The Perrin Technique: Its Theory, Current Research and Potential Role in Supporting People Living With ME/CFS and Long Covid
Updated: 4 days ago
In July 2025, The Telegraph published a feature by journalist Boudicca Fox-Leonard exploring the work of registered osteopath and neuroscientist Dr Raymond Perrin and the development of the Perrin Technique.
The article examined Dr Perrin’s theories concerning the autonomic nervous system, neuro-lymphatic drainage and the symptoms experienced by some people living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It also discussed the possible relevance of his approach to people experiencing symptoms associated with Long Covid.
This independent educational article provides an overview of the Perrin Technique, Dr Perrin’s proposed model and some of the research relevant to this developing area.
It is important to recognise that ME/CFS and Long Covid are complex medical conditions. The precise mechanisms underlying these conditions remain under investigation, research into it's possible role is still at a preliminary stage.
Read the original Telegraph feature by Boudicca Fox-Leonard https://www.telegraph.co.uk/health-fitness/wellbeing/sleep/perrin-technique-fatigue-syndrome
What Is the Perrin Technique?
The Perrin Technique is a manual osteopathic approach developed by Dr Raymond Perrin in 1989.
It was developed following Dr Perrin’s clinical observations while working with people living with ME/CFS. The approach is based on his theory that changes involving the autonomic nervous system and neuro-lymphatic drainage may be relevant to some of the symptoms experienced by people with the condition.
The technique may include:
• An osteopathic consultation and assessment
• Assessment of posture and movement
• Gentle manual techniques involving areas such as the back, chest, neck and head
• Soft-tissue approaches
• Individual self-management advice, including a prescribed self-massage routine where appropriate
The techniques are adapted to each person’s presentation and tolerance following an individual assessment.
What Is the Theory Behind the Perrin Technique?
The autonomic nervous system helps regulate many involuntary functions within the body. Dr Perrin’s proposed model suggests that dysregulation of this system may be associated with changes in neuro-lymphatic drainage and may contribute to certain symptoms experienced by some people living with ME/CFS.
Within this model, the manual techniques used in the Perrin Technique are intended to support the body’s neuro-lymphatic drainage pathways.
Why Is the Perrin Technique Discussed in Relation to Long Covid?
Long Covid can affect people in different ways. Reported symptoms may include fatigue, cognitive difficulties or “brain fog,” sleep disturbance, dizziness, headaches, pain and post-exertional symptom exacerbation.
Some of these symptoms overlap with those experienced by people living with ME/CFS. This has led researchers and healthcare practitioners to consider whether approaches previously developed in relation to ME/CFS warrant investigation in the context of Long Covid.
The Perrin Technique should not be described as a cure for Long Covid. Research into its possible role remains at a preliminary stage.
What Does the Current Research Show?
A small preliminary study published in 2022 examined a specific manual lymphatic drainage intervention in 20 people experiencing fatigue-related symptoms associated with Long Covid.
Following three months of intervention, the researchers reported reductions in the symptom scores measured. However, the study was uncontrolled, involved a small number of participants and was not a randomised controlled trial.
The results therefore cannot establish that the intervention caused the reported changes or that comparable results would occur in a larger population. The researchers concluded that further controlled studies were required.
Read the 2022 preliminary Long Covid report
A separate feasibility study published in 2025 examined a home-based self-help intervention that included elements associated with the Perrin approach for people living with Long Covid. The researchers reported preliminary indications of possible benefit but emphasised the need for further evaluation. As a feasibility study, it was not designed to provide definitive evidence of effectiveness.
Read the 2025 feasibility study
These preliminary findings may help inform future research, but they do not allow firm conclusions to be drawn about the effectiveness of the Perrin Technique for ME/CFS or Long Covid. Importantly, the findings do not exclude the possibility that the treatment may be beneficial for some individuals, and further research is needed to better understand its potential effects and the patients who may benefit from it.
