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Working on Clients with Long-Covid

by Carole Preen(more info)

listed in cfs me long covid, originally published in issue 292 - February 2024


COVID-19 is going to be with us a long time and people are still being infected with it daily. I had it for the second time three weeks ago. The vaccination is supposed to help prevent long-Covid (WHO podcast 2021), but this is not always the case. As complementary therapists we are uniquely positioned to help our clients recover from its physical, cognitive, psychological, and social effects. Let’s start by looking at the symptoms of long Covid using a chart from the BMJ from 2021:


Symptoms of Long Covid


According to NICE (2020), Long Covid is complex and often presents with clusters of symptoms, which can change and reoccur unpredictably, affecting people in different ways at different times, which makes the need for a detailed consultation very important. We do have the luxury of time with our clients for listening and observation. The symptoms are experienced for more than 4-12 weeks after being infected. Data from the Office for National Statistics (ONS) indicates that Long Covid is most prevalent in people of working age, females, people living in the most deprived areas, those working in social care and those with another activity-limiting health condition or disability (ONS 2022). As there is so much complexity involved, I have devised a chart for the most common long-covid symptoms we might see in practice and linked them to the two most common complementary therapies people tend to seek out. It is interesting to note that the medical profession has made comment on how strikingly similar these long-covid symptoms are to that of ME/CFS (Goldberg et al., 2022) and within CAM, we have been supporting clients diagnosed with these conditions for many years.

Massage is the most sought after therapy although actual statistics on this is hard to come by as massage is unregulated in the UK and many people visit a beauty therapist for spa style massage treatments rather than a massage therapist trained to work alongside mainstream medicine. In the US and Canada, where the industry is regulated, we can see increases in use of massage therapy up 36% and here it is a serious medical treatment. The other more common therapy is aromatherapy, where an aromatherapist will blend a bespoke blend of essential oils for your specific needs and either offer this in a massage and/or offer products made up that you can also use to support yourself at home. I will therefore explore these two therapies for long-covid support.


Carole Preen Table 1 292  Fatigue

Table 1: Long-Covid Symptoms: Fatigue and Pain


Carole Preen Table 2  292 Anxiety and Depression

Table 2: Anxiety and Depression and Sleep Disturbances 500x623px.jpg


Carole Preen Table 3 292  Loss of Sense of Smell

Table 3: Loss of Sense of Smell and Brain Fog


What we need to remember is that this is a multi-disciplinary approach is needed and your clients may also be getting support from their GP either with medication or referrals to psychologists or local mental health support groups. However, it is clear that both massage therapy and aromatherapy/essential oil therapy can be beneficial in supporting people who are recovering from COVID-19 and could help save the NHS money if these therapies were more widely used in healthcare.

Below is a mindmap that I created to show which essential oils I feel would be useful:


Essential Oils for Long Covid

Mind Map: Essential Oils for Long Covid



CHEN, Mei-Ling; CHEN, Yueh-Er; LEE, Hui-Fang. The Effect of Bergamot Essential Oil Aromatherapy on Improving Depressive Mood and Sleep Quality in Postpartum Women: A Randomized Controlled Trial. Journal of Nursing Research 30(2): p e201, April 2022. Available at:

Crook H, Raza S, Nowell J, Young M, Edison P. Long covid—mechanisms, risk factors, and management BMJ 2021; 374: n1648 Available at:

Davis et al., (2020) Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact  Available at:

Donelli D, Antonelli M, Valussi M. Olfactory training with essential oils for patients with post-COVID-19 smell dysfunction: A case series. Eur J Integr Med. 2023 Available at:

Field T. PhD., Morrow C., Valdeon C>B>S>, Larson S., PhD., Kuhn C. PhD., Schanberg S., MD., PhD., (1992) Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients Journal of the American Academy of Child & Adolescent Psychiatry Volume 31, Issue 1, January 1992, Pages 125-131

Goldberg N., et al., (2022) A new clinical challenge: supporting patients coping with the long-term effects of COVID-19, Fatigue: Biomedicine, Health & Behavior, 10:4, 212-230 Available at:

Hachul H, Oliveira DS, Bittencourt LR, Andersen ML, Tufik S. The beneficial effects of massage therapy for insomnia in postmenopausal women. Sleep Sci. 2014 Jun;7(2):114-6. Available at:

Haroon S, Nirantharakumar K, Hughes SE, et al Therapies for Long COVID in non-hospitalised individuals: from symptoms, patient-reported outcomes and immunology to targeted therapies (The TLC Study) BMJ Open 2022;12:e060413 Available at:

Her J., Cho M., (2021) Effect of aromatherapy on sleep quality of adults and elderly people: A systematic literature review and meta-analysis Complementary Therapies in Medicine Volume 60, August 2021, 102739 Available at:

Hou, Wen-Hsuan & Chiang, Pai-Tsung & Hsu, Tun-Yen & Chiu, Su-Ying & Yen, Yc. (2010). Treatment Effects of Massage Therapy in Depressed People: A Meta-Analysis. The Journal of Clinical Psychiatry. 71. 894-901. Available at:

Lakhan SE, Sheafer H, Tepper D. The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-Analysis. Pain Res Treat. 2016; 2016:8158693. Available at:

NIH COVID-19 Research (2023) Understanding Sleep Problems and Long COVID Available at:,feeling%20refreshed%20in%20the%20morning.

Nadal-Nicolas Y. et al., (2020) Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia Int. J. Environ. Res. Public Health 2020, 17(12), 4611 Available at:

National Institute for Health and Care Excellence (NICE (2020, updated 2021) COVID-19 rapid guideline: managing the long-term effects of COVID-19. Available at: https://

Okuda M, Fujita Y, Takada-Takatori Y, Sugimoto H, Urakami K. Aromatherapy improves cognitive dysfunction in senescence-accelerated mouse prone 8 by reducing the level of amyloid beta and tau phosphorylation. PLoS One. 2020 Oct 14;15(10). Available at:,BDNF%20levels%20were%20somewhat%20higher.

Raiesifar, Z., Molavynejad, S., Raiesifar, A., Maraghi, E., Vaismoradi, M., & Helalat, A. (2021). The effect of slow-stroke back massage on fatigue and sleep quality in hemodialysis patients: A clinical trial study. HAYAT, 27(1), 59-71.

Salarvand S, Heidari ME, Farahi K, Teymuri E, Almasian M, Bitaraf S. Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler J Exp Transl Clin. 2021 Jun 14;7(2) Available at:

World Health Organization (2022) Clinical management of COVID-19. Available at:

Zidan S., et al., (2023) Effect of aromatherapy massage on fatigue and perceived stress of multiple sclerosis patients Available at:



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About Carole Preen

Carole Preen FCHP FANM HonMIFA is a Fellow of the Association of Natural Medicine and the former Aromatherapy & Allied Practitioners' Association and has been a practitioner since 1994 and an educator since 1997. She is also an honorary lifetime member of the International Federation of Aromatherapists awarded for her contribution to the profession. As well as specializing in Aromatherapy and Anatomy, Carole also introduced Neuroskeletal Re-alignment Therapy to the UK. Carole is an specialist educator, and internal and external moderator working in both the private and FE sector and has level 4 qualifications in quality assurance. She is Director of Complementary Health Professionals and may be contacted on Tel: 0333 577 3340;
For further information about Neuroskeletal Re-alignment Therapy (NSRT) please view the website at with links to published articles and a Facebook page. The diploma course is accredited by Complementary Health Professionals through Natural Therapeutics. Training details and information on booking a treatment with me is available via Mob: 07455 195 515

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