Care That Considers the Full Picture
Living with these conditions can mean navigating symptoms that affect multiple aspects of your health and everyday life. Some patients also experience overlapping conditions that make finding the right care more complicated. Our approach brings together medical management, rehabilitation, patient education, and coordinated care to address each patient’s individual needs, concerns, and goals.
EDS
Ehlers-Danlos Syndrome
POTS
Postural Orthostatic Tachycardia
MCAS
Mast Cell Activation Syndrome
FMS
Fibromyalgia Syndrome
Chronic Pain
Fibromyalgia Syndrome
Ehlers-Danlos Syndrome (EDS) & Hypermobility Disorders
Ehlers-Danlos syndromes (EDS) are a group of connective tissue disorders that affect structures throughout the body, including the joints, skin, and blood vessels. These disorders can affect joint stability and the body’s ability to support and protect connective tissues.
Common symptoms and challenges may include:
- Joint hypermobility and instability
- Frequent sprains, subluxations, or dislocations
- Chronic joint and muscle pain
- Muscle weakness and fatigue
- Difficulty with balance or coordination
- Reduced tolerance for prolonged standing, walking, or physical activity
Symptoms vary from person to person. Some individuals also experience overlapping conditions, including postural orthostatic tachycardia syndrome (POTS).
Treatment focuses on improving joint stability, addressing pain, and supporting physical function. Depending on each patient’s needs, care may include individualized physical therapy, strengthening and stabilization exercises, balance and proprioception training, activity modification, and education on joint protection.
The goal is to help patients move more safely, manage symptoms, and maintain the activities that matter to them.
Postural Orthostatic Tachycardia Syndrome (POTS)
Postural orthostatic tachycardia syndrome (POTS) is a disorder of orthostatic tolerance that affects the autonomic nervous system, which regulates functions such as heart rate, blood pressure, temperature, and digestion. In people with POTS, standing up can cause an excessive, sustained increase in heart rate, often accompanied by symptoms that can interfere with everyday activities.
Common symptoms may include:
- Rapid heart rate or palpitations when standing
- Dizziness or lightheadedness
- Fatigue and reduced stamina
- Brain fog or difficulty concentrating
- Exercise intolerance
- Nausea or gastrointestinal discomfort
- Temperature intolerance
- Weakness, shakiness, or feeling faint
Symptoms vary from person to person and may become worse with prolonged standing, heat, dehydration, illness, or physical exertion. POTS can also occur alongside other conditions, including Ehlers-Danlos syndrome (EDS).
Treatment focuses on managing symptoms and improving tolerance for daily activities. Depending on each patient’s needs, recommendations may include appropriate fluid and sodium intake, compression garments, activity modification, and symptom monitoring. A structured rehabilitation program with gradual conditioning may also be recommended to help improve physical stamina and activity tolerance.
Mast Cell Activation Syndrome (MCAS)
Mast cell activation syndrome (MCAS) occurs when mast cells, which are part of the body’s immune system, release inflammatory chemicals called mediators inappropriately or excessively. Because mast cells are found throughout the body, symptoms can affect multiple organ systems and vary considerably from person to person.
Common symptoms may include:
- Flushing, itching, or hives
- Swelling
- Abdominal pain, nausea, or diarrhea
- Lightheadedness or changes in blood pressure
- Rapid heartbeat
- Nasal congestion or respiratory symptoms
- Severe allergic reactions, including anaphylaxis
Symptoms can fluctuate over time and may be difficult to predict, making MCAS challenging to recognize and manage.
Evaluation and treatment take into account each patient’s symptoms, medical history, potential triggers, and related health concerns. Laboratory testing may also be considered as part of the clinical assessment. Treatment is individualized and may include symptom tracking, identifying potential triggers, environmental and lifestyle adjustments, and addressing chronic pain, fatigue, or physical limitations through rehabilitation-focused care.
Living with MCAS can be challenging, especially when symptoms are unpredictable or affect several aspects of daily life. Care should take these challenges into account, helping patients better understand their condition and explore practical ways to manage its impact.
Fibromyalgia
Fibromyalgia is a chronic condition associated with changes in how the nervous system processes pain. Often described as nociplastic pain, it involves changes in the way the brain and nervous system interpret pain signals, which can make sensations feel more intense or widespread than expected.
Common symptoms may include:
- Widespread muscle and joint pain
- Persistent fatigue
- Unrefreshing sleep
- Brain fog or difficulty concentrating and remembering
- Headaches or migraines
- Increased sensitivity to touch, pressure, or temperature
- Stiffness and reduced activity tolerance
These symptoms can affect sleep, physical activity, daily responsibilities, and overall quality of life.
Treatment is individualized based on each patient’s symptoms and functional limitations. Depending on their needs, care may include medication management, physical therapy, gradual exercise progression, sleep education, and activity pacing. Treatment plans are adjusted to individual tolerance, with the goal of reducing the impact of symptoms and helping patients maintain meaningful daily activities.
Chronic Pain Management
Living with persistent pain can affect far more than physical comfort. It can interfere with sleep, mobility, concentration, work, and the activities that make up everyday life. Chronic pain is generally defined as pain lasting longer than three months. It may develop after an injury, surgery, or illness, or occur alongside an ongoing medical condition.
Chronic pain can involve several contributing factors, including the nervous system, musculoskeletal conditions, and the physical and emotional effects of living with persistent pain. Understanding a patient’s pain history, previous treatments, current symptoms, and functional concerns is an important part of determining the most appropriate approach to care.
Chronic pain conditions and concerns evaluated may include:
- Chronic neck and back pain
- Musculoskeletal and joint pain
- Neuropathic (nerve-related) pain
- Persistent pain following an injury or surgery
- Chronic widespread pain
- Pain associated with connective tissue disorders
- Pain that limits mobility or everyday activities
Treatment is based on the underlying causes of pain, the patient’s symptoms, and how pain affects everyday activities. Depending on the patient’s needs, care may include medication management, non-opioid treatment options, therapeutic exercise, and activity modification. Follow-up visits help assess treatment response, monitor safety, and determine whether adjustments are needed.
When previous treatments haven’t provided lasting relief, it can be difficult to know what to try next. A comprehensive approach to chronic pain can help patients explore appropriate treatment options and determine the next steps in their care.
A Coordinated Approach to Complex Care
When several medical conditions or symptoms overlap, it can be difficult to understand how they affect one another and what kind of care may help. Treatment begins with a careful evaluation of each patient’s medical history, current symptoms, and the ways they affect everyday life.
Depending on each patient’s needs, treatment may include:
- Comprehensive medical evaluation to better understand symptoms, health history, previous treatments, and functional limitations.
- Individualized treatment planning that may combine medical management, rehabilitation strategies, and pain or symptom management.
- Patient education and guidance to help patients better understand their conditions and manage the demands of daily life.
- Ongoing follow-up and coordination to monitor progress, adjust treatment when needed, and work with other healthcare professionals when appropriate.
Complex conditions can leave patients with many questions and uncertainty about what to do next. We believe good care starts with listening, taking concerns seriously, and helping patients make sense of their health and the options available to them.
Ready to Take the Next Step?
If you’re living with a complex or chronic condition and looking for guidance, Rehab Medicine of the Carolinas is here to help. You do not need a referral to get started. Contact our office to schedule an evaluation and discuss your care.