Softly Softly: The stats and facts of Long Covid

As part of a short series of articles on Long Covid, we take a look at the latest stats and facts and the results from FHT’s 2021 Long Covid survey

Most people affected by coronavirus (COVID-19) have mild to moderate symptoms and recover relatively quickly. However, some people experience ongoing symptoms that can last for four weeks or longer. These symptoms, often referred to as ‘long COVID’ can be highly variable and wide-ranging and are not limited to people who were seriously ill or hospitalized with coronavirus.

What is long COVID?

Interestingly, there is no universally agreed definition of the term ‘long COVID’.

‘Acute COVID-19’ is a term used by health professionals to typically describe the initial signs and symptoms that last up to four weeks. (‘Acute’ refers to the first signs of infection, rather than the severity of the illness.) If symptoms continue after four weeks, then the following two terms are typically used, both of which may also be referred to by the health authorities, researchers and media as ‘long COVID’:

Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from four weeks up to 12 weeks.

Post-COVID-19 syndrome: signs and symptoms which develop during or after an infection that is consistent with COVID-19, continue for more than 12 weeks and are not explained by another diagnosis. (NICE, RCGP and SIGN, 2020)

Common symptoms of long COVID

The most commonly reported symptoms include:

Respiratory symptoms

• Breathlessness

• Cough

Cardiovascular symptoms (heart and circulation)

• Chest tightness

• Chest pain

• Palpitations

General symptoms

• Fatigue

• Fever

• Pain

Neurological symptoms

• Cognitive impairment (‘brain fog’, loss of concentration, or memory issues)

• Headache

• Sleep disturbance

• Peripheral neuropathy symptoms (pins and needles, and numbness)

• Dizziness

• Delirium (in older people)

• Mobility impairment

• Visual disturbance

Gastrointestinal symptoms

• Abdominal pain

• Nausea

• Diarrhoea

• Weight loss and reduced appetite

Musculoskeletal symptoms

• Joint pain

• Muscle pain

Psychological/psychiatric symptoms

• Symptoms of depression

• Symptoms of anxiety

• Symptoms of post-traumatic stress disorder

Ear, nose and throat symptoms

• Tinnitus (ringing in the ears)

• Earache

• Sore throat

• Dizziness

• Loss of taste, smell or both

Dermatological symptoms

• Skin rashes

• Hair loss

(NICE, RCGP and SIGN, 2020)

According to a recent statistical bulletin published by the Office of National Statistics (ONS, 2021), as of 2 October 2021, an estimated 1.2 million people living in private households in the UK were experiencing self-reported long COVID (symptoms persisting for more than four weeks after the first suspected COVID-19 infection, that were not explained by something else). The bulletin also highlighted that:

  • Fatigue was the most common symptom reported as part of individuals’ experience of long COVID (55% of those with self-reported long COVID), followed by shortness of breath (39%), loss of smell (33%) and difficulty concentrating (30%).
  • More than two-thirds (65%) of those with self-reported long COVID said that their symptoms adversely affected their day-to-day activities, with 19% reporting that their ability to undertake their day-to-day activities had been ‘limited a lot’.
  • As a proportion of the UK population, prevalence of self-reported long COVID remained greatest in people aged 35 to 69 years; females; people living in more deprived areas; those working in health or social care; and those with another activity-limiting health condition or disability. (ONS, 2021),

As therapists, it is important to note that anyone who thinks they may have symptoms of long COVID are strongly advised to speak to their GP, who may suggest different tests to find out more about their symptoms and to rule out other underlying causes. (NHS England and NHS Improvement, 2021; NHS, 2021).

While it is difficult to say how long a person’s long COVID symptoms will last, current evidence suggests that in most cases, symptoms will improve over time (NHS infom, 2021).

