By Sam Kankanamge, Osteopath & Founder of Wimpole Street’s Sen Wellness Clinic.
Over the last 12 months, I have successfully treated some 55 patients, aged between 20 and 70, who were suffering from the symptoms of Long-COVID.
In order to treat each patient to the best of my ability, I have consistently kept an eye on the latest medical research and news. Whilst there’s now a picture of Long-COVID symptoms, doctors seem to be advocating a combination of symptom management with a focus on boosting the immune system long-term. I have not been able to discover any evidence-based treatments.
The reason for writing this article is to share what I’ve learnt from treating a wide variety of patients. I want to get the message out that it is possible to treat the most common Long-COVID symptoms of debilitating fatigue and brain fog.
In the UK only a tiny percentage of people who contract COVID need hospital treatment. Most battle the illness at home and it was only in November last year that the NHS announced 40 new clinics opening to study Long-COVID.
Official data suggests that a fifth of people with coronavirus still have symptoms five weeks after becoming infected, with one in ten symptomatic for twelve weeks. A recent study carried out in Wuhan found that three in four people hospitalised with COVID-19 still had symptoms six months after being discharged. It is troubling to reflect that most of these people have no access to medical advice or treatment and living with their symptoms is likely to aggravate their stress levels with a knock-on impact on their mental health.
Whilst I lead a holistic healthcare centre, my primary training as an osteopath means that I tend to analyse patients from an osteopathic perspective first. Many people think osteopathy is just structural, solely treating musculoskeletal issues, but in fact goes beyond this to help regulate and optimise health on a multisystemic level treating the nervous, lymphatic, endocrines (hormonal), and immune systems. This multisystemic approach is where Western medicine falls short.
In treating my Long-COVID patients it’s clear they’re not suffering from an isolated issue. Multiple systems, (including multiorgan system, endocrine, lymphatic, nervous and musculoskeletal) have been fatigued and exhausted by the virus. In response, a holistic and integrative approach has significantly, and at times after a single treatment, aided the recovery of my patients.
Charlotte, 38, contracted COVID-19 in March 2020 and was initially ill for three weeks with fever and breathlessness. After almost completely recovering, further waves of fever followed. Despite the hot weather over the summer months, and usually resilient to the cold, she spent several weeks indoors wrapped up in layers of clothing. Next came the spiralling infections over an eight to 10 week period. Symptoms included sinus and throat infections, which appeared to be localised and were unsuccessfully treated with antibiotics. Three months on from when she first became ill, she suffered from bad headaches and fatigue and sought treatment. After four osteopathy and cranial osteopathy treatments, her health has almost returned to the same as before she caught the virus.
“What was most striking to me was how this was not like normal flu where you would expect to bounce back. I had a severely weakened immune system, resulting in multiple secondary infections, as well as several post-viral symptoms. I needed an additional intervention and one that treated all the body’s systems. I doubt I would have made a full recovery without these treatments.”
The most widespread symptom among Long-COVID sufferers is muscle fatigue and weak muscle tone underlying the common thread of debilitating fatigue. This is also common with post-viral chronic fatigue where, before recovery, there’s a chemical process that results in mild inflammation within the musculoskeletal and multiorgan system.
I have consistently detected inflammation of the muscles and connective tissue in my Long-COVID patients. Those who have previously led very physical and active lifestyles find even gentle stretching stressful. With the musculoskeletal system unable to support the body’s frame, patients experience a general sense of restriction and fatigue. Many find it difficult to carry out even basic everyday tasks and functions.
Clare, 56, spent two weeks bedridden with the virus in April 2020, with a fever, breathlessness, and extreme fatigue. She had rashes on her fingers and toes, and her sense of taste and smell were also altered. Further knocks to her health came in four waves over the next month, including debilitating tiredness and hot flushes. After this, she was able to resume some of her usual daily tasks. However, she began to suffer from aches and pains, particularly in her hips and coccyx. A course of treatments has been focused on addressing the muscle fatigue and weak muscle tone endemic to Long-Covid and chronic fatigue syndrome with osteopathic techniques and acupuncture.
“In the past, I’ve been highly responsive to treatment at the Clinic for aches and pains. What has struck me, in this case, is how much the virus has exacerbated these underlying issues. The long-tail impact of the virus has really weakened my muscles. Each time I have a treatment, I make progress and get stronger. Now that I’m almost back to full health, I’m increasing my yoga practice and returning to gardening, and I’m hopeful that soon I’ll l be able to resume these activities to the same level as before.”
