Perrin Technique

The Perrin Technique for CFS / ME

Perrin Technique in London

Why Choose Rakhee Mediratta for the Perrin Technique in London?

Written and reviewed by Rakhee Mediratta, Registered Osteopath. Last updated July 2026.

When you're looking for a practitioner trained in the Perrin Technique, experience matters. The Perrin Technique is a highly specialised Osteopathic treatment approach that requires further training, a detailed understanding of osteopathy, and extensive clinical experience with supporting people living with ME/CFS and Fibromyalgia.

Rakhee Mediratta is recognised as one of the UK's most experienced Perrin Technique practitioners. She has been treating patients using the Perrin Technique for over 19 years and has helped more than 5,000 people through personalised osteopathic care.

Rakhee has worked directly alongside the technique's creator, Dr Raymond Perrin, for more than a decade. She regularly assists Dr Perrin in teaching the Perrin Technique to osteopaths and physiotherapists, helping to maintain high standards of practice for future practitioners.

Her expertise has been recognised with two Excellence in Practice Awards presented by Dr Raymond Perrin, acknowledging her contribution to the development and delivery of the technique.

Rakhee was also invited to contribute to the second edition of Dr Perrin's internationally recognised textbook, reflecting the trust placed in her clinical knowledge and experience.

Patients travel from across London, the UK and overseas to consult Rakhee because of her combination of clinical expertise, compassionate approach and commitment to ongoing professional development.

Our Experienced Team

At Rakhee Mediratta Osteopathy, we are proud to have three Registered Osteopaths & Licensed Perrin Technique Practitioners – Rakhee Mediratta, Khush Mandaviya and Nadia Hussain.

We are also pleased to have Anna Chuluunbat as part of our clinical team.

Anna is a qualified Reflexologist and Manual Lymphatic Drainage (MLD) Therapist. She is undertaking the Perrin Technique Practitioner Training Course this month as part of her ongoing professional development.

Having a team of experienced practitioners helps us provide continuity of care where appropriate. If your usual practitioner is unavailable due to annual leave or other absence, another member of our team may be able to continue your treatment, helping to minimise disruption to your care.

We believe that excellent patient care is built on collaboration. Our practitioners regularly share clinical knowledge, discuss complex cases and support one another’s ongoing professional development. By working closely together, we aim to provide consistent, evidence-informed, patient-centred care and continuity of treatment where appropriate, while ensuring every patient receives an individualised management plan tailored to their needs.

Multidisciplinary Care

We believe that many patients with Myalgic Encephalomyelitis (ME/CFS), Long COVID and fibromyalgia may benefit from a collaborative, multidisciplinary approach. Where clinically appropriate, we work alongside other healthcare professionals to help ensure patients receive coordinated, evidence-informed, patient-centred care.

Where appropriate, we collaborate with Dr Margareta Griesz-Brisson, Consultant Neurologist at The London Neurology & Pain Clinic, 4th Floor, 100 Harley Street, London, W1G 7JA. Dr Griesz-Brisson has extensive experience supporting patients with ME/CFS, Long COVID, fibromyalgia and other neurological conditions.

We also collaborate, where appropriate, with Dr Ashish Kapoor at Levitas Clinic London, 19–20 Woodstock Street, Mayfair, London, W1C 2AN. Dr Kapoor has expertise in lifestyle medicine, preventative medicine and longevity medicine, offering comprehensive medical assessments, advanced diagnostics and personalised management plans that may complement osteopathic care where clinically appropriate.

When clinically indicated, we may liaise with GPs, consultants and other healthcare professionals involved in a patient’s care to help ensure a coordinated, patient-centred approach tailored to each individual’s needs.

