Orthostatic Intolerance and POTS

Get rid of dizziness

Years ago in our clinic, we noticed many of our clients who had fatigue or pain also had many postural symptoms, such as dizziness, visual disturbance, sensitivity to the heat and swelling in their hands and feet. This led us, in collaboration with numerous specialists in Melbourne, to investigate why people had these additional symptoms, which are known as orthostatic intolerance (OI) or postural orthostatic tachycardia syndrome (POTS). We have since developed a rehabilitation program for OI/POTS that relies on the latest research to change people's lives, and has even been successfully used by our staff.

Orthostatic intolerance and POTS

Orthostatic intolerance (OI) is characterised by a drop in blood pressure of 20mmHg, while postural orthostatic tachycardia syndrome (POTS) is characterised by an increase in heart rate of 30bpm. Both of these changes happen when a person moves from lying down to standing (a postural change). OI/POTS is often associated with other conditions, such as chronic fatigue syndrome or myalgic encephalomyelitis, but can also be a stand-alone condition.

The symptoms of OI/POTS can include:

  • Postural dizziness (from lying/sitting to standing)

  • Postural vision spots or blindness

  • Sensitivity or intolerance to the heat and/or a change in temperature

  • Nausea, over-fullness and a lack of appetite

  • Swelling in the feet after sitting or standing still for a while

  • Cold hands and feet

  • Salt cravings

  • Irregular sweating patterns

  • Fatigue from standing for a while

  • Light-headedness while in the shower or abnormal fatigue after showering

  • Intolerance to alcohol

  • Fidgeting.

Our program

Our program is designed and focused on OI/POTS rehabilitation and helps our clients make and maintain gains made, through a holistic approach. We will do a thorough assessment of your health during your first appointment. Depending on your particular situation, you may need another 4-5 individual sessions over 1-2 months, or longer if you also have a fatigue or pain syndrome.

The sessions focus on:

  • OI/POTS physiology and management, including hydration, salt intake and medications

  • Setting up a cardiovascular exercise routine

  • Strength training to promote blood flow

  • Goal setting

  • Sleep physiology and hygiene

  • Identifying triggers and developing a setback plan

  • Stress and anxiety management

  • Symptom mapping.

Our program aims to help you have a ‘normal day’ or return to work or school, without increasing your symptoms. We teach you the skills to deal with any future problems through setback planning and your personal therapy manual.

We can also refer you to a specialist near you to help you manage your health and get access to medication if appropriate.

See our Testimonials page to hear from those who have experienced our OI/POTS rehabilitation program for themselves.

Cost and questions

For program costs and rebates available, please see our Fees and Rebates page.

Do I need a referral? What if I can't get to your clinic? Please visit our FAQ page for answers to these and other questions about our programs.

What if I've already done another treatment program?

If you have had treatment for OI/POTS in the past, that's great! We take an inclusive approach and can build on and increase your understanding and progress through our program. We won't make you redo things you have already done through another program.

What causes OI/POTS?

The cause of OI/POTS is unknown, however, it's most likely caused by a range of factors.

We believe that there are two main types of OI/POTS: peripheral and central.

Peripheral OI/POTS is caused by non-neurological factors. People who have OI/POTS often also have joint hyper-elasticity. This extra stretchiness may make them more likely to have joint injuries and also have OI/POTS because of increased artery or vein elasticity. This can lead to poor blood vessel constriction and therefore poor blood pressure control.

Imagine you were trying to push water through the type of balloon clowns make animals with. When you push down in one area it bulges in another. However, if you used a garden hose instead of a balloon it would not bulge but push the water out the other end at a greater pressure. People with OI/POTS and hyper-mobility are thought to have stretchier blood vessels, which leads to poor blood vessel constriction.

Central OI/POTS is most likely caused by the sympathetic nervous system, which controls automatic body functions like blood pressure and heart rate. One reason for this may be because of an increased sympathetic load leading to a delayed or irregular response. (This can also often happen in people with chronic fatigue syndrome).

Ready to learn more and conquer your dizziness?