What to Treat First When Everything Is Flaring with Dr. Dacre Knight (Ep 186)

There is no magic treatment for Ehlers-Danlos Syndrome, POTS, or mast cell activation disorders, but there is strategy. In this episode of Bendy Bodies, Dr. Linda Bluestein is joined by Dacre Knight, MD, founding Medical Director of the UVA Health EDS and Hypermobility Disorders Center, for a practical and deeply thoughtful conversation about how complex chronic conditions should actually be treated.

Rather than chasing quick fixes, Dr. Bluestein and Dr. Knight explore sequencing. What to address first when everything is flaring, how to balance short-term symptom relief with long-term sustainability, and why overtreatment can sometimes cause more harm than good. They discuss the pitfalls of siloed care, the insurance barriers that complicate physical therapy, and the importance of starting low, going slow, and minimizing treatment burden.

The episode also tackles difficult but essential questions: What does “getting better” really mean in lifelong connective tissue disorders? How do clinicians avoid reactionary prescribing? And how can patients recognize the difference between a thoughtful care plan and a rushed one?

Takeaways:

There is rarely a single “magic” treatment for EDS, POTS, or MCAS—progress usually comes from strategic sequencing.

Overtreating symptoms without addressing underlying patterns can create long-term setbacks.

Physical therapy must be individualized in hypermobility, with an emphasis on pacing and trust.

Shared decision-making improves outcomes, especially when treatment goals align with what brings the patient meaning and quality of life.

Minimally disruptive medicine matters, reducing cognitive, financial, and physical treatment burden is part of effective care.

Find the episode transcript here.

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