Relief of postural orthostatic tachycardia syndrome with chiropractic rehabilitation.

Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia that's characterised by an abnormal heart rate response to a positional change. A 50-year-old female presented with lightheadedness, palpitation, and neck pain for 3 years. Lightheadedness and palpitation occurred when shifting from a prolonged seated or lying position. Standing radiographs showed spinal misalignment with cervical kyphosis and thoracic scoliosis. Continuous static stress on these minor variants could aggravate biomechanical and autonomic disorder like POTS. After ruling out cardiovascular, neurological, or vestibular pathophysiology, a multicomponent treatment approach was adopted including the use of thermal ultrasound therapy, cervical and thoracic spinal manipulation, and intermittent motorized cervicothoracic traction to manage her neck pain complaints. Following 3 months of regular treatment, the patient reported a full resolution of neck pain, dizziness, and POTS. At 12-month follow-up, all radiographic metrics showed improvement, including improvement of cervical alignment and thoracic curvature. POTS is a prevalent, under-diagnosed dysautonomia. This study might arouse the alertness of clinicians that symptoms related to POTS may be erroneously attributed to other neuro-cardiovascular disorders.