Dr Perrin discovered that in people with ME/CFS the lymphatic system and sympathetic nervous system are both impacted. The dysfunction of one helps fuel the dysfunction of the other causing a vicious cycle that leads to a build up of toxins in the brain. The Perrin Technique is a combination of lymphatic massage and osteopathic techniques which aim to break this cycle and allow both systems to function correctly again.

The lymphatic system is similar to the blood circulation system. It is made up of tiny tubes that branch out all over your body. The fluid flowing through the lymph vessels collects toxins and waste products produced by your body, depositing them into the subclavian vein in your chest. Once in the blood, these toxins find their way to the liver and are broken down.

In people with ME/CFS the lymphatic system isn’t working properly, it flows in the wrong direction and there are blockages which prevent toxins from draining out of the brain. These toxins impact the hypothalamus, a part of the brain which is important in controlling the sympathetic nervous system. 

The sympathetic nervous system (SNS) is part of your autonomic nervous system (ANS) that manages automatic body functions, things that happen without you consciously thinking about them, such as breathing, heart rate and digestion.

The SNS also controls your “fight or flight” response. When your body experiences a perceived threat or stressor the sympathetic nervous system kicks in releasing adrenaline, increasing your heart rate, speeding up your breathing and slowing down your digestion, to help your body run or defend itself from the perceived threat.

People who have ME/CFS will have been under stress for many years prior to developing symptoms. The stress could be physical (eg. from an injury or postural strain), it could be emotional (eg. from a relationship breakdown) or it could be from the immune system having to deal with an infection or allergy. These stressors are impacting the sympathetic nervous system and setting the stage for ME/CFS to develop.

The SNS also controls smooth muscle contractions in the lymphatic system and keeps the lymph fluid moving. As the stressors compromise the sympathetic nervous system the lymphatic system also begins to malfunction meaning toxins are not being cleared from the brain efficiently. The build up of toxins in the brain impacts the hypothalamus which controls the sympathetic nervous system which in turn impacts the lymphatic system and so the vicious cycle ensues leading to the development of ME/CFS.

Dr Perrin views ME/CFS as a structural disorder that has clear physical signs such as disturbed spinal posture, swollen lymph vessels and specific tender points related to sympathetic nerve disturbance and lymph backflow. He uses these physical signs to diagnose patients and assess the severity of their condition. At each consultation patients will be given a score of 1-10 (with 1 being severe, 10 being healthy).

In 2017 Dr Perrin partnered with the NHS to conduct a research study to investigate whether, using his diagnostic criteria, health professionals could accurately diagnose people with chronic fatigue syndrome.

The trial involved 94 participants, 52 with ME/CFS and 42 without ME/CFS. Each participant was assessed by three professionals, two used the Perrin Technique diagnostic criteria and one used a standard clinical neurological and rheumatological assessment. Results showed using Perrin’s approach improved the accuracy of identifying people with ME/CFS.

The study was published in the British Medical Journal. 

It is recommended you have a treatment every week for the first twelve weeks. After this time symptoms should start improving and the frequency of treatments can be reduced. 

How long you will need to do the treatment will depend on the severity of your ME/CFS. In Dr Perrin’s book he estimates that people with moderate ME/CFS will take 6-12 months to recover, while people with severe ME/CFS will likely take 1-3 years.

If after the first twelve weeks you have experienced no change then the Perrin Technique is unlikely to work for you and Dr Perrin advises patients look at alternative ways to improve their health.

Between treatments patients are advised to do self massage and movement exercises which can be found on the Perrin website.

If you are unable to access a practitioner, or are concerned that the treatment could be too intense for you, doing the at home exercises is a great way to start.

In a word – yes! The aim of the Perrin Technique is to mobilise toxins and clear them out of the body. Side effects of this can include fatigue, pain (particularly in the head and sinuses), nausea, dizziness and skin eruptions (spots and boils).

Many people who use the Perrin Technique say that for 1-2 days after each session they feel worse. However once this crash passes they feel much better. People report these side effects occurring after every session for the first few months. 

In Dr Perrin’s book he notes that the worse the side effects are at the start of treatment the better the long term prognosis for the patient.

He also recommends supplementing with milk thistle to support the liver while it processes these toxins.

If you want to connect with other people doing the Perrin Technique and hear their experiences check out this Facebook group. 

Practitioners are all trained personally by Dr Perrin. They are typically osteopaths, chiropractors or physical therapists. As Dr Perrin is based in the UK the majority of practitioners are also UK based but there is an increasing number abroad, particularly in the US and Europe.

On Dr Perrin’s website there is a feature which allows you to search for practitioners in your area. 

If there isn’t one near you it could be worth seeing if there are any osteopaths in your area who are willing to learn the technique. In the video below Dr Perrin shares how he is willing to go anywhere to educate practitioners, many of his overseas trips have been initiated by patients asking him to train people in their area.

Unfortunately the Perrin Technique isn’t available on the NHS, however I have heard of some people being able to access the treatment through private health insurance.

Prices can vary considerably. Those in the north of England report paying around £55 per session. Whilst those in the London area are being charged £90 – £150 per session.

Reading through people’s experiences in this Perrin support group there are plenty of people who have experienced improvements in their symptoms. There is a general consensus that the first few months are the most challenging, but it is worth it in the end.

People also talk of other things they are doing alongside Perrin such as addressing gut health, underlying infections or mould toxicity. Some also take binders like activated charcoal or zeolite to ensure toxins aren’t reabsorbed in the gut, while others use saunas to help toxins come out through their sweat.

It is important to note there are some people who have become worse. I suspect this deterioration is, at least in part, due to their body being unable to effectively clear the toxins which are mobilised.

Whenever you try a new treatment for ME/CFS it is important to listen to your own body and do what feels right for you.

In this video ME/CFS YouTuber Raelan Agle talks with Dr Perrin about how he developed the technique and the science behind it.

• Books – Dr Perrin has written several books for both patients and healthcare professionals which explain the Perrin Technique in great depth
• Support group – a Facebook group for patients and practitioners to share their experiences and give advice
• Website – Dr Perrin’s website where you can learn more, watch videos of the at home exercises and search for a practitioner near you

• Chronic fatigue syndrome, a review from a biomedical perspective – read full paper here
• An evaluation of the effectiveness of osteopathic treatment on symptoms associated with myalgic encephalomyelitis – read full paper here
• Lymphatic drainage of the neuraxis in chronic fatigue syndrome: a hypothetical model for the cranial rhythmic impulse – read the full paper here
• Dr Perrin’s thesis – The involvement of cerebrospinal fluid and lymphatic drainage in chronic fatigue syndrome