Members’ experiences of long COVID

In October 2021, we launched a short survey to gain some insight into our members’ personal and professional experiences of long COVID. For the purposes of the survey, we defined long COVID as ‘signs and symptoms that develop during or following an infection consistent with COVID-19, which continue for more than 12 weeks and are not explained by an alternative diagnosis’ (NHS England and NHS Improvement, 2021; NHS 2021).

We would like to say thank you to the 345 members and other therapists who took part in the survey, the key findings of which are outlined below.

About our survey respondents

Of those who completed or partially completed the survey:

  • 88% identify as female, 10% as male and 2% as non-binary/prefer not to say
  • 89% are self-employed (other statuses included students, employees, volunteers and employers)
  • 83% live in England, 5% in Wales, 5% in Scotland, 5% in Northern Ireland, 2% Republic of Ireland or Overseas.

The majority of those who responded are experienced therapists, with 43% practising for 16 or more years, 20% practising between 11 to 15 years and a further 16% practising between six and 10 years.

Seventeen per cent (60) have personally been affected by long COVID, with the most common self-reported symptom being fatigue/tiredness (affecting 78%), followed by a change in sense of taste or smell (60%), problems with memory and concentration or ‘brain fog’ (52%), headaches (52%), shortness of breath (50%), join pain (48%) and muscular/ soft tissue aches and pains (43%).

FHT members’ experience of clients with long COVID

Based on the survey results, 147 respondents (43%) reported that they have supported clients with long COVID, while 107 (31%) reported that they have not supported clients with long COVID. This leaves 91 respondents (26%) who either chose not to comment or dropped out of the survey by this stage.

Of those respondents who indicated they have supported clients with long COVID and who went on to complete further questions in the survey:

  • 90% reported that their clients had spoken to their doctor about their long COVID symptoms;
  • 38% indicated their clients were receiving conventional care (eg. from their doctor) alongside therapeutic support, 30% indicated their clients were not receiving conventional care alongside therapeutic support, and 32% indicated their clients were a mixture of the two.
  • 49% of respondents said their clients had commented that they’d tried conventional care but felt it didn’t improve their symptoms, 40% of clients commented they had struggled to access support from their GP/ the NHS, 38% felt therapeutic intervention would be more appropriate, and 10% didn’t like to put pressure on the NHS system.

In terms of how respondents supported their clients with symptoms of long COVID, 84% reported doing this ‘in person’, 13% over the phone, 13% via a video communication platform, 8% via email, 8% using distance healing/reiki and 4% via post, for example, sending clients aromasticks or other therapeutic products.

The most commonly used treatments to help support clients manage or improve their long COVID symptoms were reflexology (52%), Swedish or body massage (30%), aromatherapy (28%), reiki (22%), remedial massage (19%), sports massage (17%), healing (24%), Indian head massage (24%), myofascial release (12%) and mindfulness (4%).

Clients’ self-reported symptoms and improvements

Below is a table outlining a) some common symptoms associated with long COVID, as worded in the FHT survey b) what signs and symptoms clients reported they were experiencing and c) which symptoms clients felt their therapy treatments had improved:

A Symptom of long COVIDB Percentage of clients experiencing the symptomC Percentage of clients who felt treatment improved the symptom
Extreme tiredness (fatigue)92%75%
Depression or low mood68%56%
Stress or anxiety68%60%
Muscular/ soft tissue aches & pains66%55%
Difficulty sleeping/ insomnia65%56%
Problems with memory/ concentration (‘brain fog’)63%33%
Shortness of breath56%30%
Joint pain52%39%
Headaches48%36%
Change to sense of smell or taste (anosmia)42%12%
Dizziness36%16%
Chest pain or tightness32%21%
Heart palpitations26%12%
Pins and needles25%15%
Cough22%8%
Tinnitus, earaches20%12%
Feeling sick, diarrhoea, stomach upsets19%10%
Loss of appetite/ weight loss16%5%
Rashes/ dry skin / skin problems11%6%

