Perrin/lymph drainage/massage: makes sense or not?

[maryb]

Re the research study
A lot depends on the screening criteria used.
Also NICE doesn't differentiate between CFS and ME - it says the same disease, really??
RP is very specific about calling the disease ME.

I suspect the reason the NHS have shown interest in this project is because,

massage by physios already employed by the NHS will be cheap.
Physios have already been encouraged to do the CBT qualifications in order to deal with ME patients. So they will have another tool to use in a new NHS bundle of treatment. CBT/GET/lymph massage
The fun will be how they cope with actually having to touch patients after new guidelines describing how they should demonstrate exercises to the patient and then leave the patient to do them at home. My friend saw an NHS physio 6 times over 12months and he never laid a finger on her
It will be a cheap diagnostic tool but the only thing on offer for those diagnosed as positive will be the lymph massage - other co-infections viral/bacterial will be ignored as they are now.

I don't blame RP for going for this project but I don't think it will benefit the very sickest for a moment.
You have to be well enough to get there - they won't visit you at home.
There have been some success stories and the original itheory makes sense but I suspect there is much much more to this illness, for the majority of us we need more than lymph massage and for that we will still be on our own.

 

[sianrecovery]

totally totally agree

 

[golden]

Hi maryb ,

Ray says his technique is for chronic fatigue syndrome, M.E., and Post Viral Fatigue Syndrome.
http://www.theperrinclinic.com/


I know they are well aware of the Canadian guidelines and using their own independent assessor may very well have used them.

Dr. Myhill uses mainly C.F.S. although interchange it with CF (potentially a mental health label), M.E. and M.E/C.F.S!!!

But both clinicians claim this illness is without doubt physical.

I see RP favours C.F.S/M.E. on his book.

I don't really know what to make of the way these labels are portrayed!!


RP almost got the PT through but the NHS rejected it - and hence his new study to try it again...

I agree, if the NHS was showing some sort of interest in it - start to suspect something dodgy !!!

It would be nice to see therapists free from psych training applying this physical therapy.

I read somewhere that initially psychiatric therapy was intended to be a touch and talk therapy....but they scrapped the touch....

Lymph Drainage therapy is designed to unclog the body to initiate the bodies natural healing abilities - so it doesn't matter what virus or bacteria are involved , the body will deal with it.


If The Perrin Technique was made available on the NHS, I would hope home visits could be arranged , i don't see why not.

As with Dr.Myhill protocol , testing to rule out all else just isn't done and its a bit of a guessing game - i don't like this.
I doubt any of us on here have had that done.
I do think that is a big problem.


And without a reliable lyme test to be found, is going to continue to be.

If I am not tickety-boo after completing my Perrin course and making appropriate lifestyle changes.....



The NHS should obviously incorporate all the tests we are trying to do for ourselves here, first and foremost.

 

[maryb]

golden - a bit tired to write anymore but in answer to

'Lymph Drainage therapy is designed to unclog the body to initiate the bodies natural healing abilities - so it doesn't matter what virus or bacteria are involved , the body will deal with it'

Lymph drainage helps the body get rid of toxins faster - unlikely if someone had a major bacterial infection eg. helibactor pylori or a aggressive bowel bacteria - that this would clear without a/biotics whether herbal or pharma drugs.

I'm a great fan of RP but don't see this treatment as a cure for what ails us.

 

[Jimble]

First post from myself so hi everyone

Talking from my own personal experience with the Perrin technique I find it very beneficial. I suffered from me/cfs from 12 to 16 after I came down heavily with a viral infection. I was mostly moderately affected so had enough energy to entertain myself for hours gaming on my computer (looking back - terrible idea with all the adrenaline) but after 3 years of my condition not improving by much, my mum booked an appointment with an osteopath down in Southsea, near Portsmouth.

