Category: Information

Diagnosing ME/CFS – further research

Research into the diagnosis of Myalgic Encephalomyelitis

A diagnosis of ME/CFS is usually made by exclusion. If you have been diagnosed with ME or CFS you know what this means. If you haven’t or you’re waiting for a ME diagnosis it can be extremely frustrating. This piece of research is important because it could potentially be key to getting The Perrin Technique and it’s “instant” diagnosis through the NHS

An earlier very small scale study was performed by Professor Basant Puri using part of the diagnostic procedure developed Raymond Perrin. This earlier showed very promising results. Dr Perrin is trying to take this research further.

Over the coming weeks I aim to break the outline for this planned research down into small easily understandable chunks. Below is Dr Perrins summary account of the research.


Examining the accuracy of a physical diagnostic technique For Chronic Fatigue Syndrome/Myalgic Encephalomyelitis


The novel manual system of diagnosis being examined was developed in 1989 by the principal investigator Raymond Perrin. The diagnostic procedure used in this technique focuses on certain physical findings, namely specific tender points in the chest and abdomen, the presence of palpable varicose lymphatic vessels in the chest, restricted and posturally dysfunctional thoracic spine and a disturbed cranial rhythmic impulse (CRI).

Illness behaviour can be defined as relatively distinct but subtle behavior, posture, mannerism and/or responses which may happen in patients with long term health problem. If the presence of physical signs were demonstrated  to be significant in CFS/ME  then this will demonstrate that one can tell that somebody has CFS/ME not only by  observing obvious illness behaviour.

Following the first oral hearing on Tuesday 18th April 2006 of the Gibson Enquiry at the House of Commons, it was generally concluded by those present that an earlier diagnosis would usually lead to a better prognosis when treating CFS/ME.  The published report from the Gibson enquiry of Nov 2006, described The Perrin Technique as “a useful and empirical method which although unorthodox should not be dismissed as unscientific and that it required further research”. The most recent survey carried out at The University of Bristol in September 2011 claimed that CFS/ME affects up to 2.6 per cent of adults in Britain. A quicker diagnosis would thus reduce the huge financial burden placed on the health service by reducing the need of some of the specialist services used and the pathological tests carried out at present.

The new research will evaluate a major principle behind the Perrin technique which is the presence of specific physical signs in CFS/ME patients. The research study, is a practical method to confirm or refute this main principle of the Perrin technique. Subsequently, this should inform the Perrin practitioners, CFS/ME patients and general clinicians about the role this technique may or may not play in the management of CFS/ME patients.


The aim of this study is to explore if there is validity in the use of specific physical signs as an aid to diagnosing CFS/ME



100 participants will take part in the study which will consist of CFS/ME patients and healthy controls.


Group 1 will be around 50 volunteers who have been selected consecutively by the research assistant from a larger group who have been diagnosed by consultant in the NHS and confirmed as suffering from CFS/ME using an informal interview screening tool based on the NICE guidelines.

Group 2 will be around 50 healthy controls again selected consecutively from a larger group of volunteers by the research assistant and who have been matched for age and gender with the patient group  and confirmed as not suffering from CFS/ME using an informal interview screening tool based on the NICE guidelines.


Health professionals involved the study

The examination of the participant using the Perrin Technique will be carried out by a trained chartered physiotherapist with a few years experience in this specific manual technique working with CFS/ME patients and the other a registered osteopath who has been recently trained in the manual technique specifically for this study with little or no prior experience of CFS/ME patients. Training of the osteopath in question should only take around two weeks working in The Perrin Clinic under the guidance of Dr Perrin. When the osteopath is having his/her training, he/she will only stay in the treatment room for Dr Perrin to demonstrate the physical signs and then leave to let Dr Perrin carry on with his consultation. This will be done to minimise the osteopath’s ability to use anything other than the Perrin signs to reach their final conclusions during the study. The third clinician involved in examining the participant will be a physician who will be selected due to a reasonable knowledge of CFS/ME and have had experience working in an NHS clinic for CFS/ME. They will not have had any experience regarding the physical aspects of the Perrin technique.

Examination of Participants

The participant will see all three practitioners on the same day. This will take place no later than 1 month of being accepted onto the study.

The examination of the participant by both the physiotherapist and osteopath will follow the same  protocol as developed by Dr Perrin.The NHS physician will examine the participant using a standard clinical neurological and rheumatological examination.


The basic method of this project is represented in the flow chart below:


Recruitment and Research of ME/CFS research





January 2013                                                           Recruitment of research assistant,

NHS physician and osteopath.


May 2013                                                                 Begin recruitment of volunteers and proceed with

diagnostic instruments.


