Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, long-term condition that can have a significant impact on a person’s physical, cognitive, emotional and social functioning. It is characterised by a combination of symptoms that can vary considerably between individuals and can fluctuate over time.
One of the key features of ME/CFS is post-exertional malaise (PEM). This describes a worsening of symptoms following physical, cognitive, emotional or social activity that would previously have been tolerated. Other commonly reported symptoms include significant fatigue that is not substantially relieved by rest, unrefreshing or disrupted sleep, difficulties with concentration and memory (often described as "brain fog"), headaches, muscle and joint pain, sensory sensitivities and symptoms associated with autonomic nervous system dysfunction, such as dizziness or difficulty tolerating prolonged standing.
The underlying mechanisms of ME/CFS are not yet fully understood. Research has identified a number of biological differences in people with ME/CFS, including findings involving immune function, autonomic regulation, metabolism and the body's response to exertion. However, there is currently no single biomarker or established explanation that accounts for all cases of ME/CFS. Research into these mechanisms is ongoing.
A gentle and individualised approach
Because ME/CFS can affect people differently, management needs to be individualised and should take into account symptom severity, activity tolerance and the presence of other conditions. Current clinical guidance emphasises symptom management, energy management and supporting the person's ability to function within their individual limits.
Importantly, people with ME/CFS can be particularly sensitive to overexertion. Treatment and exercise approaches therefore need to be carefully considered and should not involve routinely pushing through symptoms or progressively increasing activity regardless of how the person responds.
The Perrin Technique
The Perrin Technique, developed by osteopath Dr Raymond Perrin, is a gentle manual therapy approach that has been proposed as an adjunctive treatment for people with ME/CFS. The approach incorporates gentle manual techniques involving areas such as the spine, chest and soft tissues, together with breathing techniques and self-management strategies.
The proposed rationale for the technique relates to supporting lymphatic drainage and autonomic nervous system function.
Supporting people with ME/CFS
At Fundamental Health, our approach is centred around listening to the individual and adapting treatment to their presentation on the day. For someone living with ME/CFS, this may mean keeping treatment gentle, allowing adequate recovery time and recognising that even relatively small amounts of physical or cognitive activity can sometimes contribute to a delayed increase in symptoms.
The aim is not to "push through" fatigue, but to work within the person's current tolerance and support their broader management plan.
If you are living with ME/CFS and would like to discuss whether the Perrin Technique may be appropriate for you, you can book an appointment with Kat, our Perrin Technique-trained osteopath.