The term “coat hanger pain” gives you an idea of where someone with the condition may be experiencing their discomfort. However, it wasn’t until recently that this phenomenon got its own name. Coat hanger pain spreads from the mid back, between the shoulder bladers, up to the base of the skull. When patients do not respond to traditional orthopedic treatment, they are often misdiagnosed with fibromyalgia or complex cervical conditions. Treatment is not entirely successful because it isn’t getting to the root of the problem. 

 Coat hanger pain also gets confused with symptoms associated with Ehlers Danlos Syndrome and the hypermobility spectrum disorders (EDS/HSD). In cases of hypermobility, the range in which one or more joints moves is beyond the normal limit. The muscles then overwork in order to compensate for the instability, leading to cramping, fatigue, and shortening of the muscles. 

The one factor that differentiates coat hanger pain from other conditions is the fact that the pain goes away with positional changes, specifically laying down. Once gravity is taken away, blood flow up to the neck and head increases, and the pain temporarily goes away. In individuals with postural orthostatic tachycardia syndrome (POTS), there is often an inadequate redistribution of blood when transitioning from a horizontal to a vertical position, leading to reduced blood flow to the upper extremities. This insufficient blood supply can result in oxygen deprivation and muscle tension, with the pain worsened by imbalanced muscles.

Coat hanger pain is heavily associated with postural orthostatic tachycardia syndrome (POTS), and researchers note it is present in 93% of autonomic dysfunction. POTS is a complex and often debilitating condition, and coat hanger pain adds an extra layer of complexity. Simple activities such as standing, sitting, or even holding objects can become excruciatingly painful, limiting mobility and functionality. The constant discomfort can also lead to fatigue, anxiety, and depression, further affecting the overall well-being of individuals with POTS.

While there is no cure for POTS, there are strategies to manage and alleviate coat hanger pain. It is crucial for patients to work closely with their healthcare providers to develop an individualized treatment plan. Some common approaches include:

  • Fluid and Salt Intake: Increasing fluid and salt intake can help expand blood volume, potentially improving blood flow and reducing the severity of Coat Hanger Pain.
  • Compression Garments: Wearing compression garments, especially on the lower extremities, may aid in improving blood circulation and mitigating the symptoms associated with inadequate blood flow.
  • Physical Therapy: Engaging in specific exercises designed to improve posture, strengthen muscles, and enhance cardiovascular fitness can be beneficial for POTS patients, potentially reducing Coat Hanger Pain.
  • Medication: In some cases, medications such as beta-blockers or vasoconstrictors may be prescribed to help regulate heart rate and blood flow, alleviating symptoms including Coat Hanger Pain.
  • Lifestyle Modifications: Implementing lifestyle changes such as avoiding prolonged periods of standing, maintaining a balanced diet, and incorporating relaxation techniques can contribute to overall symptom management.

Coat Hanger Pain in POTS patients adds a unique challenge to an already complex condition. Understanding the mechanisms behind this phenomenon and exploring effective management strategies are crucial steps in improving the quality of life for individuals living with POTS. By working collaboratively with healthcare professionals and adopting a holistic approach to care, patients can navigate the intricate landscape of POTS and strive for a better, more comfortable life despite the challenges posed by Coat Hanger Pain.