Physical, occupational, and talking therapies for long Covid

This page covers:

  • Physical therapies
  • Occupational therapy
  • Talking therapies

Physical therapies

People talked about seeking help for their Long Covid symptoms from physiotherapists. Many people were shocked at how little activity they could do before they started to feel very tired, breathless, dizzy, or generally unwell. They wanted advice from physiotherapists on how to rebuild their strength and get back to doing physical activity safely. When Lyn was discharged from hospital she couldn’t walk up or down stairs and felt that she needed a physiotherapist to help improve her movement.

Lyn’s home was fitted with equipment to stop her from falling but she was disappointed that she had no ongoing physiotherapy.

However, people were wary of being told by physiotherapists to build up their physical activity by a little bit each day. This approach is known as graded exercise therapy by physiotherapists and some people with Long Covid found it unhelpful. In 2020, NICE warned against using graded exercise therapy when recovering from Covid-19. After listening to other people’s experiences, Callum stressed the need to give your body a chance to recover and not to get into a “destructive cycle” of pushing to do more exercise too soon. Xanthe spoke about an upcoming appointment with an NHS physiotherapist. She said: “I’m hoping it will be more of an occupational therapy, sort of helping me to pace rather than exercise, because if they tell me to exercise, I will just walk out; it’s like the most dangerous thing you can do. And it’s been proven that… to be the most dangerous thing as well and yet the NHS sometimes are still offering it.”

Some people told us about positive experiences with physiotherapists. Hannah had been helped to see “certain things I was doing without noticing that would be making [my symptoms] worse, which are obviously things that I can then work on and change which will hopefully make things a bit better.” Jennifer was seeing two private physiotherapists who specialised in different areas – one was a breathing specialist (respiratory physiotherapist) and one helped her to rebuild her strength (rehabilitation physiotherapist). Callum had been helped by a physiotherapist who worked for a health and wellbeing charity.

Jennifer saw a breathing specialist. She was amazing because she explained that Jennifer had “bad breathing patterns” due to Covid and gave her lots of breathing exercises to help.

Callum trusted the physiotherapy advice he was given because it was based on experience of working with people with long-term conditions. It helped him to speak to someone who “had seen a lot of recoveries.”

Iain had been referred to a respiratory physiotherapist first and then to a mental health physiotherapist. He was waiting to start a course based around tai chi which he hoped would help him “in all sorts of ways,” but especially with his worries about what would happen if he got reinfected with Covid.

Sara said that her respiratory physiotherapist seemed “so overbooked” and didn’t have “the time or the options” to call to see how she was getting on with the breathing exercises she had been given. Fiona A had decided not to accept a physiotherapy referral because: “They had a big backlog and…I’m a nurse and because my son had breathing difficulties, so I knew what they were going to tell me [and] they sent me some details and I said, “That’s fine, I’ll do that, I’ll pace myself, I know how to do it.”

Occupational therapy and occupational health services

Occupational therapists and occupational health services were highlighted as a source of help by some of the people we spoke to, particularly whilst people were having to take time off work or when they were thinking about going back to work. Susan was taking part in a Long Covid rehabilitation programme which involved contact with an occupational therapist.

As part of a Long Covid rehabilitation programme, Susan was in contact with an occupational therapist. She hoped that they would help her to arrange her return to work with her employers.

Judy had very positive experiences with the occupational therapist she had seen. She listened and gave practical advice and was very willing to learn.

Shaista and Tom both had positive things to say about the occupational health services they had been put in touch with.

Shaista waited a long time for an occupational health service appointment. She was relieved when they explained to her bosses that she would need to go back to work gradually.

Tom had been able to see specialists using private medical insurance through his work. He had mixed experiences with the specialists he saw but praised the occupational therapist that he had been in touch with through work.

Talking therapies

A few people also told us about taking part in talking therapies to help them deal with their Long Covid symptoms and how it had affected their lives. Shaista said she had done a six-week counselling course to help her deal with anxiety which she said had “suddenly emerged.” Michelle said that she was getting psychotherapy sessions along with physiotherapy and occupational therapy. At the time of Hannah’s interview, she had been referred to a specialist health psychologist. She said: “I think it will really, really benefit me.” Blake said that a neuropsychologist had provided helpful strategies for their bad memory and difficulties planning. Anthony did not think psychological techniques helped for “a physiological condition” which for him caused severe headaches.

Blake saw a specialist who used some psychology techniques to help them think in more positive ways.

Anthony was referred for “psychological support” but he didn’t find it helpful and thought the approach that had been used wasn’t the right one for people with Long Covid.