My cranial osteopathic training enables me to work beyond the musculoskeletal system to analyse the movement and alignment of the central nervous, glandular, lymphatic and multiorgan system. Long-COVID patients often present with a congested lymphatic system, which is unsurprising as this is one of the most active defensive mechanisms under viral attack. Patients I have treated consistently present with exhausted lymphatic systems, especially in the major lymph glands.
In healthy central nervous systems the spinal fluid has a natural coiling and uncoiling motion, similar to the pulse of the cardiovascular system. In Long-COVID patients, the fluid feels static and congested, as does their connective tissue. In a similar way the multiorgan system, from intestinal tissues to reproductive organs, feel congested and tight.
The impact on sufferers’ lungs and breathing is also palpable in patients who present with deflated lungs, lack of fluid within the lung tissue itself and physical tiredness of the diaphragm. Whilst not all patients present with these symptoms, those who do face ongoing difficulties with breathing normally. Chronic fatigue is, however, the most common thread.
Scientific research into chronic fatigue syndrome now attributes fatigue to changes to normal cellular function. This is because our mitochondria, the part of our cells responsible for producing most of the body’s energy, cannot effectively function after defending against external pathogens during a viral attack.
The insights and professional knowledge I have accumulated in treating a wide spectrum of patients over the past 25 years has allowed me to go much deeper with my patients to provide a genuinely holistic and effective treatment programme. This depth has been invaluable preparation for the influx of Long-COVID patients over the last few months.
Over the years I have seen that people with weaker immune systems find they cannot recover from a strong post-viral infection, often developing chronic fatigue symptoms. Right now, a similar pattern is occurring with Long-COVID. The strength of this virus is sending the immune system into reactivity where it becomes exhausted attempting to fight off the virus. The adrenal and autonomic nervous systems, also central to the response, become depleted and chronic fatigue type symptoms follow. Interestingly, this is a consistent response that doesn’t seem to be related to the initial spectrum of mild to severe COVID symptoms.
Overshadowing the physical symptoms reported, the emotional and mental impact of COVID-19, especially on those battling long-term symptoms, has been less frequently discussed. When I look into my patients’ eyes I can immediately detect the significant mental and emotional strain they are under anxiety at living for as long as they have with these symptoms, no solutions despite consulting their usual medical professionals, often compounded by being separated from their wider support network.
The impact of anxiety and stress on the body is palpable. The nervous system is strained and depleted and there is an obvious tension in the face and head. High levels of fear, anxiety, stress, and grief all impact our physical health, blocking full recovery, which is why the role of holistic care is so important.
The purpose of sharing my experience is to offer a new perspective for the treatment of Long-COVID, one that will help people realise they don’t need to suffer and that effective support is available.
The holistic approach to treatment is fundamentally different from a Western medical approach in that it goes beyond the physical to encompass the mind, emotions and spirit. As we know, a virus affects more than just one system in the body. When you are also presented with mental and emotional stressors the treatment needs to address the whole person to be effective.
The holistic approach does this as well as taking into account the uniqueness of each individual. As a skilled practitioner, I am looking to understand every aspect of my patient to develop a tailored treatment programme with the precise interventions they need to recover and thrive. For me, there are a variety of modalities and treatments that can be combined to optimize results. Over the years I have successfully worked with osteopathy, cranial osteopathy and acupuncture to support chronic fatigue syndrome patients.
Osteopathy is already well known for helping with musculoskeletal issues. There are techniques to improve alignment, movement and restore fluid to joints, muscles and connective tissues. However, where tightness and constriction are caused by fatigue rather than injury, recovery can be a prolonged process so there is value in also drawing on other techniques.
Cranial osteopathy can help stimulate and ease stagnation in the lymphatic and glandular systems. It can be utilised to assist the lungs and respiratory organ system, with specific techniques to improve lung function and strengthen the intercostal and diaphragm muscles. I have found cranial techniques extremely effective for treating the ‘brain fog’ many Long-COVID sufferers have been afflicted with. These techniques have released pressure in the connective tissues and nerves around the brain and tightness in the facial muscles.
Rachel, 32, tested positive for COVID-19 in October 2020, and had mild to moderate symptoms for two weeks, including a headache, tiredness, and a slight cough. After an initial two weeks of illness, she believed she was fully recovered. However, for the next 10 weeks, a cycle of intermittent debilitating ‘brain fog’ and extreme fatigue followed. Unable to sustain mental concentration, she could only work 10 hours a week in this period. During her first session at Sen Wellness Clinic, it was immediately clear that her dura, the outer layer of connective tissue surrounding the brain and spinal cord, had become extremely tight and contracted under attack from the virus. Applying cranial osteopathic techniques to her head eased this cranial pressure with immediate effect.