I wasn't expecting anything of a miracle cure when I visited, to be honest I was quite in denial of my suffering with the illness, so I had no hopes or expectations. Several weeks of the treatment and I definitely felt the treatment was starting to get things 'moving'. The biggest benefit I noticed was that the aches and decreased mobility in my neck had become so much better. The stiffness subsided every so slightly after every treatment, and this cumulatively added up over the months I saw my Osteopath. In under a year of the treatment I was back to school with increased energy and slowly gained my strength and stamina enough to complete very short aerobic exercises in the gym.

Now I'm 21 and am having a second bout of me/cfs after smashing myself to pieces on a uni rowing training camp several weeks after a viral infection and came down with all the same symptoms I once suffered from before. After several months of bed rest and popping all the supplements known to man, I am back seeing my Osteopath after 5 years. I have to say, it is still benefitting me the most out of everything i am currently doing, including Equilibrant, PeaPure, Pharma Nord CoQ10, essential fatty acids, D-ribose, probiotics, magnesium, selenium, lipolife liposomal vitc and glutathione etc.

Considering there is no miracle cure out there for this condition, I recommend at least looking into it and trying some of the home exercises for several months before passing judgement as it could potentially help you as it is helping me!

 

[h111]

I've come across a few posts on the Perrin Technique lately and in the ME Association's survey, 115 PWC had tried the technique and 51% considered it to have improved their symptoms (14% "greatly improved" and 37% "improved").

It's a technique developed by an osteopath that involves light massage and exercises to improve lymph drainage. The technique's originator (a PhD, not a medical doctor) has treated a lot of ME/CFS patients and on his Perrin Clinic website says:

"We at the Perrin Clinic believe that Chronic Fatigue Syndrome/Myalgic Encephalitis and Post Viral Fatigue Syndrome is a physical disorder that leads 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. [...]

"Raymond Perrin's research at the University of Salford in conjunction with the University of Manchester has provided strong evidence that an important component of CFS/ME involves a disturbance of lymphatic drainage of the brain and muscles. The novel osteopathic treatment developed by Raymond Perrin has been statistically validated in both clinical trials, emphasising the need to focus future research on the biomechanical aspects of this disorder. Raymond has expanded our knowledge of CFS/ME, which led to a doctorate awarded by the University of Salford."​

I must admit that when a practitioner starts talking about "toxins" and "poisons" it sounds vague and alarmist to me; I'd rather they specify what they mean, although in a video on the site it appears that the "toxins" he's talking about are specific immune products (macrophages and stuff, I think - I'm no biologist). And he is talking about a different method of diagnosing ME/CFS than, say, the Canadian Consensus or other criteria, based on physical signs and symptoms including a flattened thoracic spine as you can see in his YouTube stuff (at 1:50 to 2:30 mins in this section). So I'm not sure whether he's really treating ME/CFS patients as we'd recognise them though it's possible that such patients are approaching him for treatment and he's just "confirming the diagnosis".

I've skim-read some of his stuff at this point and I hope I'm not misrepresenting him but for me he rings alarm bells in terms of the manner of his claims while on the other hand, I gather it makes sense to get your lymph system moving because it carries immune system "messengers" around the body and disposes of waste, but relies on the movement of your body to function (it doesn't have a pump like the blood system has the heart). So if you're not moving much, neither is your lymph.

So, a few questions. Pick any one(s) you like!

1. Anybody with a proper background in biomedical stuff have an opinion on whether the basic approach makes any sense?

2. That flattened spine thing: is that something that can develop in people with an illness, say, through long periods of being confined to bed? I hadn't heard that the spine could change shape in adults except through osteoporosis. If so, can it be changed back to normal? I'd be amazed if that were so but maybe I will be.

3. The above blurb mentions that he's done a couple of clinical trials (I think they might have formed part of his PhD). Does anyone know where there's a summary? I'm interested in their design quality, his results, and how he is defining ME/CFS.

4. Some of the exercises in the video on his site (shoulder rolls, marching on the spot, twisting from side to side) are identical to some I've just been given by a physio to sort my back out. Is it possible that his techniques help people with pain symptoms but for different reasons than he thinks?