Why Patients Choose Rakhee

Over 19 years' experience practising the Perrin Technique
More than 5,000 patients treated
One of the most experienced Perrin Technique Practitioners in London
We offer 45 minute appointments and have some of the lowest fees in London to try to keep treatment as accessible as possible
Advanced Licensed Perrin Technique Practitioner
Personally trained and mentored by Dr Raymond Perrin
Assists with teaching Perrin Technique practitioner courses
Recipient of two Excellence in Practice Awards
Contributor to the second edition of Dr Perrin's book
Harvard Medical School Executive Education – Master Class in Health, Wellness and Nutrition, covering nutrition science, lifestyle medicine and behaviour change coaching
Registered Osteopath with the General Osteopathic Council
Clinics in Central London and Buckinghamshire
Home visits available where appropriate

What is the Perrin Technique?

The Perrin Technique™ is a hands-on approach that assists in the relief of the symptoms of Chronic Fatigue Syndrome /Myalgic Encephalomyelitis ME/CFS. This technique was pioneered in 1989 by renowned British osteopath and neuroscientist Dr Raymond Perrin DO Ph.D.

The Perrin Technique is based on Dr Perrin’s theory that different stress factors whether that be physical (through postural problems or injury), infectious (bacterial or viral), environmental (exposure to toxins or allergies), emotional stress (work or family) or more usually a combination of these which leads to an overload on the sympathetic nervous system. This in turn results in a build-up of toxins in the fluid around the brain and spinal cord. These toxins are supposed to drain down the spinal cord and into the lymphatic system where they leave our bodies via the liver but in people with CFS / ME and similar conditions the drainage points into the lymphatic system are blocked leading to the build-up of congested toxins. This accumulation of toxins can irritate the brain, spinal cord and surrounding tissues contributing to the wide ranges of symptoms associated with CFS / ME.

According to Dr Perrin, ME/CFS results from a build-up of inflammatory chemicals and other toxic substances in the brain and spinal cord. This leads to malfunctioning of the sympathetic nervous system, which is a part of the body's autonomic nervous system that manages all automatic body functions. Known for its role in our 'Fight or Flight' responses during danger or stress, the sympathetic nervous system also regulates blood flow and the standard functioning of all body organs such as the heart, kidney and bowel. It is essential for healthy lymphatic drainage. In ME/CFS patients, the sympathetic nervous system has undergone stress for many years before the symptoms become apparent. This stress could be physical due to postural strain or an old injury, emotional, environmental such as pollution, or due to stress on the immune system because of infection or allergy.

Dr Perrin proposed that a final trigger factor, typically a viral infection, leads to a collapse of the sympathetic nervous system’s control of lymphatic drainage, causing a reversal of the flow of toxins towards the brain and spinal cord. This leads to further dysfunction of the central nervous system, causing a further back flow of toxins and continued disruption of normal bodily functions, resulting in ME/CFS. However, the final trigger may not necessarily be an infection but could be a physical, emotional, or chemical trauma. Every patient has a different toxicity level and type, and with over 100 Billion neurons (nerve cells) in the brain, it is no surprise that each ME/CFS patient presents with different symptoms, adding to the confusion in the medical field.

FAQ's

The Perrin Technique is a specialised osteopathic approach developed by Dr Raymond Perrin for people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It combines osteopathic assessment with gentle manual techniques delivered as part of an individualised treatment programme.The approach is based on Dr Perrin’s theory, which proposes that dysfunction of the autonomic nervous system and changes in neuro-lymphatic drainage may contribute to symptoms experienced by some people living with ME/CFS. Some practitioners also use the Perrin Technique when supporting people living with ME/CFS fibromyalgia and post-viral fatigue, where clinically appropriate.

The Perrin Technique is based on Dr Raymond Perrin’s theory, which proposes that dysregulation of the autonomic nervous system and changes in neuro-lymphatic drainage may contribute to symptoms experienced by some people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and related conditions.Treatment combines osteopathic assessment with gentle manual techniques that form part of Dr Perrin’s approach. According to Dr Perrin’s theory, these techniques are applied with the aim of supporting the proposed neuro-lymphatic drainage pathways and are delivered as part of an individualised osteopathic treatment programme.Research into the Perrin Technique and its proposed mechanisms is ongoing. While some patients report improvements in their symptoms, further high-quality research is needed to better understand its effectiveness and the mechanisms by which it may work.