“I felt like a totally different person leaving the Clinic from the one who had entered. It was almost unbelievable to experience such a dramatic shift in the space of an hour. After nearly three months of stress and worry, not knowing when I’d recover, I’m no longer plagued by ‘brain fog’, and I have regained my previous energy levels, and ability to focus.”
Acupuncture is also effective in treating chronic fatigue syndrome. Research from the BMJ notes that traditional Chinese medicine (TCM) has been ‘applied widely, and has played substantial roles in the management of COVID-19 in China.’ In my practice, I use traditional five elements of acupuncture to target specific meridian points in the body which also helps to facilitate the physiological changes that my osteopathic work is focused on.
There are also some lifestyle elements that sufferers can consider to support their recovery. In other circumstances, my opinion is that vitamins, supplements and herbal medicines are overrated. However, I think Long-COVID patients would benefit from additional support, specifically Vitamin B complex, which feeds into the nervous system, and Vitamin C to boost the immune system. It might be wise to analyse vitamin levels via blood sampling for further clarification. Breathing exercises are also worth exploring, and there are now a plethora of online resources and practitioners to draw support from.
To make a full recovery, we also need to look at the effect of any illness on confidence, anxiety and stress levels. I work closely with patients offering guidance on how to pace themselves when getting back to work. This is particularly important given today’s screen-heavy lives and the screen aversion that those with ‘brain fog’ and fatigue naturally have. I believe it’s also valuable to use some energy reserves spending time in nature and, if restrictions allow, spending time with and getting support from good friends.
I am writing this to offer some hope to those suffering from Long-COVID who may currently believe their situation is hopeless. There are effective treatments available and it is possible to recover within a relatively short time frame. I would encourage everyone to seek the necessary support for musculoskeletal, glandular and lymphatic systems to recover. Without this, recovery will potentially take many more months.
I would recommend finding a local holistic practitioner, osteopath or acupuncturist, ideally recommended by word of mouth. If they have a history of successfully treating patients with chronic fatigue, even better.
There is a limit to what can be achieved via a screen. Over 25 years I have repeatedly seen that healing happens more easily when my patient is in my consulting room. The practitioner can provide a reassuring presence and the benefits of being able to look into a patient’s eyes, feel the connection and empathy as human-to-human, cannot be underestimated.
For those who are truly unable to access professional help from a holistic practitioner, there are some DIY techniques you can do at home. You are welcome to contact us at the Clinic for more advice. www.senwellnessclinic.co.uk
NHS England, ‘NHS launches 40 ‘long COVID’ clinics to tackle persistent symptoms’,
The Guardian, ‘Long Covid alarms as 21% report symptoms after five weeks’, https://www.theguardian.com/society/2020/dec/16/long-covid-alarm-as-21-report-symptoms-after-five-weeks
Huffington Post, ‘3 in 4 Covid Hospital Patients Struggling With Long Covid Six Months Later’, https://www.huffingtonpost.co.uk/entry/long-covid-wuhan-study_uk_5ff87febc5b66f3f795d5f6e?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZWNvc2lhLm9yZy8&guce_referrer_sig=AQAAALzkrcx4R9pEwgGPQU1aIzaH-amAXzZXW7Az4yXH-S1Xsp-V5iwjDyE9Bf4oYkjaNpMJudvhNtK2f6yTb4boFiPOt3hNGLdXejPFaB4jtLvaESr9C90tkTj5yzYW8mwI39S3ot813EmvFzdH5eFQkwuueGcYFaBw1MTW8ma_BiTU
ITV, ‘Long Covid: What is it, what are the symptoms and what help is there for sufferers?’ https://www.itv.com/news/2020-08-12/long-covid-what-is-it-what-are-the-symptoms-and-what-help-is-there-for-sufferers
The ME Association: ‘MEA Summary Review: The role of Mitochondria in ME/CFS’, 12th July 2019, https://meassociation.org.uk/wp-content/uploads/MEA-Summary-Review-The-Role-of-Mitochondria-in-MECFS-12.07.19.pdf
BMJ: ‘Rapid Response: Traditional Chinese Medicine for COVID-19’ https://www.bmj.com/content/368/bmj.m606/rr-13