Connective Tissue Disorders

Connective tissue disorders are a group of conditions that affect the body’s structural tissues—like skin, joints, ligaments, and blood vessels. These tissues provide strength, flexibility, and support throughout the body. When they’re not working properly, it can lead to symptoms like:

  • Joint pain and instability
  • Stretchy or fragile skin
  • Easy bruising
  • Chronic fatigue and pain
  • Digestive or bladder issues
  • Problems with the autonomic nervous system.

One of the most commonly linked connective tissue conditions in people with Postural Orthostatic Tachycardia Syndrome (POTS) is Hypermobility Spectrum Disorder (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS).

What is hEDS?

Hypermobile Ehlers-Danlos Syndrome is a hereditary condition that affects how the body produces and uses collagen; a protein that provides structure and stretch. Key features of hEDS include:

  • Joint hypermobility (joints that move beyond the normal range)
  • Frequent joint pain, subluxations, or dislocations
  • Soft or stretchy skin
  • Delayed wound healing
  • Fatigue and widespread pain

There’s currently no genetic test for hEDS, so diagnosis relies on clinical evaluation using strict diagnostic criteria. You can find a link to this document here.

What is Hypermobility Spectrum Disorder (HSD)?

HSD shares many symptoms with hEDS but doesn’t meet all the criteria for a formal diagnosis. That said, HSD is not less serious. People with HSD may still have significant joint, pain, and fatigue symptoms. HSD and hEDS are often managed in very similar ways.

Why Are hEDS and HSD Important in POTS?

Connective tissue provides the structure and tone that supports blood vessels. In people with hEDS or HSD, these vessels may be more stretchy than usual, making it harder for the body to maintain blood pressure when standing up. This leads to blood pooling in the legs, and a reduced return of blood to the heart which contributes to hallmark POTS symptoms like dizziness, light-headedness, rapid heart rate, and fainting. There is also a recognised connection between hypermobility disorders and autoimmune conditions, which may help explain why individuals with these disorders are more prone to developing POTS, particularly following a viral infection.
Other common overlaps between hEDS/HSD and POTS include:

  • Fatigue and chronic pain
  • Gut issues like bloating or nausea
  • Pelvic floor and bladder symptoms
  • Balance problems or clumsiness, sometimes due to reduced proprioception (your body’s awareness of where it is in space)

Getting the Right Support

If you or your healthcare team suspect a connective tissue disorder, it’s important to seek a proper evaluation. This may involve a specialist doctor or physiotherapist familiar with these conditions.

A diagnosis can guide treatment options including:

  • Physiotherapy and joint-stabilising exercise programs
  • Hydration, salt, and compression strategies for POTS symptoms
  • Pain and fatigue management
  • Education on joint protection, pacing, and self-care
  • Multidisciplinary care for complex or overlapping symptoms

For credible information and diagnostic tools, visit:

Living with POTS and a connective tissue disorder can be complex—but you’re not alone. Understanding the overlap is a powerful first step toward better management, better care, and a better quality of life.

Visit our Resource Hub to learn more about POTS.

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