Long Covid

Long Covid

What is Long Covid?

There are a number of challenging symptoms associated with Covid infection including persistent post-exertional fatigue, muscle pains and aches, brain fog, and non-restorative sleep.

Long-COVID is the name given to the set of symptoms that persist after Covid infection which includes muscle pain, fatigue, poor sleep and depression. These symptoms are very similar to those of chronic fatigue syndrome (CFS) / myalgic encephalitis (ME), symptoms that were also reported following severe acute respiratory syndrome (SARS) infection (which is also a coronavirus). Post-viral coronavirus[1]  symptoms can persist and prevent a return to work for as long as 20 months following the infection and may have consequences for many other aspects of health.

Long Covid is hypothesised as congestion in the ‘glymphatic’ system – the drainage system for waste products produced in the central nervous system. It is made up of lymphatic vessels specific to the central nervous system (brain and spinal cord). Its thought that coronavirus infection, which caused loss of taste and smell by affecting function in the olfactory nerve, may also have blocked cerebrospinal fluid drainage causing backup in the glymphatic ducts.

Do osteopaths treat long Covid?

Yes! Some osteopaths treat long Covid — particularly Perrin technique practitioners

I’m not sure if I have long Covid or am just feeling poorly after days ill in bed?

Lots of people feel poorly, achy and drained after a prolonged or severe respiratory tract infection and high temperature.

All osteopaths are trained to treat chronic and acute musculoskeletal pain and stiffness which can be caused by a lack of movement while you have a Covid infection. Osteopaths are also excellent at resolving pain in the upper back, ribcage, neck and shoulders following periods of coughing.

So if my symptoms persist, who should I see?

For long Covid symptoms such as muscle pain, brain fog, poor sleep and post-exertional fatigue, osteopaths trained in the Perrin technique are particularly effective. We use manual techniques to facilitate central lymphatic drainage and improve lymphatic circulatory dynamics, both the glymphatic system around the brain and spinal cord and the lymphatic ducts throughout the rest of the body.

Osteopathy helps with the maintenance of good autonomic nervous system balance to support improved circulation. A recent study investigating treatment outcomes of the Perrin technique on 20 patients, none of whom had a prior diagnosis of chronic fatigue, found that after 9-10 treatments their symptoms had all reduced by 50% on average and for fatigue by 60%.

One of my patients complained of waking frequently at night with heart palpitations. These symptoms were greatly reduced within two sessions. At the third, she told me that her heart rate was no longer shooting above 110bpm when she was “just pottering around the house, hanging up laundry”.

The rate of improvement varies greatly — I always counsel patients to practise pacing and address lifestyle factors (nutrition, stress management and so on)  in conjunction with receiving the Perrin Technique.

Would Perrin Technique work for post-viral syndrome? 

Absolutely. The Perrin technique was established several decades ago as a system of manual treatment to help with chronic fatigue (CFS) and myalgic encephalitis (ME). It has helped alleviate the symptoms of thousands of patients with chronic fatigue, depression, and muscle pain since its inception more than 30 years ago.

“I’ve been seeing Jackie at Kennington Osteopaths for two months and she is amazing! I have post-viral fatigue and she has been treating me with the Perrin Technique. She has an in-depth knowledge of ME/CFS and related conditions and has been more helpful than my own GP when it comes to advising how to manage my illness. Jackie is highly empathetic and a fantastic osteopath and I would recommend her to anyone who is looking to start the Perrin Technique.” Shayna Kowalczyk



Cicchitti L, Martelli M, Cerritelli F. Chronic inflammatory disease and osteopathy: a systematic review. PLoS One 2015;10:e0121327. [PMC free article] [PubMed] [Google Scholar]

Heald A, Perrin R, Walther A, Stedman M, Hann M, Mukherjee A, Riste L

Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage interventionCardiovasc Endocrinol Metab. 2022 Jun; 11(2)