Adverse or unusual responses to treatment

When asked, ‘Did any of your clients with long COVID experience any contra-actions or unusual responses to your treatments?’, 88% or respondents reported ‘no’ and 12% reported ‘yes’. Where further information was provided, the responses included: the client feeling more tired or symptoms worsening for a day or two after treatment but then much improved after; a change in colour in the urine; feeling slightly sick or faint; the feet jerking or twitching when treated; and heightened emotional release (for example, crying). One respondent commented that, ‘My client had recurrences of purpling on the toe after a couple of treatments (has had probably ten treatments now, weekly). But after discussion with doctors at a hospital appointment for overall long COVID symptoms, they concluded that it was highly unlikely to be related to the massage treatment’.

Adapting treatments for clients with long COVID

In the survey, we asked members if they adapted their treatments when supporting clients with long COVID. Sixty said that they had made adaptations, including:

  • A change of position – treating clients in a seated or supine position rather than prone, to assist their breathing and make them feel generally more comfortable.
  • More gentle treatments, including lighter techniques, reducing pressure, avoiding sensitive areas.
  • Reducing the length of treatments, going at a slower pace and even taking short breaks.
  • Additional pillows and bolsters to support the client and enhance comfort.
  • A number of respondents mentioned using reflexology instead of other treatments, perhaps to avoid physically working/applying pressure to larger areas of the body.
  • More communication than usual was also key – from regularly ‘checking in’ with clients, to spending much longer listening, as clients needed to talk more.
  • Other adaptations including selecting products to use during the treatment or in the treatment area, such as essential oils, to assist breathing and promote relaxation.

Self-care techniques for clients

A total of 115 respondents reported that they had provided their clients with self-care techniques to help them manage or improve their long COVID symptoms. Of these, 17 provided the techniques instead of hands-on treatments, while the other 98 provided techniques to be used alongside (in between) treatments. The most popular self-care techniques shared with clients were:

  • Meditation/ mindfulness/ visualization/ relaxation techniques (51 respondents)
  • Gentle, graded exercises and stretches, including yoga and tai chi practices (43)
  • Breath work/ breathing exercises (40)
  • General guidance and advice around diet and nutrition (31)
  • Essential oil preparations, including aromasticks (28)
  • Working different reflex (reflexology) points (18)
  • Self-massage/ trigger point work (13)
  • Walking/ being outdoors/ fresh air (10)
  • Advice on staying hydrated (10)
  • Asking clients to rest when needed/ to listen to their body (9)
  • Journaling and bench marking progress in writing (5)
  • Therapy-specific self-care techniques, eg. manual lymphatic draining, emotional freedom technique (5)
  • Bach/ flower remedies (4)
  • Salt products, including bath salts and salt pipes (4)

Other self-care techniques provided or suggested included listening to relaxing music, the application of hot and cold products, hypnotherapy techniques and Chinese medicine.

Fifty-two percent of respondents indicated that the self-care techniques helped to improve their clients’ symptoms, 32% indicated these helped some clients but not all, and 16% indicated self-care techniques did not help their clients.

Supporting clients with long COVID

The results of FHT’s survey suggest that certain therapies and self-care techniques may be of benefit to clients experiencing symptoms of long COVID. This is very encouraging, particularly when we consider that many of these symptoms  – including fatigue, stress and anxiety, and muscular aches and pains – can be difficult to treat effectively with conventional medicine (sometimes referred to as ‘effectiveness gaps’). It is also important to bear in mind that, where appropriate, supporting clients with mild to moderate COVID-19 symptoms with complementary and other therapies could also help to take pressure off the NHS, which needs to prioritise clients with acute illnesses. 

However, it is important to note that these survey results do not constitute robust ‘evidence’ and although many long COVID symptoms are typical of what is seen in day-to-day therapy practice, the medical and scientific communities still have much to learn about long COVID, the full impact of the virus on long-term health, and the successful management of long COVID symptoms. This is an ever-evolving situation, with new data and new variants of the virus are regularly coming to the fore.