December 2013                                                      Complete recruitment of volunteers and diagnosis.


January 2014 – April 2014                                   Analysis and documentation of results.


May 2014 +                                                            Publish results and dissemination of findings through

relevant conferences and patient groups.



The costs of this research project have been calculated as being no more than £60,000 for the year and are being fully funded by the FORME Trust,  Charity No 104 5005.



The Perrin Technique

The Perrin Technique for ME/CFS

I’ve Ignored this part of the site too long time. Planning on a lot more content. I have some ideas for content, but I’d also like to know what would you like to read about. You can contact me with your suggestions by clicking here. Just use bullet points if you want.

This is to get you thinking

I have trouble Writing about ME/CFS. Everyone seems to have an opinion. Some are very vehment in defense of their diagnosis, view or treatment. That’s why I’m asking you what you’d like to read about.

First of all there’s the names ME/CFS, Myalgic Encephalomyelitis, Chronic Fatigue syndrome, NeuroME, CFIDS, Fibromyalgia. These are just the names I can quickly think of it’s endless.

Are these all the same condition?  Does it depend on who diagnoses it? What do you think about this?


Date written Thursday 26 April


Osteopathy for Pain Relief

Treatment for pain

Pain relief is one of the main reasons people come to osteopaths for osteopathic treatment. Osteopathy helps people of all ages who suffer from pain, tackling complaints ranging from sports and work-related injuries to arthritis and sciatica. The osteopaths role is to alleviate pain and improve the patient’s mobility in order to make life more comfortable.

What is pain?

Pain is your bodies way of telling you that something is wrong. It is often caused by swelling of tissue, which creates pressure on nerves and leads to discomfort. Pain is a useful mechanism to alert you to a problem, and stops you from damaging your body further.

It should always be taken seriously.

Pain can affect many areas of the body, but particularly the lower back, head, neck, joints and legs. It can result from injuries and arthritis, and can also manifest itself in the form of rheumatic pain and period pain.

Osteopaths diagnose the causes of pain and help to ease it by increasing movement, decreasing muscle spasm and reducing tissue inflammation.

Treatment methods range from massage and soft tissue techniques to muscles and connective tissues to manipulation and stretching of joints. This helps to reduce muscle spasm, increase mobility and to create a healthier state in which damaged tissues can heal.

The skilled techniques of an osteopath can often allow you a speedy return to normal activity. If you have had a pain for a long time, and other forms of treatment have not helped, osteopathic treatment could be beneficial.

Book an appointment online

Osteopathy vs Chiropractic vs Physiotherapy

The Difference between Osteopathy,Physiotherapy and Chiropractic

I frequently get asked what’s the difference between an osteopath, a chiropractor and a physiotherapist. I keep trying to think of a punch line that’s funny, but haven’t come up with one yet (suggestions in the comments section). Another therapist did once attempt a humourous answer, but it was just that, an attempt.

This can be quite a hard question to answer professionally as I’m an osteopath and I’m biased!

This is a go at an over simplified differentiation of the differences (I hope)

Osteopaths treat the bones, muscles, ligaments, and joints. We can therefore treat any part of the body directly. We are also looking at how these different areas connect together. This helps us find predisposing and maintaining factors i.e. trying to find the real cause of your problem and make sure it doesn’t come back. What I mean by this is you may have pain in your knee that is caused by twisting and torsion in your calf as a result of your flat foot. Treating the knee may make your knee pain go away, but if the foot problem isn’t addressed your knee pain will keep coming back. (still with me?)

A chiropractor would probably look at your knee, X-ray your back and tell you that your knee pain is caused by a joint in your back out-of-place. This is because Chiropractors generally look at spinal joints and the way this would affect the nervous system, and nothing else. (still there?)

A physio (now this is a hard one). The best way I can show you the difference is to describe a patient I used to treat and let you work it out for yourself. I used to treat a footballer who suffered with recurrent groin and hamstring strains. The club physio kept getting him pain-free, and back to training. Within a couple of “proper” matches he’d be out again with the same problem as before.

This had happened 3 times in one season. (nearly the whole season wasted). The player was frustrated. When I saw him for the first time I looked at his whole body and found most of his problems were due to overtight muscles in his hip/buttock area and his low back.

I treated those and I haven’t heard of any problems since (on TV, radio or press. Yes he was that well-known)

This is a very general reply, and the best way to find out for yourself is to try the 3 therapies. Most offer a free assessment, just make sure they don’t sign you up for life!

If you want to find out a little bit more about osteopathy I do a free 15 minute assessment. You can book an appointment online