Please feel free to add other questions of your own or comments on the Perrin technique or lymph massage/drainage generally!

Hi, have just watched Perrin's lecture on You Tube. In this he takes bits of information and manipulates them to support his argument. His descriptions of the lymphatic system are very partial and frequently inaccurate. Where to start?! Very dubious.

 

[maryb]

Very interesting @h111 can you elaborate?

 

[CantThink]

How are you feeling now? @Jimble

 

[h111]

Perhaps I was a little hard on Dr Perrin. To put it in context, in the last decade or so new ways of identifying and visualising the lymphatic system has led to an explosion of scientific interest in its functions and activity, whilst quite separately and not reflecting this new knowledge, it has become very fashionable to write all manner of peculiar things about the lymphatic system on internet sites, which get picked up and repeated as truths. There are even people doing internet correspondence courses which they say certify them as lymphologists! Unfortunately people worried about their health then interpret this as facts applying to them, and state with confidence that they are doing strange things like cleaning out or detoxifying their sluggish or blocked lymphatic systems even though there may be no anatomical or physiological basis to justify their actions.

Under these circumstances I think people like Dr Perrin have a responsibility to be very careful to present information accurately, because someone is going to interpret and run with it in very strange directions! I admit I have only read some of his work and seen his You Tube presentation, but I did feel these were rather careless in places.

So, to elaborate a little. Dr Perrin asks why we need a lymphatic system then says it is to transport large protien molecules. Yes, this is one of its roles, but not the only one, and it is essential to life because the body use protein macromolecules to transport nutrients from the blood stream to the tissues. These molecules must be returned to the blood for the process to be repeated, and this can only occur through lymphatic transport. However Dr Perrin's presentation gives the impression that all protein macromolecules are 'toxic' and must be broken down.

He describes lymph as being milky white. Until very recently it has been difficult to visualise lymphatic vessels because lymph is a clear fluid, except for some of that being drained from the intestines, which can appear milky due to the presence of fats, again this is misleading. Dr Perrin identifies swellings under the skin as varicose lymphatic vessels which match the colour of the skin because they are full of this milky fluid.

He also says that the lymphatic system has a pump and that this is in the thoracic duct. Lymphatic vessels have been shown to contract throughout the body, sometimes having a pumping role, sometimes transportation, depending on local circumstances. They are extremely sensitive to a great variety of stimuli and their activity is very complex. Dr Perrin's statement suggests that there is only one pumping stimulus to the system, in the thoracic duct. Dr Perrin says that changes in this particular pulse stimulus result in lymph backflow. Is all lymphatic backflow damaging? Researchers have shown that a small degree of backflow is normal and supports the closing of lymphatic vessel valves, but a significant disruption of lymph flow in the thoracic duct would be expected to cause serious discernable health problems such as oedema. Dr Perrin links his photograph of 'varicose lymphatics' to lymph backflow in the thoracic duct, lymphatics just under the skin would be expected to be part of the superficial system, blockage of which causes lymphoedema, yet he doesn't show or mention this.

Dr Perrin is dismissive of Vodder MLD which he says is mainly concerned with sluggish lymphatic systems and could increase retrograde flow, whereas his proposed treatment uses effluerage in the direction of the subclavian veins. If he knew anything about Vodder MLD he would know that it always starts by stimulating drainage at the region of the junction of the lymphatic system and the jugular and subclavian veins, so that whatever area of the body is being treated, it can proceed in this direction! He would also know that it works with the autonomic nervous system.

I am a Vodder qualified MLD practitioner, so have a professional interest in the lymphatic system, based upon my training, which is continual and involves reviews which examine the latest findings in lymphology. I do have clients with ME/CFS and they are of course keen to discover anything that can improve their health. They tell me MLD is beneficial but I am aware that they are sometimes trying to put this within the context of things they have read, and as some of these contradict my understanding I am unable to give the answers they probably want in their need to understand what is happening to them and regain some control of their health. There may be something in Dr Perrin's treatment, in which case I wish he presents his arguments on You Tube with more care, and I would say to those who say all our illnesses are caused by toxins which can be sorted by the lymphatic system, I wish this was true as I would be a very rich practitioner by now and could retire!

