What is long COVID?
Many patients report prolonged symptoms lasting for months after their initial infection of COVID-19. These symptoms affect different systems in the body and negatively impact the ability to work and function normally in daily life (Davis et al., 2021). It is commonly referred to as 'long COVID' and is estimated to affect 10 - 30% of people (Davis et al., 2021; Rivera-Izquierdo et al., 2022).
Long COVID affects all ages, irrespective of the severity of initial COVID-19 infection (Yong, 2021). Despite the fact long COVID does not discriminate who can get the condition, persisting symptoms are most prevalent in those who have been hospitalised with severe COVID-19 or have other risk factors such as diabetes, obesity and/or hypertension (Pérez-González et al., 2022).
Common symptoms of long COVID
There are over 50 symptoms that are associated with long COVID; with some of the most common symptoms are muscle pain, headache, fatigue, breathlessness, brain fog, memory issues, mood disturbance, anxiety and depression (Davis et al., 2021). Other common patient symptoms reported by healthcare providers are:
respiratory, including ongoing cough;
musculoskeletal, including muscle fatigue and pain and joint pain;
neurological, including headache, loss of smell, loss of taste and sleep disturbance;
cardiovascular, including palpitations and chest pain;
gastrointestinal, including diarrhoea, acid reflux, nausea and abdominal pain;
genitourinary, including pain urinating and pelvic pain.
How can your Osteopath help your long COVID symptoms?
Osteopaths can help in several ways, including the use of hands-on manual therapy as part of a multidisciplinary approach. Given the fact long COVID is complex and impacts multiple systems, it is paramount that patients get multidisciplinary treatment and that the healthcare providers involved in the management of the condition are aware of and make clear to the patient the limitations of their scope of practice and the reasons why they are working with other health professionals to appropriately diagnosis, treat and manage the condition.
Ensuring you are safe to treat
At Movement Mechanics Osteopathy Auckland, your safety is our main concern. We require all our patients to be cleared of more severe conditions of the cardiac and respiratory systems related to COVID-19 prior to treatment. If we see a patient we suspect as having symptoms relating to long COVID we will get them to see their GP and arrange appropriate testing.
Helping you to become active again after COVID-19
We understand that fatigue is a major component for many of our patients suffering from long COVID. When managing your activity levels and the amount of rest required, we work with our patients to develop a pacing strategy for return to activity. This strategy is made up of three key components:
Stop: We help our patients develop the tool to ensure that they stop before overexerting themselves, as this can have a negative impact on their recovery.
Rest: We provide education on the importance of rest and why it is essential to rest frequently and to do so before symptoms appear.
Pace: We work with our patients to ensure they space out their daily physical and mental activities to avoid triggering symptoms.
Breath a little easier with Osteopathy
Dysfunctional breathing presenting as a disordered breathing pattern, hyperventilation at rest, excessive ventilator response to exercise and breathing distress is common in long COVID patients. One study found that it was present in 88% of long COVID patients with unexplained dyspnoea (Mancini et al., 2021). Correction of dysfunctional breathing might help to reduce symptoms and psychological distress, improve exercise intolerance and support recovery (Koniukhovskaia et al., 2021; Mancini et al., 2021; Motiejunaite et al., 2021).
Hands-on help for long COVID
There is some evidence to suggest that the addition of manual therapy in the form of myofascial release of the rib cage and neck improved heart rate and subjective sense of ease of breathing after a single treatment (Fereydounnia et al., 2022). When used in conjunction with breathing retraining, osteopathic manual techniques can improve breathing symptoms, breathing patterns and hyperventilation (Courtney et al., 2019). Another component often overlooked is additional musculoskeletal stresses on the body from dysfunctional muscles and tendons, which further deplete an already stressed system.
Although long COVID is a condition in its infancy in terms of our understanding of it, Osteopathy can, at the very least, help with any muscle aches and pains that will add to a sufferers sense of fatigue and even be able to alleviate some of the pain and dysfunction associated with the condition. So, if you are tired of feeling like you are suffering alone, it may be worth trying Osteopathy.
Jonathan Hall M.Ost, GradDipHeal, BAppSci (HB)
Jonathan Hall is the founder and principle Osteopath at Movement Mechanics Osteopathy, and specialises in Shockwave Therapy. A fully qualified Osteopath currently studying Western Medical Acupuncture out of AUT New Zealand, Jonathan founded Auckland Shockwave Therapy to help bring evidence-based Shockwave treatment to New Zealand using the industry-leading EMS Radial Shock Wave device.
Davis, H.E., Assaf, G.S., McCorkell, L., Wei, H., Low, R.J., Re 'em, Y., Redfield, S., et al. (2021) Characterising long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 38, 101019. DOI: 10.1016/j.eclinm.2021.101019
Koniukhovskaia, J., Pervichko, E., Mitina, O., Stepanova, O., Dorokhov, E. (2021) The interaction between personality traits and dysfunctional breathing during the COVID-19 pandemic in Russians. European Psychiatry 64(S1), S306–S307. DOI: 10.1192/j. eurpsy.2021.824
Mancini, D.M., Brunjes, D.L., Lala, A., Trivieri, M.G., Contreras, J.P., Natelson, B.H. (2021) Use of cardiopulmonary stress testing for patients with unexplained dyspnea post–coronavirus disease. JACC Heart Failure 9(12), 927–937. DOI: 10.1016/j. jchf.2021.10.002
Pérez-González, A., Araújo-Ameijeiras, A., Fernández-Villar, A., Crespo, M., Poveda, E., Cohort COVID-19 of the Galicia Sur Health Research Institute. (2022) Long COVID in hospitalised
and non-hospitalised patients in a large cohort
in Northwest Spain, a prospective cohort study. Scientific Reports 12(1), 3369. DOI: 10.1038/s41598- 022-07414-x
Rivera-Izquierdo, M., Láinez-Ramos-Bossini, A.J., Guerrero-Fernández de Alba, I., Ortiz-González- Serna, R., Serrano-Ortiz, A., Fernández-Martínez, N.F., Ruiz-Montero, R., Cervilla, J.A. (2022) Long COVID 12 months after discharge: persistent symptoms in patients hospitalised due to COVID-19 and patients hospitalised due to other causes—a multicentre cohort study. BMC Medicine 20(1), 92. DOI: 10.1186/s12916-022-02292-6
Yong, S.J. (2021) Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infectious Diseases 53(10), 737–754. DOI: 10.1080/23744235.2021.1924397
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