The Perrin Technique: Osteopathic treatment for Chronic Fatigue Syndrome

Using the Perrin Technique to treat CFS and ME

The Perrin Technique™ is a manual treatment for chronic fatigue syndrome which aims to restore health to the patient’s body by removing toxins which have accumulated in the brain and spinal cord and in the tissues.

Osteopathic treatment for Chronic Fatigue Syndrome

Most of the treatments for CFS/ME leave out the possibility of using manual treatment to improve the health of the patient’s body. However it is possible to treat chronic fatigue syndrome using osteopathy combined with advice on nutrition, posture, exercise and lifestyle. Scores of patients have been helped using the Perrin Technique, the osteopathic system developed by Manchester osteopath, Dr Raymond Perrin.

All sufferers of this debilitating illness appear to have upper back problems, either through previous injury or chronic postural strain. It has been suggested that the chronic stiffness in this part of the spine leads to irritation of the sympathetic nervous system with which this area is closely linked. The lymphatic vessels, which form the body’s natural waste disposal system, are eventually affected by the disturbed sympathetic nerves. The M.E. sufferer is left with a clogged and toxic lymphatic system, chronic muscular tension over the upper back and rib cage and poor breathing patterns.

Eventually backflow in the lymphatic system leads to accumulation of toxins in the central nervous system, which Dr Perrin believes is the cause of chronic fatigue syndrome. He has discovered definite physical signs common to all CFS/ME sufferers and these can be used to reach a definite diagnosis.

You can read more about the CFS/ME and the Perrin Technique in Dr Perrin’s book.

What is The Perrin Technique?

At the Perrin Clinic we believe that Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Post Viral Fatigue Syndrome are physical disorders that lead to a build up of toxins within the brain and the spine. The Perrin Technique™ has been developed to diagnose CFS/ME by identifying definite physical signs and to treat the disorder by improving drainage of these poisons from the central nervous system.

How does the Perrin Technique work?

The Perrin Technique™ uses osteopathic techniques to stimulate fluid motion around the brain and spinal cord. Manipulation of the spine further aids the drainage of toxins out of the cerebrospinal fluid. Massage of the soft tissues in the neck, back and chest direct the toxins out of the lymphatic system and into the blood, where they are eventually detoxified in the liver. Massage and mobilisation help to restore normal spinal function, and this is complemented by cranial osteopathy which helps to improve fluid motion around the brain and drainage of fluid from the head.

No two M.E. sufferers are the same and treatment programmes have to be tailored to the individual needs of each patient. Recovery takes time with such a chronic condition but in each case full involvement in the regime is encouraged, as this will speed the recovery process. Patients are given a home massage routine and gentle exercises to improve spinal mobility, relax the back and shoulders and begin the process of restoring body condition and coordination.

After a long distressing marriage, a very stressful job and finally a divorce, I became very tired and could sleep all day as well as night. I was very tired all the time so went to the doctor who just said it was due to long term stress and it would gradually go, but it didn’t. I then saw an advertisement from Sorrel with all the symptoms I was suffering from and saying that it was probably early signs of M.E.

Her treatment, the Perrin Technique™ involved massaging and exercises and eating the right foods, but after 3 months I felt so much better.

I have now returned to work as I like to be busy and I go jiving with my partner two or three times a month.

I am so glad I saw that advertisement.

Valerie Swan, 67

Tell Me About The Clinical Trials

Dr Raymond Perrin DO, PhD has been involved in the treatment of patients with CFS/ME since 1989 and has spent the past eighteen years researching into this debilitating disorder. He has published three scientific papers and a book on this subject. The treatment developed by Dr Perrin, The Perrin TechniqueTM aims to improve lymphatic drainage, in order to facilitate the removal of metabolites and toxins from the peripheral tissues and the cranium, and to restore sympathetic function.

Dr Perrin has conducted two studies of the efficacy of osteopathic treatment for symptoms associated with M.E. The first trial was carried out over a two year period at Salford University and Hope Hospital, together with bio-engineer Prof. Jack Edwards and health psychologist Dr. Pat Hartley. This study examined the change in the symptoms following a year of treatment, using self-report questionnaires and muscle testing. It demonstrated that the treatment techniques did help reduce symptoms and restored patients to a much better quality of life.

In 2005 Raymond Perrin completed further research at Salford University’s Dept. of Biological Sciences into the treatment of CFS/ME, together with neuro-biologist Dr. Vic Pentreath. This study repeated the first study and also examined the possible mechanisms underlying the improvement. Central lymph scans were carried out showing a possible trend of enlargement in CFS/ME sufferers. The research findings point to a possible reduction of lymphatic drainage of the central nervous system, 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 many of the symptoms experienced by the CFS/ME sufferer. These symptoms include physical fatigue, reduction in concentration, disturbed sleep, problems with short term memory, difficulty reading, brain fog, nausea, sinusitis, head, neck, shoulder, and other joint pain, numbness, pins & needles, anxiety, photophobia, sensitivity to noise, dyspnoea, chest pain and palpitations. Further symptoms of physical fatigue and pain appear to be due to a build-up of lymph in the muscles.

Dr Perrin is planning further research to compare the results of his diagnostic method with those of the standard NHS work-up. Click here for a summary of the research proposal.


Perrin RN (1993) Chronic Fatigue Syndrome, a review from the biomechanical perspective. British Osteopathic Journal; 11

Perrin RN (2007) The Perrin Technique: How to beat CFS/ME. Hammersmith Press, London.

Perrin RN (2007) Lymphatic Drainage of the Neuraxis in Chronic Fatigue Syndrome: A Hypothetical Model for the Cranial Rhythmic Impulse. Journal of the American Osteopathic Association, 107(06), 218-224

Perrin RN, Edwards J and Hartley P (1998) An evaluation of the effectiveness of osteopathic treatment on symptoms associated with Myalgic Encephalomyelitis. A preliminary report. Journal of Medical Engineering and Technology , 22(1), 1-13

There is a lot more information about the Perrin Technique on Dr Perrin’s own website.

What Are Lymphatics?

The key to the Perrin Technique is the lymphatic system. In people suffering from CFS/ME there is a problem with the lymphatics, both in the body and in the head itself. This is accompanied by an increase in the activity of the sympathetic nervous system (which mediates the body’s fight/flight response).

A probable cause of this nervous system overload is a build up of toxins in the fluid around the brain and the spinal cord. Some of the poisons caused by infection or inflammation in the head or spine flow through perforations in a bony plate (the cribriform plate) just above the nasal sinuses into the lymph ducts of the face and neck. The toxins are also meant to drain down the spinal cord and out into the lymph ducts lying along the spine. In a CFS/ME sufferer these normal drainage points are congested.

According to Dr Perrin’s theory, different stress factors whether physical, allergic, emotional or infectious lead to an overstrain of the sympathetic nervous system. This impacts on the lymphatic system, an important network of small channels carrying lymph, which is a fluid collected from all tissues and eventually returned to the blood. The lymphatic system is basically a secondary waste disposal unit within the body which flushes out the waste products of the cells and foreign bodies that are toxic to us. The sympathetic nerves have been found to control a pump mechanism within the main drainage of the lymphatic system which becomes disturbed in CFS/ME. The resultant back flow engorges the lymphatic vessels, especially in the chest and neck.

Back in 2007 Perrin published an article in the Journal of the American Osteopathic Association, in which he proposed a system of lymphatic drainage from the head and brain. This has recently been demonstrated by researchers at the University of Rochester in the United States. You can read a summary of their research on the University of Rochester’s website.