 

[Effi]

I haven't been able to read the entire thread, but manual lymph drainage (Dr Vodder Method, not Perrin) is one of the only things that have given me real symptom relief so I wanted to share my experience.

From what I understand it is important to have this treatment regularly: the lymphatic vessels are very thin, so only a limited amount of drainage can be done in one session. It is a very 'soft' approach that has a relaxing effect (stimulating the parasympathetic nervous system).

Apparently my lymphatic system gets clogged extremely quickly. I don't know the science behind that, but it could be caused by anything: over-active immune system, chronic inflammation, ...? The only thing I know for sure is that it leaves me feeling physically refreshed every single time. Ever since I started these regular treatments I feel less stiff, have less pain in tenderpoints, no traveling pain and my migraines (mainly aura without pain) have cleared up. There were two times in all these past years when I couldn't get treatment for a couple of weeks in a row and all these symptoms came back. This is how I know it works for me. I don't think it's a cure, but it does make my life a lot more bearable.

 

[Wayne]

I am a Vodder qualified MLD practitioner

Hi @h111,

Thanks for your discourse. Do you by any chance have a website? This is the first time I've run across the Vodder method, and would be interested in learning more.

I do dry brush skin massage and other massages on my body daily, and feel it helps me a lot. I mentioned to my osteopath that when I massage along my spine, my sinuses always clear up. He said that's because I'm massaging in a major lymphatic drainage area. Any thoughts on that? -- Thanks.

 

[RosieBee]

Hi @h111,
Thanks for the analysis of Perrin's youtube presentation, which I haven't seen, but it sounds from your description that it is not as comprehensive as it could be.

I knew Raymond Perrin 20 years ago when he was first working with people with ME. To put your mind at rest, the description of the lymph system he gave me was more detailed than it seems the youtube clip is - he did indeed describe to me the importance of muscular activity to drive the movement of lymph.

So I think the omissions that concern you may not be in his knowledge but possibly just in this clip - and the effluerage he recommends must not be too vigorous as @Effi outlined above.

The biggest problem for me with the Perrin technique is how hard it is to find an osteopath that actually does the full technique properly. I had very good results with Raymond himself and with the osteopath that used to share his practice. In my opinion lymphatic drainage is only part of the picture with ME, not a cure, but still an important aspect.

Just for information - lymph fluid changes colour depending upon the amount of fat in the diet. You have to be virtually fat-free to get the milky white colour to change.

I think your detailed interest in how the Perrin Technique and Vodder MLD work for people with ME is important and helpful to your clients. Did you put your concerns in the youtube comments section? You might get some useful discourse from him. In the end all that matters is what works for the client and ME is so different from one person to the next. Good luck with your MLD practice.

 

[Troyza]

Could it be microfilarial worms causing the issue? From this thread elsewhere: http://www.mdjunction.com/forums/ly...be-a-big-part-of-lyme-suffering/limitstart/20
"most interestingly, Microfilarial worms. The latter are microscopic worms, which tend to block off the lymphatic system. This is essential for immune function as most of the body's defense activity takes place within this system. It also is the body's waste disposal system in that it deals with all the toxins produced either from normal physiology of the cells or from infection or toxic overload. With the lymphatics unable to work people generally feel awful. This mirrors the work of Dr Raymond Perrin, the Osteopath in Prestwich, who finds that lymphatic massage, where you simply physically move the lymph, can help tremendously. Also the microfilarial worms cause problems within the blood micro-circulations. This is the blood flow in the tiny capillaries, which particularly impairs the nervous system and will aggravate many neurological symptoms and signs with problems of memory, concentration and nerve function."

 

[Little Bluestem]

Is there any kind of test for these worms?

 

[roller]

its all worms.
though, nobody wants to hear this.

i dont think there are tests for microfilarial worms, they dont even have tests for big worms, for all i know.

important drug may be diethylcarbamazine.
doxycycline too.

