A Chiropractic & Neurological Approach to Evaluation and treatment in Maroubra and Sydney’s Eastern Suburbs
Every heartbeat, every breath, every postural adjustment you make when standing up is governed by an exquisitely timed neurological system. When this system is working well, you feel stable, alert and resilient. When it is not, symptoms such as dizziness, palpitations, fatigue, anxiety, brain fog or heat intolerance can dominate daily life.
At Sydney Neuro & Integrative Health, we see a growing number of patients from Maroubra, the Eastern Suburbs and from all over Australia! presenting with POTS (Postural Orthostatic Tachycardia Syndrome), dysautonomia and complex autonomic symptoms – often after illness, concussion, chronic stress or hormonal transition.
Understanding why these symptoms occur requires looking beyond strength, fitness or isolated organs. It requires understanding the Central Autonomic Network (CAN).
What Is the Central Autonomic Network (CAN)?
The Central Autonomic Network is a distributed network of brain regions that coordinates heart rate, blood pressure, breathing, digestion, temperature regulation and arousal. It links the brainstem, limbic system, cerebellum and cortex into one integrated control system.
Importantly, the CAN is not about autonomic strength.
It is about autonomic coordination and timing rather than strength.
You can have a “strong” heart and still faint.
You can be fit and still develop POTS.
Because dysautonomia is fundamentally a timing and regulation problem, not a conditioning problem.
Sympathetic vs Parasympathetic: It’s Not About “Calming Down”
One of the biggest misconceptions we see is that dysautonomia is simply a vagal or parasympathetic deficiency.
In reality:
- The sympathetic system is just as important as vagal parasympathetic activity
- Many POTS patients have poor sympathetic activation when upright
- Others have excessive, poorly timed sympathetic surges
The issue is often a failure to switch cleanly between tonic and phasic autonomic responses:
- Tonic responses maintain baseline blood pressure, vascular tone and alertness
- Phasic responses allow rapid adjustment to posture, stress, exertion or recovery
When these systems lose synchrony, symptoms emerge.
Why POTS and Dysautonomia Are Brain-Body Disorders
The CAN integrates signals from multiple key brain regions:
- Brainstem nuclei that regulate blood pressure and heart rate
- Cerebellum for postural and autonomic timing
- Insula and anterior cingulate cortex for interoception and emotional-autonomic integration
- Hypothalamus for endocrine and autonomic coupling
- Prefrontal cortex for top-down regulation
When communication between these regions degrades – due to inflammation, concussion, viral illness, trauma, hormonal change or chronic stress – the result is autonomic misfiring, not organ failure!
This explains why many patients with dysautonomia are told their tests are “normal” while they continue to feel profoundly unwell!
How Sydney Neuro & Integrative Health Assesses Dysautonomia
As a neurologically-focused chiropractic clinic in Maroubra, our role is to assess functional neurological regulation, not to replace cardiology or conventional medicine.
Our in-clinic assessments may include:
- Orthostatic vitals and heart rate responses under different conditons
- Autonomic stress responses using advanced software
- Neurological examination of brainstem and cerebellar function
- Postural and vestibular evaluation using clinically objective data
These assessments, along with a complete clinical examination, allow us to determine where timing, coordination or signalling is breaking down within the Central Autonomic Network.
What Chiropractic Care Looks Like for POTS & Dysautonomia
Chiropractic care at Sydney Neuro & Integrative Health is not symptom suppression.
Our approach focuses on:
- Improving brainstem and cerebellar integration
- Supporting appropriate sympathetic engagement, not just vagal tone
- Restoring postural-autonomic coupling
- Enhancing sensory input quality to stabilise autonomic output
- Reducing maladaptive tonic autonomic loading
- Improving autonomic flexibility, not forcing relaxation
This may involve specific neurological chiropractic techniques, targeted sensory input, postural retraining, strategic use of nutraceuticals, breathwork and graded autonomic challenges, for example, using strategic grouping of therapies on a tilt table – always within the patient’s physiological tolerance!
Why This Matters for Patients
Many of our patients arrive after:
- Multiple specialist appointments
- Normal imaging and blood tests
- Being told symptoms are anxiety-driven
- Failed exercise or “push through” approaches
Understanding dysautonomia through the lens of a practitioner who understands the Central Autonomic Network provides a unifying explanation for symptoms that seem unrelated but share a common regulatory origin.
The Takeaway: Dysautonomia Is a Timing Problem!
POTS and dysautonomia are not about weakness, deconditioning or lack of willpower.
They are disorders of:
- Autonomic coordination
- Tonic vs phasic response control
- Sympathetic-parasympathetic integration
- Brain-body communication
At Sydney Neuro & Integrative Health, our role as chiropractors is to help identify where that communication has broken down and to support the nervous system in regaining more stable, adaptive control.
“By addressing autonomic coordination, timing and integration, rather than chasing isolated symptoms, chiropractic neurological care can play a meaningful role in a broader, collaborative management strategy.”
So if your symptoms worsen with standing, stress, or exertion – and you’ve been told everything looks “normal” – the issue may lie in how your nervous system is coordinating your physiology.
If you are experiencing dizziness on standing, rapid heart rate, fatigue, brain fog, or symptoms consistent with POTS or dysautonomia, a focused neurological assessment may help clarify what is driving your presentation.
What to expect in your initial consultation:
- A detailed clinical history
- In-clinic neurological and autonomic screening
- A clear explanation of findings and relevance to your symptoms
- Guidance on whether care is appropriate or referral is indicated
Click here to schedule an appointment or to book an initial discussion prior to consultation.
Please note: Appointments are assessment-based and not suitable for acute medical emergencies. This page is intended for educational purposes and does not replace medical diagnosis or specialist care.
References:
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