Science is nothing but trained and organised common sense.
Thomas Henry Huxley (1825–1895)
CFS/ME can affect all ages and all cultures, men as well as women, but many more women suffer from the disease than men. This is because (1) women’s hormonal systems are so much more complex than men’s and those hormonal changes affect CFS/ME1, and (2) there is much more lymphatic tissue in the breast in women and thus there is much more congestion of the tissue in the chest, irritating more of the sympathetic nerves in this important area.2
There are many factors involved in the process leading to CFS/ME, as discussed in earlier chapters. The head may be traumatised at birth or there may be a genetic predisposition that affects the normal development of the head or back.3 Years before the onset of symptoms, perhaps even in early childhood, the patient may have suffered from trauma to the head or spine. Teenage years bring with them problems of their own and the spine of a very active teenager, or of those who tend to slouch when sitting, is prone to developmental problems.
One of the functions of the cerebrospinal fluid is drainage. Some poisons caused by infection, inflammation or toxins from the polluted environment enter the brain and spine and flow out through perforations in the skull and minute channels in the spine, entering the lymphatic system.4 If there are structural problems affecting both the head and the spine together, there is no safe drainage pathway for the cerebrospinal fluid to take. In a CFS/ME sufferer these normal drainage points are congested, leading to a build-up of poisons within the central nervous system.2
The main organ in the brain to be affected by poisons is the hypothalamus, which is the control centre for the hormones and the sympathetic nervous system. The latter helps the body cope in times of stress. In CFS/ME the toxic cocktail brewing in the hypothalamus leads to an overload of the sympathetic nervous system, which will have been affected by other stress factors – whether physical, allergic, emotional or infection – in the years leading up to the illness.5,6
One final trigger, which is usually a viral or bacterial infection, will lead to a breakdown in the normal functioning of the sympathetic nervous system.5 Furthermore, the lymphatic system, which is meant to aid drainage, is controlled by the sympathetic nervous system.7 When this system is functioning poorly, toxins are pumped in the reverse direction, which adds further poisons to the central nervous system. As the toxicity builds up, brain function worsens, leading to further sympathetic disarray. The vicious circle that ensues leads to the myriad symptoms affecting the patient with CFS/ME.2
The Perrin Technique stimulates the motion of fluid around the brain and spinal cord via cranial techniques8 (see Chapter 10). Treatment to the spine, as well as certain exercises, further aids drainage of these toxins out of the cerebrospinal fluid.9 Massage of the soft tissues in the head, neck, back and chest directs all the poisons out of the lymphatic system and into the blood, and eventually to the liver where they are broken down and readily detoxified.10
Eventually, with no poisons affecting the central nervous system, the hypothalamus and the sympathetic nerves start to work better, gradually stimulating improved lymphatic drainage. Thus the body starts to function correctly and, providing patients do not overstrain themselves as the nervous system is recovering, their symptoms should gradually improve.
‘The rule of the artery reigns supreme.’ This tenet was formulated by the founder of osteopathy, Dr Andrew Taylor Still, who stated that illness is mainly due to stagnation of body fluids and that if you can stimulate blood flow and other fluid motion, including cerebrospinal fluid and lymphatic drainage, the body will recover.10
My method of treating CFS/ME, using the principle above, is analogous to mending a blocked main drain in your home. By increasing pressure into the main drain, one pumps out the blockage. It is obviously more complex in the body and the techniques do not actually unblock the thoracic duct, the body’s main drain, but by cranial treatment, articulation of the spine and manual lymphatic drainage massage, one stimulates the movement of cerebrospinal fluid from the brain and the spine to the lymphatics. This increases pressure and thus improves the movement of lymph fluid from the thoracic duct into the bloodstream, from where it will eventually detoxify in the liver.2
The most common symptoms in the early stages of treatment include nausea, headaches, general pain and the appearance of spots and boils.2 (See pages 115–116.) My experience has shown that the worse the patient becomes in the early stage of treatment, the better the overall prognosis is likely to be. What matters is the change that occurs with the treatment. If change has not occurred in any way in the first twelve weeks, it does not mean that the patient has no hope of recovery but it may mean they have to seek an alternative therapy in their search for a cure. Some fortunate patients do improve immediately, so it is not necessarily the case that a CFS/ME patient’s condition worsens before improving.11
At the beginning of treatment, the patient is treated once a week. As the symptom picture improves, there should be a gradual increase in the period between consultations. Below is the treatment schedule for an average patient who initially scores a 5/10 on the severity scale. It is important to realise that every patient is different and in some cases the improvement may be achieved much more quickly or, unfortunately, much more slowly, than expected (See Table 2, page 114).
| Week 1–12 | weekly |
| Week 13–24 | every 2 weeks |
| Week 25–36 | every 3 weeks |
| Week 36–52 | every 4 weeks |
| Month 12–18 | every 3 months |
| Month 24 | final check-up (if symptom-free for 6 months, patient is discharged). |
Once patients have noticed a reduction in their symptoms, they can begin the uphill battle to improve their health and stamina. They have first to convalesce. Convalescence is no longer a fashionable concept. People having some operations nowadays tend to be discharged from hospital within a day and may be at work within the week. Convalescent rest, however, is a must during the process of recovery from CFS/ME.
