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For a POTS patient, simply changing posture can result in a skyrocketing heart rate, palpitations, tremors, and a profound sense of panic or anxietyoften referred to in the patient community as an "adrenaline dump." The body is trapped in a perpetual state of hyper-arousal, which is incredibly draining and contributes significantly to the profound fatigue seen in these conditions

In the medical journal Insights into imaging , researchers wrote of the four factors associated with the degenerative changes of the spine that cause spinal canal stenosis: disc herniation