Developments in Understanding the Brain’s Waste-Clearance Systems
Scientific understanding of fluid movement and waste clearance around the brain has developed over recent years.
In 2012, researchers at the University of Rochester described a previously unrecognised waste-clearance pathway in the brains of mice. This pathway subsequently became known as the glymphatic system.
Read the University of Rochester research summary
In 2015, researchers reported the presence of lymphatic vessels associated with the meninges in mice. Further research has continued to investigate the relationship between cerebrospinal fluid, perivascular pathways, meningeal lymphatic vessels and the body’s wider waste-clearance systems.
In 2024, researchers studying five people undergoing neurosurgery reported evidence of glymphatic waste-clearance pathways in the living human brain.
Read the NIH summary of the 2024 human study
These discoveries represent important developments in our understanding of neuroscience and may provide relevant context for some of the mechanisms proposed within the Perrin Technique. However, as the studies did not specifically investigate the Perrin Technique, their findings cannot yet be taken as direct evidence of the proposed model or as definitive evidence of the technique’s effectiveness for ME/CFS or Long Covid.
For this reason, it may be more appropriate to view these findings as providing relevant scientific background and context, while recognising that further research is needed to explore how they may relate to the mechanisms underlying the Perrin Technique and its potential therapeutic effects.
What Happens During an Appointment?
What Happens During an Appointment
Initial Consultation — 90 minutes
The initial consultation is a detailed 90-minute appointment and includes:
A thorough case history: The practitioner will discuss the patient's symptoms, medical history, current health and any other relevant factors to gain a comprehensive understanding of their individual presentation.
Review of patient information: Any patient intake forms completed prior to the appointment will be carefully reviewed and discussed.
Physical examination: A detailed physical assessment will be undertaken, which may include assessment of the cranial rhythm, the spine and areas of inflammation or tension, alongside other factors considered relevant to the Perrin Technique.
Assessment of suitability: The practitioner will assess whether the Perrin Technique appears appropriate for the individual. Where appropriate, they may recommend that the patient discusses further investigations, testing or alternative avenues with their GP or other healthcare professional.
Detailed explanation of the treatment: As the Perrin Technique is a specialised approach, time is taken to explain the treatment carefully, including what patients can expect during treatment and why particular techniques are used. This is particularly important where treatment involves more intimate areas of the body, such as the chest. The practitioner will explain techniques such as chest effleurage fully and ensure that the patient is comfortable with the proposed approach before proceeding.
Discussion of prognosis and treatment approach: Once the case history and assessment have been completed, the practitioner will discuss their initial clinical impressions and provide an indication of the recommended treatment approach and likely number of sessions. This is individual to each patient and may be adjusted according to their response and progress.
Individualised approach: As people with ME/CFS can experience post-exertional malaise (PEM), where symptoms can worsen following physical or cognitive activity, treatment is approached carefully and adapted to each individual's tolerance and presentation.
Lifestyle and supplement advice: Where appropriate, lifestyle and supplement advice approved by Dr Perrin may also be discussed as part of the overall approach. Patients are advised to check any supplements with their GP, doctor or other appropriate healthcare professional, particularly if they are taking medication or have existing health conditions.
The initial consultation is therefore a comprehensive appointment designed to allow sufficient time to understand the individual patient, assess their suitability for the technique, explain the treatment in detail and establish an appropriate way forward.
Second Appointment — 60 minutes
The second appointment is usually a 60-minute session, including a 30 minute treatment and a 30 minute self massage demonstration.
Where appropriate, the practitioner will introduce the patient to specific self-massage techniques that they may be advised to carry out between practitioner appointments.
These techniques are not recommended universally and will depend on the individual's symptoms, presentation and tolerance.
The practitioner will explain how and when the techniques should be performed and may adapt them according to the patient's response.
Ongoing Treatment Appointments — 30 minutes
Follow-up appointments are usually 30-minute treatment sessions.
Initially, treatment is generally recommended on a weekly basis for approximately 8–12 weeks, although this is individual to each patient.