Following an individual osteopathic assessment, the Perrin Technique may be considered, where clinically appropriate, for people living with:•⁠ ⁠Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)•⁠ ⁠Post-viral fatigue•⁠ ⁠Fibromyalgia•⁠ ⁠Persistent fatigue, where an osteopathic assessment indicates that this approach may be appropriateEvery patient is different. A comprehensive consultation and osteopathic assessment are carried out before any treatment recommendations are made, ensuring that care is tailored to each individual’s needs.

Some people living with Long COVID choose to enquire whether the Perrin Technique may be appropriate for them. A registered osteopath will carry out a detailed consultation and assessment before deciding whether the Perrin Technique is appropriate for the individual. The Perrin Technique has not been established as a treatment for Long COVID, and research in this area is ongoing. Patients with Long COVID should continue to seek advice and treatment from their GP or relevant medical specialist.

The Perrin Technique is a gentle form of osteopathic manual therapy, and many people tolerate treatment well. As with other forms of manual therapy, some patients may experience temporary reactions following treatment, particularly during the early stages of their care. These reactions are usually mild and settle within a short period of time.Possible temporary reactions may include:•⁠ ⁠A temporary increase in fatigue•⁠ ⁠Mild muscle soreness or tenderness•⁠ ⁠Headache•⁠ ⁠Nausea•⁠ ⁠Flu-like symptoms•⁠ ⁠An increased need to rest for 24–48 hours•⁠ ⁠A temporary increase in existing symptoms before they settleIf you experience symptoms that are severe, persistent or cause concern, you should contact your practitioner or seek appropriate medical advice.

Diagnosing CFS/ME using
The Perrin Technique™

Dr Perrin’s research has revealed that the disruption of the neuro-lymphatic flow and the sympathetic nervous system gives rise to physical symptoms common in ME/CFS patients. ME/CFS is essentially a bio-mechanical disorder that presents identifiable physical signs including:

• Abnormal spinal posture

• Varicose enlarged lymph vessels

• Specific tender points associated with sympathetic nerve disturbance and lymphatic fluid back flow

• Disruption in cranial rhythm - The fluid drainage from the brain to the lymphatics occurs rhythmically, a rhythm that can be detected using cranial osteopathic techniques. A skilled practitioner can identify a disruption in the cranial rhythm in ME/CFS patients.

By recognising these common signs in all ME/CFS patients, Dr. Perrin has created

a physical examination that assists in making a definitive diagnosis. The diagnostic signs of The Perrin Technique™ have undergone testing and have been backed by the rigour of an NHS-controlled trial, the results of which were published in the

British Medical Journal (BMJ Open) in November 2017.

Evidence & Further Reading

We believe patients should have access to clear, evidence-informed information when considering treatment options. The resources below provide further information about the Perrin Technique, osteopathy and current scientific understanding of ME/CFS, Long Covid and the lymphatic system.

Professional Organisations

Learn More About the Perrin Technique

The Perrin Technique Official Website

Selected Research

This page was last clinically reviewed July 2026 by Rakhee Mediratta, Registered Osteopath and Advanced Licensed Perrin Technique Practitioner.

‘The Perrin Technique: How To Diagnose And Treat CFS/ME and Fibromyalgia via the lymphatic drainage of the brain.’

Here at the clinic we are very excited for the release of Dr Ray Perrin’s new book ‘The Perrin Technique: How To Diagnose And Treat CFS/ME and Fibromyalgia via the lymphatic drainage of the brain.’

