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Holistic Approach to ME/CSF

by Jonathan Lawrence(more info)

listed in craniosacral therapy, originally published in issue 205 - April 2013

ME (Myalgic encephalitis) or CFS (chronic fatigue syndrome) is a puzzling and debilitating disorder affecting about 250,000 people in the UK according to the ME association website;  

Symptoms of ME often include the following, although this list is not exhaustive:

  • Extreme fatigue;
  • Poor sleep;
  • Muscle weakness;
  • Insensitivity to stimuli such as light and smells;
  • Dysbiosis;
  • Muscle pain.

Patients with a diagnosis of ME often have a case history including some common factors, which may indicate a predisposition. For example we look for a history of glandular fever, exposure to chemicals including pesticides and some food additives and drug treatments such as multiple courses of antibiotics. In addition, there may be personality traits such as being a ‘driven’ type of person. Also invariably there has been a history of low-grade chronic illness including allergies.

ME is a difficult condition to diagnose and criteria varies from country to country. Some authorities suggest, controversially, that it is primarily a psychiatric condition, others that it is entirely physical and that any psychological manifestations are secondary to the illness.

Often the diagnosis is done through a process of elimination, distinguishing it from anaemia, liver disease, neoplastic disease and many others whose primary presentation may be similar. Because of the difficulty in identifying some conditions such as low-grade thyroid disease and Lyme disease, it is probable that some of those diagnosed with ME are misdiagnosed.

There are many approaches to the treatment of ME both in the orthodox world and the complementary / alternative field. Two that have influenced our approach include Sarah Myhill and the Perrin Technique.

Dr Sarah Myhill, a medical doctor experienced in cases of ME and chronic fatigue believes that the origin of the disease may be due to mitochondrial dysfunction. She has written a paper on the subject and one of her co workers has devised a blood test to identify where metabolic blockages occur in the cellular aerobic respiration of individuals. A mixture of diet, supplements, exercises and lifestyle changes can be prescribed as a result of these findings. We can use her principles, send patients for blood tests or refer patients directly to her when necessary.

Raymond Perrin, an Osteopath, has researched ME as a disease of the lymphatic system leading to toxicity in the nervous system. His osteopathic background helped him to formulate his ideas and devise a protocol for treating the disease with some success. To me his ideas make a lot of sense and have influenced the way we work osteopathically with ME patients at our clinic.

EAV Testing
EAV (Electroacupuncture According to Voll) Testing

We follow the key principal of complementary medicine, which is to treat the person and not the disease. In common with chronic states, we work with all the tools at our disposal and if necessary in cooperation with other practitioners both orthodox and alternative. The two most useful tools at our disposal are homotoxicology, a modern form of homeopathy aimed at detoxifying the body of homotoxins (substances that are poisonous to man), aided by the use of an EAV (Electroacupuncture According to Voll) machine which helps to pinpoint body systems that are out of balance via the acupuncture meridians and also helps with choosing remedies for prescription.

The second tool is osteopathy including cranial osteopathy. When used advisedly with ME patients, it is a gentle and supportive modality that can unlock tension patterns in the body, which are a block to achieving health.

There are broadly 2 stages to the illness: acute initial stage where almost any intervention is aggravating. and the chronic phase where the patient responds slowly to treatment. In the latter phase overstimulation can aggravate symptoms. One of the signs of progress is that these periods of aggravation become shorter and less severe.

Also in the chronic stage, exposure to infectious agent will worsen the condition without the expected acute reaction; this suggests immune system dysfunction. Indeed the appearance of more acute reactions such as fevers may well be a sign of recovery.

Our experience with such patients is that they need a multifaceted approach to treatment along with advice on managing their life, particularly with regard to periods when they feel better. The common mistake  is that they over exert themselves risking a relapse. Thus it is not uncommon for patients to sabotage their own recovery.

S is a woman in her early thirties. She developed ME at 17 years of age. She has therefore been suffering with the disease exactly half of her life. I was asked to see her at her home ten years ago. She presented with severe fatigue, headaches and nausea. Mentally she was very low at that time. With rest and avoidance of exertion, she was able to get around in a limited way, enough to get onto my portable treatment table.  Her cranial rhythm was weak with points of restriction in the bones on the left side of the skull and the underlying membranes.

