Little is understood about long covid, and the knowledge base is expected to change quickly. This post will be updated as evidence emerges. It was last updated on 9th November 2020.

What is Long Covid?

Most people who contract COVID-19 recover quickly, but others develop complications. Of the latter, some can be diagnosed with “long covid”. This often follows mild illness, and is characterised by:

  • fatigue
  • muscle and body aches
  • shortness of breath
  • headaches
  • “brain fog”
Long covid symptoms

It seems that about 5% of people who have had COVID will develop long covid (LC) that lasts 8 weeks or more. This number is higher in the older population, those with asthma, and people with a high BMI. LC is often relapsing and remitting, seemingly coming out of nowhere. It may also come with symptoms that we often see in clinic, such as pins and needles and muscle aches.

Can Osteopaths Help with Long Covid?

Because the understanding of LC is still lacking, there is currently no formal pathway for these patients. However, an article in the British Medical Journal suggests a multidisciplinary approach. This includes respiratory physiotherapy, mental health support, and an exercise plan among other things. Some of these elements cross over into our remit.

Shortness of Breath

The article showed specific breathing exercises to be particularly effective in managing the effects of prolonged coughing on the diaphragm. These are ideas that we are already familiar with. After a lot of coughing, the diaphragm and muscles in the shoulders can get tight, leading to inefficient breathing. This causes shortness of breath and fatigue.

This tightness may also be a factor in reports of pins and needles in LC patients if nerves are trapped or irritated by these muscles. This too is a concept we are familiar with and comfortable treating. It appears that some chest pain is also of a similar nature. It is important that this is brought up with a doctor before seeking osteopathic treatment.


In the same vein as breathlessness, returning to exercise can also help with fatigue of this nature. It’s important not to do too much too quickly, however. This is great news, especially when it seems that medication is ineffective for this kind of fatigue. Again, direct evidence for management strategies is limited, but your osteopath is able to develop an exercise regime with you.

It is important not to over-exert oneself with any post-viral fatigue. Patients whose hearts have been affected need specialist sign-off before resuming cardio exercise.

Current Conclusion

As it stands, there is no direct evidence that osteopathy can help with LC. However there is evidence that certain treatments can help with the symptoms of LC, and some of those are within our remit. We are definitely not claiming to be able to cure anyone of the virus itself.

If you think you have long covid, you can book online here. Please ensure you are acting in line with our COVID policy.