Radical rest for long covid

Can ‘Radical Rest’ Help With Long COVID Symptoms?

An article on WebMD covers the growing evidence that rest and pacing are important in managing the symptoms of Long Covid.

Dr Charles Shepherd comments

Basic information from the MEA on activity and energy management and pacing:

Activity and energy management, which should include physical, mental and emotional activity, has to take account of the stage (ie how long you have been ill), severity, progress and variability of your illness.

In other words, the type of activity and energy management programme you carry out has to be done on a very individual and flexible basis.

The type of activity and energy management programme we have long recommend is a process called pacing – which is consistently reported by people with ME/CFS to be a very safe and helpful way of learning to cope with ME/CFS.

We have MEA an information leaflet covering activity and energy management, and pacing, in more detail

This is a free download while it is being updated

It is also worth reading the sections on activity and energy management (1.11.2 – 1.11.14) in the new NICE guideline on ME/CFS

The other key point we would make is that getting the right balance between rest and activity is often a do-it-yourself process involving a degree trial and error.

However, it is extremely helpful to have some good initial advice on establishing an appropriate baseline of safe activity levels, along with how to gradually and flexibility increase what you are able to do – as well as cutting back when appropriate

To do so you really need some help from a health professional – doctor, OT, physiotherapist – who fully understands the way to deal with this key aspect of ME/CFS management

And if you want something to show to a physiotherapist, or other health professional who is supervising activity management but appears to be giving unhelpful or even harmful advice, this is an article from a professional journal for physiotherapists:

Finally, as this article correctly points out, a more prolonged period of rest and convalescence is extremely important during the weeks following a viral infection when someone is clearly not making a normal recovery


There’s growing evidence that overexertion and not getting enough rest in that acute phase of COVID-19 infection can make longer-term symptoms worse. 

These sustained periods of rest and “pacing” – a strategy for moderating and balancing activity– have long been promoted by people with post-viral illnesses such as myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS), which share many symptoms with long COVID.

That’s why researchers and health care providers who have spent years trying to help patients with ME/CFS and, more recently, long COVID, recommend they rest as much as possible for at least 2 weeks after viral infection to help their immune systems. They also advise spreading out activities to avoid post-exertional malaise (PEM), a phenomenon where even minor physical or mental effort can trigger a flare-up of symptoms, including severe fatigue, headaches, and brain fog.

An international study, done with the help of the U.S. Patient-Led Research Collaborative and published in The Lancet in 2021, found that out of nearly 1,800 long COVID patients who tried pacing, more than 40% said it helped them manage symptoms.

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