The Perrin Technique for the Treatment of Chronic Fatigue Syndrome/ME and Fibromyalgia




The common symptoms of physical fatigue, reduction in concentration, disturbed sleep, problems with short term memory, difficult  reading, ‘muzziness’ in the head/ brain fog ,nausea, sinusitis, head, neck, shoulder,  and other joint pain, numbness, paraesthesia, anxiety, photophobia, hyperacusis, dyspnoea, palpitations, chest pain, are all classic symptoms of CFS/ME or fibromyalgia, especially if the symptoms always worsen after exertion.  

Exertion has been shown to severely exacerbate the symptoms for CFS/ME sufferers in many studies. Unlike some psychological illnesses, CFS/ME patients retain their motivation but struggle with post exertion malaise, leading to often needing complete bed rest for prolonged periods.  

The main reason why about 25% of patients with CFS/ME become bed ridden sometimes for years is that they have listened to advice that they will improve by increasing daily activity at too quick a rate. 


The Perrin Technique Trials  

The Perrin Techniquetm was developed following a discovery in 1989 during the clinical practice of Manchester osteopath, Raymond Perrin. This osteopathic system of manual treatment alleviates many of the symptoms of chronic fatigue syndrome, known as CFS/ME. The effectiveness of this manual approach was tested using two separate clinical trials. The first examined the change in the symptoms following a year of treatment. The second repeated the first study and examined the possible mechanisms of the improvement. The studies were designed to develop a greater understanding of the disorder, for which there is much scientific uncertainty regarding cause, diagnosis and treatment.  

Phase 1 of the research trials was completed nine years ago and was reported throughout the worlds press. It included self-report questionnaires to examine overall symptom change. With post-exercise fatigue being a major symptom of CFS/ME, the treatment protocol was shown to improve muscle function which was analysed utilising isometric testing of the knee extensor muscles measuring the impulse torque.  

The second trial, which included the same self-report questionnaires assessing symptom relief as in the initial trial, was divided into two parallel phases. One primarily took the form of brain analysis using magnetic resonance imaging (MRI) to confirm if brain abnormalities seen in previous research were found in sufferers of CFS/ME. No cerebral abnormality was detected in the patient group. Central lymph scans were also carried out showing a possible trend of enlargement in CFS/ME sufferers. In the other part, isometric tests were repeated with more accurate equipment than in phase 1. Muscle fatigue was measured using a KINCOM dynamometer and surface electromyography.   

Overall this study has provided strong evidence that an important component of CFS/ME involves a disturbance of lymphatic drainage of the brain and muscles. Dr Perrin has groundbreaking photographic evidence of varicose lymphatic vessels taken during a research project at Salford University which shows for the first time the "backflow" of lymphatic drainage that he believes is the cause of toxin build-up. It is this accumulation of toxins in the central nervous system, which Dr Perrin believes is the cause of conditions such as chronic fatigue syndrome and ME and fibromyalgia. The osteopathic treatment developed by Raymond Perrin has been statistically validated in both clinical trials, emphasising the need to focus future research on the biomechanical aspects of this disorder. Together with Neuro-biologist Dr Vic Pentreath and Bio-engineer Prof. Jim Richards at the University of Salford in conjunction with Neuro-radiologist Professor Alan Jackson and his team at the University of Manchester, Raymond has expanded our knowledge of CFS/ME, which has recently led to a doctorate awarded by the University of Salford. 

Dr Perrin: "Normally these vessels are the size of the thinnest pencil line and you can't usually see them without a magnifying glass, but the fact they are swollen like this is significant. There is a backflow against the valves. 

"Very rarely can you see these, but with every person I have seen in the last 16 years with chronic fatigue syndrome you can feel them under the surface. It means this person has had ME for a number of years." 

Until now experts have believed that valves in the lymphatic vessels only allowed the flow of fluids in one direction. But Dr Perrin believes these varicose lymphatic vessels - which resemble varicose veins but are the same colour of the skin instead of a bluish colour - are the proof that the backflow exists when vessels are damaged, allowing toxins to concentrate in the central nervous system. The research findings point to a possible reduction of lymphatic drainage of the neuraxis which leads to a build-up of toxins in the brain and spinal cord. This results in the irritation of the sympathetic nervous system that leads to the many severe symptoms experienced by the CFS/ME sufferer.



The Perrin Technique Treatment 

Louise Hull, osteopath and Elinor Anderson, physiotherapist are licensed to use the treatment protocol of Dr Raymond Perrin DO, PhD.  


Initial consultation and follow-up session  

A detailed questionnaire is filled in by the patient during the initial consultation that gives the practitioner information they will use to help diagnose the condition. An examination will also be carried out, which includes a breast examination. You are encouraged to bring a chaperone with you on your first consultation and follow up session when you will receive the manual lymphatic drainage techniques. Your chaperone will also be able to learn the massage technique and assist you at home.  

The treatment includes massage of the chest, head and face, neck and back to encourage drainage of the lymphatic tissue. The massage technique will be taught to the patient so they can continue with it daily at home. Osteopathic treatment will also be given alongside the massage technique.  

   The Perrin Technique helps drain the toxins away from the central nervous system and incorporates manual techniques that stimulate the healthy flow of lymphatic and cerebrospinal fluid and improve spinal mechanics. This in turn reduces the strain on the hypothalamus and the sympathetic nervous system which aids a return to good health.  

Dietary advice is also given, with recommendations for some supplements to be taken.