• Currently there are a lot of unknowns about long Covid. Although the process can be slow, most people are appearing to recover in time with the appropriate support.
Long Covid is a term to describe the effects of Covid-19 that continue for weeks or months beyond the initial illness. The health watchdog the National Institute for Health and Care Excellence (NICE) defines long Covid as lasting for more than 12 weeks, although some people consider symptoms that last more than eight weeks to be long Covid.
Other names that have been used for the condition include post-acute Covid-19 syndrome, post-Covid-19 syndrome, chronic Covid syndrome (CCS), post-acute sequelae of SARS-CoV-2 infections (PASC). Please note that long Covid is still a newly emerging condition and as such research and guidance are changing on a daily basis. We will do our best to keep this information as up-to-date as possible.
Symptoms of long Covid are varied and still emerging (1-4). Due to the many different body systems affected – respiratory, cardiac, vascular and digestive to name a few – long Covid is classified as a multi-system disease by the medical profession (4).
It is usual after a significant virus to have some lingering symptoms, so some general guidelines have been put together based upon knowledge of other similar conditions to provide an indication of what is expected in a “normal” recovery.
A number of theories currently exist around the cause of long Covid, however, as this illness is still in its infancy, research and understanding are underway, but conclusive findings are not yet possible.
Long Covid has been noted following all severities of the initial illness (1, 3). There have been no conclusive findings regarding any specific risk factors for developing long Covid.
1 in 10 people (10%) still have symptoms at 12 weeks post-Covid infection (4, 5). This indicates a considerable number of people will be suffering from long Covid symptoms.
Long Covid is classified as ongoing symptoms post 12 weeks after infection of Covid-19 (3, 5). The first point of contact is often with the GP. It has been noted that older adults and those who have received hospital care more frequently contact their GP after Covid-19 infection (6). However, these are not the only people who suffer from long Covid; there are no common risk factors meaning it affects all ages, genders and the severity of the initial infection does not matter.
The main message from the health service is to seek help if you are concerned about symptoms or if things are not improving (2). When suffering from ongoing symptoms, you may need to undergo further tests to ensure any complications from the initial Covid-19 infection or other illnesses are ruled out (1, 4).
Long Covid clinics are now being set up around the country via the NHS and several providers, including Pure Physiotherapy, now have dedicated Covid rehabilitation services.
There are many useful resources emerging (some are listed at the end of this article) to assist with self-management of post-Covid symptoms. As long Covid still has a number of unknowns, anxiety relating to the condition is common and being able to access the information available can assist with reassurance. Support groups can also be useful, especially in reducing the feeling of isolation if you do not know any other sufferers; a number of these now exist online and on social media.
We have produced some information leaflets to assist with self-management of different symptoms of long Covid. We do recommend that you discuss your symptoms and management with a healthcare professional to ensure you are safe to self-manage your symptoms.
Pulse oximetry (measuring the oxygen levels in your blood) can be useful for reassurance and management at home and has been shown not to increase anxiety (4). A pulse oximeter measures the oxygen level in the blood. Pulse oximeters are now available to purchase fairly cheaply, however, please be aware that applications utilising a phone camera are not accurate and should not be used. Normal readings would be >96%. If readings persistently drop below 96% speak to your GP; if your reading goes below 92%, please seek immediate healthcare advice.
Any post-Covid treatment needs to be individualised; long Covid is not ‘one size fits all’ (5). It is encouraging that more recent studies are showing that patients are recovering with the correct support, however, the correct support remains very much debated.
As of now, the best guidance is rest, symptomatic treatment using multi-discipline support where needed (this may be a mix of doctors, physiotherapists, occupational therapists, psychologists), and a very gradual increase in activity (4). One of the main challenges is difficulty adapting to the reduced function in the early stages. People often try to manage their symptoms whilst pushing through to try and maintain previous levels of activity/exercise risking a relapse in symptoms (7).