Rakhee's review is even on the cover! The second edition of Dr Ray Perrin’s book is not solely about The Perrin Technique Treatment itself but also many other treatments, recommendations and lifestyle factors for an overall approach to recovery from CFS/ME and Fibromyalgia.

Dr Raymond Perrin’s book is available to purchase on Amazon.

Rakhee has assisted Dr Raymond Perrin on a 3 day Lymphatics masterclass in Hamburg, Germany in March 2023.

Awarded Twice for Excellence in the Perrin Technique by Dr Raymond Perrin

How does the Perrin Technique treatment work?

The Perrin Technique™ is an osteopathic method of treatment for ME/CFS that involves manually stimulating the movement of fluid around the brain and spinal cord. This is achieved through a combination of specialized osteopathic techniques and manual neuro lymphatic drainage techniques developed by Dr. Raymond Perrin, which assists in removing toxins from the cerebrospinal fluid.

The method incorporates cranial and spinal techniques along with massages of the soft tissues in the head, neck, back, and chest. Gentle lymphatic drainage techniques are also used to direct toxins out of the lymphatic system and into the bloodstream for detoxification in the liver.

As the toxins are removed, the brain is no longer affected by them, enabling the sympathetic nervous system to function properly. If the patient takes care to avoid overexertion and pace themselves, their symptoms should begin to lessen over time. In some cases, patients may even become completely free of symptoms.

Studies conducted over the past three decades have confirmed the theories put forth by Dr. Perrin. The results of the initial research can be found in the following peer reviewed papers.

1. Perrin R,N. 1993 Chronic Fatigue Syndrome, a review from the

biomechanical perspective. British Osteopathic Journal; vol xi.

See paper here

2. Perrin RN, Edwards J and Hartley P (January/February 1998) An

evaluation of the effectiveness of osteopathic treatment on symptoms

associated with Myalgic Encephalomyelitis. A preliminary report.

Journal of Medical Engineering and Technology , 22(1), 1-13.

See paper here

3. Perrin RN. Lymphatic Drainage of the Neuraxis in Chronic Fatigue

Syndrome: A Hypothetical Model for the Cranial Rhythmic Impulse.

Journal of the American Osteopathic Association, 107(06), 218-224. 2007

See paper here

By identifying the common signs in all ME/CFS sufferers, Dr. Perrin has devised a physical examination that results in aid to a definitive diagnosis. The diagnostic signs of The Perrin Technique have been tested and supported by the rigor of an NHS-controlled trial, published in the British Medical Journal (BMJ Open) in November 2017.

Read a recent research paper published by the founder of the Perrin Technique Dr Perrin supporting the use of lymphatic drainage techniques in the recovery from Long Covid:

Also there is a recent article in the Telegraph titled “It’s the illness that has no cure. But this doctor believes he’s found the answer to chronic fatigue syndrome”. https://www.telegraph.co.uk/health-fitness/wellbeing/sleep/perrin-technique-fatigue-syndrome/

What will happen during the consultation?

•Prior to your initial consultation we will ask you to complete a comprehensive online form which we will then discuss during the appointment.

•The initial consultation is 90 minutes long and involves taking a full case history where we will discuss how your condition impacts you and affects your life.

•A full physical examination will be completed and then a diagnosis can be given for your condition.

•We will discuss how the treatment works, the research that supports this treatment approach as well as a prognosis and an out-line for the tailored follow up treatment plan to improve your quality of life and support you during the recovery process.

•You may want to bring a chaperone (partner or friend) with you to your first appointment because we need to examine the spinal and breast tissue to provide an accurate assessment.

•We will also require you to sign a consent form to allow us to proceed with this in a professional manner.

•Please note that there is no treatment provided in the initial consultation for The Perrin Technique.The initial consultation includes the consultation, examination and diagnosis. If your practitioner advises that The Perrin Technique is suitable for you following your initial consultation, the treatment will commence from the second appointment.

If you have any further questions please don’t hesitate to get in touch.