My initial treatment plan was to try and stimulate the cranial rhythm using a very gentle compression technique at the base of the skull known as a 4CV (compression of the fourth ventricle); in my experience this is effective in creating positive change with severe ME, avoiding any significant adverse reaction.

However before we could progress with the treatment, her doctor referred her to a hospital in London where she was subjected to a ‘pull yourself together regime’ of CBT and graded exercise. She suffered a major physical collapse, and when she returned home after several months she was unable to stand and required help from carers several times a day to wash and feed her. Her hands became excruciatingly painful due to poor handling.

My treatment resumed on a weekly basis, and was gratified to observe a slow positive response. In the early days after treatment resumed, the therapy would take place in silence, as the effort of conversing would have a deleterious effect. The pains in her hands improved despite several relapses; we identified tension of the shoulder muscles and compression through the fascia around the vertebrae at the junction of the neck and upper back as being a factor in these episodes.

IVF Testing
Evaluating IVM (involuntary motion)

Every treatment would be unique in that it would be guided by the needs of the patient as evaluated by the practitioner. Observation of the patient followed by an evaluation of the IVM (involuntary motion) to assess the state of the energy in the system. As the treatment progresses changes in the demeanour of the patient also assists in determining how the treatment unfolds. Positive signs would include a healthy skin colour usually observed on the face, relaxation and deep breathing accompanying a perceived release of the tissues being treated.

We also used homotoxicology, prescribing remedies matching the characteristics of infectious agents such as Epstein Barr virus, as well remedies for detoxification and drainage. She is now able to tolerate a variety of more vigorous osteopathic techniques reflecting the progress she has made. I am always careful to make sure that the treatment is well within her tolerance levels.

As the years have progressed S has become the lively intelligent person she was before her ME. In addition to Osteopathy and homotoxicology she has seen an EFT practitioner, a Nutritionist, an Alexander teacher and is able to treat herself, by stimulating trigger and tender points in her muscles.  She is able to walk, but still requires assistance in getting in and out of bed. She has a very positive attitude and I was gratified to receive a note in her Christmas card to me in which she says that she feels that she has made hugely significant progress in the last year and is very optimistic for the future.

There is no doubt that the mostly cranial osteopathic treatment has contributed significantly to her progress, especially for certain symptoms such as headaches, muscle pain and fatigue. The homotoxicology has appeared to give her more vitality working synergistically with the osteopathy and speeded up her recovery. Having experienced similar symptoms myself in the early 90s has helped to give me an empathic understanding of her experience. I currently have 13 patients on my books that have been diagnosed with ME all of whom find holistic approach a valuable part of their rehabilitation.


1. Mitochondrial dysfunction and the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Booth, Myhill, Mclaren-Howard Int J Clin Exp Med. 2012; 5(3): 208–220. Published online  June 15 2012.

2. Perrin R..The Perrin Technique, How to beat Chronic Fatigue Syndrome/ME.  London: Hammersmith Press. 2007.

3. Raymond Perrin Research can be found at


  1. Fiona Rowbotham said..

    My husband suffers from ME and has done for 13 years.Hia doctor prescribed tramadol and was "left to get on with it".After many years of being victim to his mood swings and general malaise I now would like to explore all options open to me,as his wife,to help him.
    The first port of call ,I would consider,is dietry , a monumental task as he is die hard traditional eater. I am slowly trying to introduce nutritional value into his everyday eating.
    Please advise ( I live for the day to see him constantly happy)
    Fiona Rowbotham

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About Jonathan Lawrence

Jonathan Lawrence BA DO Cert Ed, following 4 years teaching Environmental Science, trained at the European School of Osteopathy graduating in 1985. Jonathan has been practising Osteopathy in private practice for 25 years, treating patients of all ages – from babies to the elderly. Having lectured to audiences ranging from small technique classes to presenting at the 2008 Advancing Osteopathy Conference, he established Turning Point Training in order to bring high quality and affordable professional courses in Craniosacral and positional release techniques to practitioners trained in conventional or complementary medicine. He may be contacted on Tel: 01769 579004;  

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