Currently, the guidance is that exercise and/or increasing activity should be undertaken cautiously (4). Return to exercise after Covid-19 and return to exercise with long Covid are two different topics. After Covid-19, it is recommended seven symptom-free days as a minimum before return to exercise (8). However, long Covid sufferers have ongoing symptoms and therefore return to exercise needs to be planned, ongoing complications ruled out and utilise a symptom-related outcome measure to monitor and track progress. An activity would not be measured by time, distance or repetitions, but based upon the score the suffering rates themselves on the scale. Ideally, the main symptom would be utilised if appropriate, so this may be breathlessness, fatigue or heart rate as examples.
Pure Physiotherapy has developed a specific post-Covid rehabilitation service. Our aim is that a fully individualised approach is taken and we have invested in a specific kit to be able to carefully monitor and review individuals over time. We will work with the individual to identify their goals and then work out the best way to move towards these based on their specific symptoms. We have useful links with other healthcare professionals to be able to provide a holistic approach to the rehabilitation process, referring and working alongside as necessary.
Long Covid rehabilitation is based on the severity and nature of your symptoms. Our experienced physiotherapists will support you as an individual and generally steer you away from generalised graded exercise exposure. Breathing exercises, fatigue management, cardiovascular and respiratory function are all considered in detail before making an informed decision, working closely with your needs to make the most effective recovery programme.
The majority of people who suffer a Covid infection will recover with time. Many people will recover rapidly after initial infection and return to normal life after a few weeks, for those with ongoing symptoms this can take months or even years. The main advice is to pace yourself and initially work on functional tasks in your daily life before working on a return to sport. There are a number of different ways to be able to self-monitor your return such as heart rate and breathing. Our Covid service can assist with guiding you through your recovery.
There is currently a lot of research occurring around treatment options with covid. Treatments are often based on similar existing conditions and then applied to the covid symptoms. Our advice is to speak with your GP, long covid clinic, or give us a call for a chat around our rehabilitation services and other members of the multi-disciplinary team that may be able to assist.
Covid-19: the Road to Recovery (csp.org.uk)
Your COVID Recovery | Supporting your recovery after COVID-19
Post-COVID HUB – By Asthma UK and British Lung Foundation (post-covid.org.uk)
Support for Rehabilitation Self-Management after COVID-19-Related Illness (who.int)
Recovering from COVID-19: Post viral-fatigue and conserving energy – RCOT
Long Covid Physio: Website is for everybody living with Long COVID
An injury which typically occurs following a road traffic collision, often affecting the soft tissues of the neck.
Sciatica is a symptom describing pain and/or pins and needles down the back of the leg.
Disk/joint-related issues that can cause pain, weakness and altered sensation in the neck and arms.
With PCN partnerships from Cornwall to Durham, Weston-Super-Mare to Southwold, our network of specialist physiotherapists operate face-to-face or remotely depending on your local needs.
Pure Physiotherapy Limited (PP) understands that your privacy is important to you and that you care about how your personal data is used and shared online. We respect and value the privacy of everyone who visits this website, www.purephysiotherapy.co.uk (“Our Site”) and will only collect and use personal data in ways that are described here, and in a manner that is consistent with Our obligations and your rights under the law.
Strictly necessary cookies are required on this website to help us remember your options, and also protect our website and our users.
We use a range of technologies on our website that restrict and deter the use of bots. These include Google's ReCaptcha service. https://www.google.com/recaptcha/about/
To read more about our Strictly Necessary Cookies, Please Click Here
If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.
This website uses Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.
Keeping these cookies enabled will help us to improve your experience on the Rehab Direct website.
Please enable Strictly Necessary Cookies first so that we can save your preferences!
Pure uses cookies when you use our website, https://purephysiotherapy.co.uk to help improve security and improve the experience of our users.
Before any cookies are placed on your device, we will present you a message bar and the opportunity to learn about the cookies we use, and we will allow you to give consent to the use of cookies that are not strictly necessary.
Click Here to view our cookie policy.
