Blair technique is a unique approach to chiropractic that does not involve any bending, twisting, popping or cracking. It is a gentle and personalized approach that uses neurological testing, diagnostic scanning and precision-based measurements to make sure that you get the right care.
If you or a loved one are experiencing positional orthostatic tachycardia syndrome, the Blair technique might be the solution you are looking for. If you are looking for a chiropractor in Spokane, visit our home page more information. To schedule a new patient appointment with our Mead (north Spokane) or South Hill offices, complete a new patient request form here or call us direct at 509-315-8166.