 

[roller]

interactive map of the lymph system

http://www.innerbody.com/image/lympov.html

 

[edn]

Looks like he's basically repackaged manual lyphatic drainage, stuck his name in front of it and is now charging through the nose for it. Personally I would trust any diagnosis or treatment (at least non musculoskeletal treatment) from an osteopath about as far as I could comfortably spit a rat.

 

[slysaint]

@Cheesus
old (2010) but explains the PT quite well:
https://www.edmesh.org.uk/the-perrin-technique-report-on-talk-by-raymond-perrin-march-2010/
and includes a note of warning:
"Dr Perrin concluded by warning that the World Health Organisation and the American Psychiatric Association are thinking of reclassifying CFS/ME as a psychiatric disease, and that his work is one of the main things that could stand in the way."

OK so the WHO haven't gone that far yet.........but in the UK it has 'come to pass' anyway.

14th Dec 2016:
http://www.robinkiashek.co.uk/london-osteopath-w1-n2-n10/perrin-technique-nhs-research/
NHS Research findings:
"The research has proved successful however as with any research there is a period of confidentiality so I cannot dwell on them in detail in this article. The results are being currently submitted to the BMJ (British Medical Journal) for publication, hopefully, next summer." ..........ie 2017
http://www.theperrinclinic.com/nhs2016.pdf

this link covers combined use of PT and nutrition and a bit on methylation:
https://igennus.com/practitioner-blog/lifting-fog-chronic-fatigue/

 

[John Mac]

http://www.theperrinclinic.com/nhs2016.pdf

I took part in the above study that would see if a physical examination by a Perrin practitioner could identify an ME/CFS patient from a healthy control.
You were given a physical exam by a general doctor first then an exam by both a Perrin practitioner and an NHS physiotherapist.
They didn't tell you which was which but I was extremely impressed how the first woman was able to quickly home in on my sore lymph nodes, some of which I didn't even know were sore. The second woman however just seemed to be prodding around without much luck until I asked her to go over areas again and she eventually found the sore lymph nodes.
When I got home I did a search for Perrin practitioners and eventually found a photo that confirmed the first woman was a Perrin practitioner.

I was so impressed I decided to give the technique a go and found a practitioner nearer home, I didn't mention I had taken part in the study in case it wasn't allowed but seeing it's been completed it's probably ok to come clean now.
Again I was impressed by the physical exam that quickly found the sore Lymph Nodes typical of ME/CFS.
I started the therapy but as it involves a lot of self massage, head, neck, chest, spine, it caused a lot of PEM and I started to decline and had to stop (my arms are particularly weak and unable to do much exercise).
However glad to hear it was a success.
I am currently applying for ESA and the practitioner wrote me a report to give as evidence of my illness and when this study gets published in a journal it will add weight to that.

 

[John Mac]

It's interesting that the studies were funded by the NHS

As far as I know Dr Perrin had to raise the money for the trial himself to pay the NHS staff taking part.


https://osteopathyforall.wordpress....-whether-osteopathy-can-help-chronic-fatigue/

Help support research into whether Osteopathy can help Chronic Fatigue
Posted on October 24, 2013

Dr Perrin has asked me to share this appeal with you.. for further details on the Perrin Technique for Chronic Fatigue, visit http://www.theperrinclinic.com.
Appeal:
Please watch this film and realise that with your contribution to the FORME trust (www.forme-cfs.com) we will reach the £60,000 that we need to start a project that should change the way CFS/ME is viewed and hopefully help millions of sufferers worldwide . Any donation is welcome however small. Every penny goes into the research as there are no admin costs. I do not get paid one penny. The money is needed for university costs and for the clinicians involved in examining the participants.
Please help this research as without the funding we cannot start this important NHS project at Wrightington Hospital, Wigan in conjunction with The University of Central Lancashire..
With Thanks
Dr Ray Perrin Chief Investigator