The treatment approach and frequency are reviewed according to how the patient responds and progresses.
As a patient progresses through their treatment, the frequency of appointments may gradually be reduced, where appropriate.
The overall number of sessions varies between individuals and will depend on their presentation, response to treatment and progress over time.
An osteopath does not replace a GP or medical specialist in diagnosing or medically managing ME/CFS or Long Covid. Where symptoms have not been medically assessed, have changed or require further investigation, an appropriate medical referral may be recommended.
Is the Perrin Technique a Cure for ME/CFS or Long Covid?
No. The Perrin Technique should not be described as a cure for ME/CFS or Long Covid.
Frequently Asked Questions
Who developed the Perrin Technique?
The Perrin Technique was developed by registered osteopath and neuroscientist Dr Raymond Perrin following clinical observations that began in 1989.
What was the Perrin Technique developed for?
The technique was originally developed in relation to Dr Perrin’s work with people living with ME/CFS. Its possible relevance to fatigue-related symptoms associated with Long Covid has subsequently been explored in preliminary research.
Is the Perrin Technique proven to work for ME/CFS?
The current evidence base is still developing, and further robust and independently conducted clinical research would be valuable in helping to better understand the effectiveness and potential benefits of the Perrin Technique for people with ME/CFS.
Is the Perrin Technique proven to work for Long Covid?
A small uncontrolled study and a subsequent feasibility study have reported preliminary findings that warrant further research. These studies do not provide definitive evidence of effectiveness.
Is the Perrin Technique recommended by the NHS or NICE?
The Perrin Technique is not currently included within NHS or NICE guidance as an established treatment for ME/CFS or Long Covid. This reflects the current scope of formal clinical guidance and the available evidence, rather than necessarily indicating that the approach has no potential value for individual patients. Further research may help to clarify its potential role alongside established approaches to managing these conditions.
Can results be guaranteed?
No. Responses to any form of care vary between individuals, and no particular improvement or result can be guaranteed.
Final Thoughts
The Perrin Technique is a developing area of osteopathic practice based on Dr Perrin’s proposed relationship between autonomic nervous system function and neuro-lymphatic drainage.
Developments in glymphatic and meningeal lymphatic research have improved scientific understanding of how fluid and waste-clearance pathways are associated with the brain. However, these discoveries do not prove that dysfunction in these systems causes ME/CFS or Long Covid, nor do they establish that the Perrin Technique is effective.
Preliminary research has generated questions that may warrant further investigation. Larger, controlled and independently conducted clinical studies would help to further understand the effectiveness, safety and longer-term outcomes associated with the Perrin Technique.
People living with ME/CFS or Long Covid should receive individualised care and appropriate medical assessment. Anyone considering the Perrin Technique should understand the limitations of the current evidence and consult suitably qualified healthcare professionals. At the same time, the current limitations in the evidence do not exclude the possibility that the Perrin Technique may be helpful or beneficial for some individuals, and further research may help to identify those who may be most likely to respond positively to treatment.
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Written and clinically reviewed by Rakhee Mediratta August 2026
Registered Osteopath — General Osteopathic Council registration number 6576
BSc (Hons) Osteopathic Medicine, BCOM
Advanced Licensed Perrin Technique Practitioner
19 years’ clinical experience
This article provides general educational information and does not constitute personal medical advice, diagnosis or a guarantee of treatment outcome. The Perrin Technique is not presented as a cure or an established treatment for ME/CFS or Long Covid. Evidence concerning its effectiveness remains limited, and further high-quality clinical research is required.
Copyright notice
This is an independently written educational overview. It was informed in part by subjects discussed in Boudicca Fox-Leonard’s feature about Dr Raymond Perrin, published by The Telegraph on 4 July 2025. It does not reproduce the original Telegraph article.
The original Telegraph article, headline, photographs and wording remain the copyright of Telegraph Media Group and/or their respective copyright holders. This website is not affiliated with or endorsed by The Telegraph.
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