When it comes to supporting clients with symptoms of long COVID, there are no black and white answers. As with any condition, every client’s experience is unique. Some people may experience severe or debilitating symptoms that impact their daily lives and quality of life, others may have more mild and ‘irritating’ symptoms. Some will see their symptoms wax and wane, overlap and change over time, others will wake up one morning and notice their symptoms have gone. Some may have pre-existing health conditions as well as long COVID symptoms. Others will be receiving ongoing medical care and assessment. And some may think they have long COVID symptoms, when in fact there is another underlying cause (which is why anyone who thinks they have symptoms of long COVID should be encouraged to see their doctor).

What is key is that any therapist looking to support a client with symptoms of long COVID follows the principles of best practice including:

  • First, do no harm. If in doubt, or you simply feel uncomfortable about treating someone, do not treat them.
  • If you have any cause for concern about a client’s symptoms, refer them on to their GP or another healthcare professional.
  • If a client is receiving medical care for their long COVID symptoms, ask them to speak to their GP/ health care provider about having treatment before going ahead.
  • Carry out a full and detailed consultation, before every treatment, to help you determine if there are any red flags or health changes that may make treatment inappropriate. The information they provide you will also help you to adapt your treatments accordingly.
  • If, after a full assessment, you and your client are comfortable to go ahead with a treatment:
    • A common phrase used by many therapists is ‘less is more’. Start very gently and take a graded approach (eg. provide shorter treatments with less pressure or exercises than usual to see how your client responds).
    • Adapt your treatments to suit their current needs at that given point in time and to ensure their comfort.
    • Monitor your clients closely throughout the treatment and contact them in the days immediately after for feedback about how they are feeling. Do not go ahead with any further treatments if they raise anything that concerns you and where necessary, advise them to see their GP.
    • Be prepared to spend a little extra time listening to clients with long COVID and validating their symptoms and concerns.   
    • Keep detailed records about their treatments and treatment outcomes.

Remember you can always offer self-care advice or non-hands-on treatments and support to clients who you are concerned about physically treating or who are particularly sensitive to touch.

by Karen Young

Therapy dogs for children with speech difficulties shows promising results

Therapy dogs

Therapy assisted by a dog could be more effective than standard speech and language therapy for children with communication impairments, suggests a new study published in the journal Anthrozoös.

The study found children with the condition developmental dysphasia, which affects the ability to communicate and form words, were more likely to be able to mimic communicative signals in a therapy session where a dog was present.

Researchers observed that the children in the group with the therapy dog also seemed more motivated and open to communicating. Additionally, the children displayed authentic, natural expressions during their interactions with the dog.

Lead author Kristýna Machová from Czech University of Life Sciences in Prague commented, “The presence of the dog improves the relationship with the therapist, as it distracts from the fear of therapy in children and provides them with a form of support during the practice.”

In this study, researchers at Czech University conducted the first long-term randomized study of its kind, with a control and an experimental group, involving 69 nursery-school children (52 male and 17 female) participants diagnosed with developmental dysphasia. The aim was to understand if undergoing speech therapy accompanied by a dog improved results.

For both groups, the initial examination of each child involved evaluating their skills at baseline, with a follow-up scheduled for 10 months later. The control group received traditional speech therapy, while the experimental group had animal assistance therapy sessions with a female middle-aged Peruvian hairless dog named Agáta.

Despite the promising findings from this study, as this is the first of its kind and there were improvements found in both groups, the authors have stated that further research would be needed to consolidate the findings – especially those involving a larger group of participants.

However, they do agree that there is great potential in the approach to complement and aid the current conventional approach, as canine-assisted therapy has been found to be more effective than more standard forms of delivery in many other disciplines.

Developmental dysphasia, or specific speech impairment, is a common disorder whereby sufferers struggle to formulate words verbally and rank significantly below their non-verbal intellectual level. It is widely thought that the ability to improve communication skills in sufferers would also help to improve quality of life which strongly supports funding more research into this area.