In order to turn the remission period in CFS/ME into a permanent cure, as well as convalescence patients must keep to the half rule until they are symptom-free for at least six months. As I tell my patients, ‘remember that half of more is still more!’ In other words, as you recover and can do more before fatigue sets in, you should only gradually increase activity, while still taking care to avoid too much exertion. Double the effort may prove possible but at this stage it is not advisable.
Climbing the recovery mountain carries its own hazards. When one is very poorly with any protracted illness, the recovery mountain exists, but one is too ill to notice or care, so one passes it by; it has no relevance to the day-to-day existence of the sufferer. When one embarks on a treatment programme and symptoms start to improve, it is akin to climbing that mountain. As patients get higher and higher, they look down and feel sad and depressed that they were so ill. When they look up, their anxiety increases as they realise how much further they have to go until they reach the summit. So, patients’ moods will often change as they improve. It was noticeable, in the clinical trials, that as the treated patients’ fatigue, pain and cognitive function improved, in the early stages their anxiety and depression scores worsened.11 This, at least, showed that CFS/ME is not a psychological disorder in which the other symptoms correspond to depression or anxiety scores.
With treatment and exercise, the patient will gradually improve and, as time goes by, will become capable of leading a more active life. Patients who are eager to resume sports should begin by gentle walks up and down the road and gradually build up the distance.
Swimming is of benefit when the patient feels ready, preferably gentle backstroke. Breast stroke should be avoided as it exerts too much pressure on the spine with the stretch of the neck and the kicking of the legs. I recommend backstroke with low rhythmic up and down movements of the legs and with sidestrokes of the arms, as in sculling. This will improve joint mobility and increase the tone of the muscles throughout the body.
As the symptoms continue to improve, both the patient and the practitioner will be greatly encouraged. By steadily improving the mobility of the spine, and by relaxing all the irritated surrounding tissues, the function of the sympathetic nervous system should finally be restored to full working order. The patient once again enjoys health, vigour and a good quality of life.
All of us are exposed to many pollutants in our everyday lives. CFS/ME sufferers need to minimise as far as possible their exposure to these toxins. (See Chapter 7 for a detailed list.)
Avoid having further mercury amalgam dental fillings.12 When visiting the hair salon, the use of chemicals in your hair should be limited.13 Remember that the scalp is very close to the brain and it is not advisable to massage poisons into the skin in this area. Take care to make sure that your neck is in a comfortable position, too, when your hair is being washed in a back basin.
If you live in the countryside, take a trip away from home during crop spraying days.14 If your work entails working with harmful toxins, you may want to consider a career change.
As patients recover, if they overdo things, suffer from infections or have to cope with too much stress, their symptoms may return or get worse. Some patients do suffer recurrences when they have significantly improved, but few experience relapse once they have been discharged, unless they push themselves too far day after day. CFS/ME patients, once recovered, need to reassess their lifestyle and take steps to reduce the continual stress that may have partly led to the illness in the first place. They should be able to exert themselves when cured, but knowing when to stop is important.
Patients who are discharged should continue the dorsal rotation exercises three times a day for life. Self-massage to the chest and neck should be done once a week in the shower. An annual check-up is advisable.
Should a relapse occur, it might take a long time to reverse, but remember, if the treatment worked the first time, it can work again and perhaps more quickly the second time. Psychologists and counsellors are invaluable in these cases. The important rule in treatment, and even more so after relapse, is to remain as positive as possible. To secure a permanent remission and to remain in good health, you have to focus on the task ahead by means of sensible pacing. Once better, follow a graded exercise programme thus achieving a slow, sure return to good health.
I am one of the few practitioners who maintain that CFS/ME can be prevented. The physical signs are very real and usually are seen long before the symptoms begin (see Chapter 8). This is why in the very early stages of the disorder only a physical and postural-based examination can detect the development of this disorder before the sympathetic nervous system breaks down.
If CFS/ME is found in more than one family member, there may be a genetic predisposition that leads to a restricted flow of toxins from the brain and spine. I have observed this genetic factor many times where the children or siblings of the patient show very early signs of fatigue. Sometimes the family member may suffer only from chronic infections but nothing more specific, and yet, on examination, they have all the physical signs of CFS/ME, which quickly disappear with only a few weeks or months of treatment. For these reasons, I believe that CFS/ME is preventable if treated and managed properly in the early stages.
Most leading authorities agree that the quicker that CFS/ME is diagnosed and treatment starts, together with avoiding overstrain on the body, the better the chances of recovery are. The very severe cases of patients in bed 24/7 in silent, darkened rooms should never happen. This may occur as a result of inappropriate treatment being given in the early stages of the illness, with patients being advised and sometimes coerced to increase their activity, and/or being wrongly medicated. I believe early rest, pacing at the outset, together with prompt treatment to restore a healthy lymphatic and nervous system, will one day make CFS/ME an illness of the past.
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