July 2026

Dysautonomia and Your Spine: A Chiropractic Perspective on "Coat Hanger Pain"

What Is Dysautonomia?

Your body runs on autopilot far more than you realize. Your heartbeat, blood pressure, digestion, temperature, and breathing all happen without you thinking about them. The system in charge of all this behind-the-scenes work is called the autonomic nervous system.

When this system stops working smoothly, we call it dysautonomia. It's an umbrella term for a group of conditions where the automatic controls of your body get out of balance. One of the most common forms is POTS (Postural Orthostatic Tachycardia Syndrome), where your heart races and you feel dizzy, foggy, or exhausted simply from standing up.

Living with dysautonomia can feel like your body has stopped listening to you. The good news? Your nervous system is exactly where chiropractic care focuses.

Meet "Coat Hanger Pain"

One of the most telling — and often overlooked — symptoms of dysautonomia is something called coat hanger pain.

It's named for exactly where it shows up: a deep, aching pain across the back of your neck and out along the tops of your shoulders, forming the shape of a coat hanger. Many people describe it as a heavy, dragging soreness that gets noticeably worse the longer they stand and eases when they lie down.

One of my patients, a young woman in her twenties, told me she'd spent years being told her shoulder pain was "just stress" or "bad posture." What she actually had was classic coat hanger pain tied to POTS. Once we understood the real source, we could finally address it in a way that made sense to her body.

Why does this happen? When you stand up, your body has to work harder to pump blood up to your brain and to the muscles that hold your head and neck upright. In dysautonomia, blood flow to these muscles isn't well regulated, so they become starved and start to ache. It's not a muscle problem — it's a nervous system communication problem.

The Spine–Nervous System Connection

Here's where chiropractic comes in.

Your spine does far more than hold you upright. It houses and protects your spinal cord — the information highway between your brain and body. When the bones of your spine, especially in your neck, aren't moving and aligned the way they should be, we call this a subluxation.

A subluxation creates interference in that communication highway. And the upper neck is particularly important, because it sits right near the brainstem — a major control center for your autonomic nervous system.

When the alignment and posture of your spine are off, the messages traveling between your brain and body get distorted. For someone with dysautonomia, this added stress can make an already struggling system work even harder.

Poor posture puts extra load on the muscles and joints of your neck
Upper cervical subluxations may interfere with brainstem signaling
Altered spinal alignment can affect how well your body regulates blood flow and heart rate
Reduced nervous system function shows up as fatigue, brain fog, and yes — coat hanger pain

How Chiropractic Care Can Help

Chiropractic care isn't a cure for dysautonomia, and I want to be honest about that. But it addresses something incredibly important: reducing the interference in your nervous system so your body can regulate itself better.

By gently correcting subluxations and improving your spinal posture and movement, we help take unnecessary stress off your nervous system. When the communication between brain and body flows more freely, many patients notice:

Less neck and shoulder pain
Better energy and clearer thinking
Improved tolerance for standing and daily activities
A greater sense of overall balance and calm

The goal is a nervous system that's working with you instead of against you.

You Don't Have to Just "Push Through It"

If you've been told your symptoms are all in your head, or you've been quietly powering through dizziness, fatigue, and that stubborn coat hanger ache — I want you to know there's another way to look at this.

Your symptoms are real, and they're often rooted in how well your nervous system is communicating. At Omni Family Chiropractic in Richmond, VA, we take the time to understand your whole story and check how your spine may be influencing your body's automatic functions.