Access the full study

Source

 

Emma Holly, Highly Commended for 2017 FHT Complementary Therapist of the Year, gets a hometown highlight

HERTFORDSHIRELIFE COVEREmma Holly, Highly Commended for 2017 FHT Complementary Therapist of the Year, has been featured in Hertfordshire Life magazine for her work with charities.

The local publication highlights ScarWork, a unique therapy with only around 100 qualified practitioners in Britain.

Read the article here.

 

Natural Health gets harmonious with Ayurvedic massage

NATHEALTHFEB18Ayurveda is an ancient Indian holistic system, based on achieving physical and mental harmony with nature and has been practised for more than 5,000 years. Ayurveda quite literally translates as ‘science of life’ (‘Ayu’ meaning life and ‘Veda’ meaning science), and was first recorded in the Vedas, the world’s oldest surviving literature.

One component of this system with numerous benefits is Ayurvedic massage. We help Natural Health magazine readers ease into this relaxing and re-balancing therapy with a full page feature, detailing what to expect during an Ayurvedic massage treatment session and how it can form part of a more holistic lifestyle.

Read our Ayurvedic massage feature here.

 

In The Moment feels out reiki

in the moment issue 7 jan 18Have you always wanted to try reiki, but didn’t know what to expect? You can learn all about this wonderful therapy in our latest contribution to In The Moment magazine.

In The Moment is a beautiful, practical lifestyle magazine for the modern-thinking creative woman. Enjoy practical creative projects, positive features and stories to inspire, adventures near and far for a healthy body and mind, and ideas embracing every aspect of women’s lives: friends, family, self, work, rest and play!

And in their seventh issue, readers will find an introduction to reiki. Our own Karen Young, editor of International Therapist magazine, and Julie McFadden, the FHT’s resident reiki master, discuss what you can expect from a reiki treatment, as well as things to avoid.

Reiki is one of the therapies on our Complementary Healthcare Therapist Register. Find out more about our Accredited Register here, and read our reiki feature here.

FHT Excellence Award Winner Emma Holly

2017 FHT Excellence Awards Emma Holly Mary Dalgleish

Healing Hands Network has featured one of our 2017 FHT Excellence Awards winners. Emma Holly, Highly Commended for Complementary Therapist of the Year, discusses her introduction to ScarWork, as well as what winning the award means to her.

Read their feature here. You can also catch Emma on Radio Verulam (92.6FM) soon. On 16 January at 11am she’ll be discussing her prestigious award from the FHT as well as her charity work supporting women after breast cancer surgery in St Albans. Learn more about the show she’ll be on, Verulam in the Morning, and listen in on their website.

It is our mission to make the public more aware of the FHT and its members. Our coverage also highlighted the importance of the FHT’s Accredited Register, independently approved by the Professional Standards Authority, and directs readers to search for an FHT member at fht.org.uk/findatherapist

The FHT guides Guardian readers on improving their lives in the New Year

Recently, the FHT contributed to the Guardian’s ‘New Year, New You’ supplement. It contained advice on de-stressing, self-care, and mindfulness.

The Guardian - New Year, New You supplement

It is our mission to make the public more aware of the FHT and its members. Our coverage also highlighted the importance of the FHT’s Accredited Register, independently approved by the Professional Standards Authority, and directs readers to search for an FHT member at fht.org.uk/findatherapist

New Year, new you…new local support group?

pexels-photo-288478

It’s that time again! We’re all putting on our mindfulness caps and deciding what our New Year’s resolutions will be.

If your resolution is to be more active in the community, perhaps now is the time to start a local support group in your area?

FHT Local Support Groups (LSGs) are a valuable hub for our members, students and even the public, where all those with a passion for therapies can meet and hear from speakers on various topics within the fields of complementary, beauty and sports therapy.

Benefits of attending a group include:

  • Meeting with other like-minded therapists, students and those interested in their own health and well-being
  • Hearing from excellent speakers about the latest therapies and treatments
  • Attending local therapy workshops, fairs and events
  • Taking part in outings and social events
  • Enjoying treatment swaps and sharing best practice
  • Feeling part of a large therapy community… and having fun!

Why should you do it?

It’s a deeply rewarding experience, a chance to learn something new at every meeting, and meet new friends and contacts. Here’s what some of our current coordinators have to say about running a group:

“Being a Coordinator for the Hertfordshire Local Support Group means I am liaising with and meeting so many interesting people who are also passionate about holistic therapies and natural wellness. It is rewarding helping to source speakers for our meetings and I am looking forward to seeing many attendees at our planned evenings throughout the year.”

– Rowenna Clifford, Joint Coordinator, Hertfordshire LSG

 

“I am a local Support Group Co-ordinator as I believe the Support Group Network provides invaluable support for therapists who often work in isolation. The Group meetings and contact gives all therapists local to me the opportunity to network, share concerns and successes, and attend interesting talks. My support group is a friendly and caring bunch of Therapists and I really enjoy sharing with the lovely therapists who attend my Group.”

– Carole Roberts, Joint Coordinator, Wrexham LSG

 

“Running a FHT Local Support Group keeps me in touch with other local therapists as well as being able to help those looking for a bit of encouragement, especially but not just solely those just starting. It’s amazing the amount of varying information around that can all go into helping us grow as therapists and it’s great when people take different things on board.”

– Liz Cox, Joint Coordinator, Hampshire Waterlooville LSG

Ready to dive in? You can read more about becoming an LSG coordinator on our website. Coordinators must be full FHT members, so if you haven’t already, join us now!

President’s Award Profile: Professor George Lewith

In memory of Professor George Lewith – for outstanding contribution to the integrated healthcare

Prof George Lewith1A qualified physician and Professor of Health Research, the late Professor George Lewith was the first doctor in England to receive specialist training in Complementary Medicine. Between 1980 and 2010, he set up and partnered the largest practice of integrated medicine in the UK, with NHS contracts in both Southampton and London. In an obituary published in British Medical Journal, it was commented that, ‘George gained much pleasure from seeing and treating patients and was passionate about treating them as a whole, with great emphasis on holistic care. Thousands of patients feel indebted to George for the compassionate, often life changing, treatment they received.’

Alongside being a practitioner of acupuncture, nutritional and herbal medicine and homeopathy techniques up until 2011, he was also a founder member and trustee of the Research Council for Complementary Medicine in 1982. He also established the Complementary and Integrated Medicine Research Unit at the University of Southampton in 1995, and founded the annual conference on Complementary and Alternative Medicine Strategies, Training, Research and New Developments – or CAMSTRAND, for short. He was a prominent researcher in the CAM field, and passionate about the importance of building the scientific evidence base for complementary medicine. Indeed, he had more than 350 peer review papers published, and raised more than £5 million in research funding – a huge accomplishment, by anyone’s standards.

 

In The Moment readers follow their noses and discover aromatherapy

in-the-moment-6Have you always wanted to try aromatherapy, but didn’t know what to expect? You can learn all about this wonderful therapy in our latest contribution to In The Moment magazine.

In The Moment is a beautiful, practical lifestyle magazine for the modern-thinking creative woman. Enjoy practical creative projects, positive features and stories to inspire, adventures near and far for a healthy body and mind, and ideas embracing every aspect of women’s lives: friends, family, self, work, rest and play!

And in their sixth issue, readers will find an introduction to aromatherapy. Our own Karen Young, editor of International Therapist magazine, and FHT Vice President Mary Dalgleish discuss what you can expect from an aromatherapy treatment, things to avoid, and various types of oils to try.

Aromatherapy is one of the therapies on our Complementary Healthcare Therapist Register. Find out more about our Accredited Register here, and read our aromatherapy feature here.