How to fight the most common long-Covid symptoms – from fatigue to flare-ups

While millions of people had Covid-19 and has recovered with no lasting effects, there is a sizeable minority who have not been so lucky.

An estimated 1.3 million people said they were affected Long covid Symptoms in December 2021 according to the Office for National Statistics.

Post-Covid-19 syndrome, to give it its official name, is defined as: “Persistent symptoms at 12 weeks that are not explained by an alternative diagnosis. It usually presents with clusters of symptoms, often overlapping, that fluctuate and can affect any system in the body.”

The most common symptom is fatigue, with up to 80 percent of those affected feeling an overwhelming sense of exhaustion that makes it impossible to lead a normal life.

Here, specialist occupational therapist Rachael Rogers, from the Post-Covid Assessment Clinic, Oxford, and co-author of the Long Covid Self-Help Guide, shares her tips for people with fatigue – and how to regain your energy for good.

Fatigue is a common symptom of Long Covid (stock photo)


Getty Images/Westend61)

What is fatigue?

Everyone is familiar with fatigue, but it’s usually resolved with a good night’s sleep or with your feet up for half an hour.

However, fatigue goes beyond normal fatigue and is not only a physical sensation, but also a mental one. It doesn’t go away no matter how much rest or sleep you get and interferes with daily activities.

Fatigue is a symptom of many other conditions, including multiple sclerosis, Parkinson’s disease, hypothyroidism, ME, and chronic fatigue syndrome, and is common in patients recovering from infections, surgery, or major medical events such as a heart attack or stroke.

There are no specific medications to cure or treat fatigue, but there are many things you can do to control your energy levels.

Fatigue is also a symptom of other diseases (stock photo)


(Getty Images)

The three P

Imagine a cell phone battery that is much smaller than it used to be and in worse condition.

Shortly after Covid you had a bigger, better quality battery that could get you through each day with confidence. It charged regularly and would charge easily when relaxing or getting a good night’s sleep.

Now, however, you need to think about that reduced battery and think: How are you going to put the energy you have to good use? How can you keep charging it? And finally, how to gradually improve the quality and size of the battery?

This is where the three Ps – prioritization, planning and pace – can help.

Prioritization: Are there areas in your life where you could save energy?

Consider these changes: making an online store instead of going to the supermarket; taking the bus instead of walking to work; and to accept help with household chores when it is offered.

  • TIP: Wondering what needs to be done, what can wait, what can be crossed off the list altogether? Besides, what can someone else do?

Planning: Knowing how you’ll spend your day — from big events to smaller chores — can help you manage the energy you have in your battery.

Build in recovery time after doctor appointments. Schedule important calls for a time when you usually feel better. Take time to rest. Do a relaxation exercise earlier in the day to give you more energy in the afternoon.

  • TIP: Use a planner to prioritize and time your activities, especially if you suffer from brain fog. Written plans give you less to think about instead of trying to keep everything in your head.

Tempo: That means doing one activity throughout the day, then rest, then more activity, followed by another break, and so on.

You may need to break an activity into small chunks, so instead of vacuuming the whole house at once and then sitting down for a cup of tea, you might just need to do one room and then rest.

Pacing also applies to mental tasks – these use just as much energy from the battery. So instead of working on the computer for two hours, you might need to stop and rest after 30 minutes.

  • TIP: Set an alarm as a reminder to pause for five minutes every hour on the hour.

Know when to stop

The lack of energy can feel very frustrating and overwhelming at times, especially when there are things you want or need to do.

You may find that you react fairly immediately to overdoing an activity by feeling tired or running out of energy midway, or you may have a delayed reaction.

Setting time or task limits can ensure you rest early enough.

For example, if you lose focus after 10 minutes of reading, you know you need to stop at that point and not continue.

Or if a day of gardening wipes you out for the next two days, set yourself the task of cleaning up just a small section, then quit for the day.

  • TIP: Break activities into smaller parts and be clear about the breakpoint.

If you get tired from an activity, you should take a break


AFP via Getty Images)

Get the right rest

Many of us think that we are resting when we are reading a book or magazine, watching TV, or scrolling through our phone. But while they don’t require a large amount of energy, they still use a little.

The right restful rest helps to recharge your battery. Breaks are “breaks” in activity.

These can take the form of relaxation or breathing exercises, meditation techniques, mindfulness, restorative yoga practice, or calming sensory techniques like sound apps, an electric blanket, or aromatherapy.

It’s best if you can keep away from your bedroom so you can only keep it for sleeping. Many people describe feeling “tired but exhausted” at night, often making it difficult to fall asleep or have a restful night’s sleep.

Taking regular rest breaks throughout the day can help avoid this feeling.

  • TIP: Avoid napping during the day as it can affect your sleep at night. If you need to take a nap or think you might fall asleep while resting, set an alarm so you don’t sleep late.

You should set an alarm when you take a nap (stock photo)


(Getty Images/iStockphoto)

How to make pace

Finding your energy base is an important part of the recovery journey. That means figuring out how much activity you can comfortably accomplish each day, and which tasks can drain or increase your energy.

Once you’ve done that, you may feel ready to “pick up the pace.”

Pacing up means carefully increasing physical and mental activity. Start by just adding a new activity or extending an existing one. That might mean listening to the radio a little longer or having longer conversations with people.

But you need to get used to the new level before you push yourself any further. For example, instead of increasing the daily walk every time you go out, maintain your new level for a week or two and then consider the next increase.

As you speed up, you may notice a slight increase in fatigue, stiffness, or brain fog.

This is normal and will hopefully subside after a day or even a few hours.

However, if the sensations last a week or more, it may mean the increase was too much or too fast. Adjust accordingly.

  • TIP: Keep the increase very low so it has minimal effect on your body. We often recommend about 10 percent more initially to avoid a crash.

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flare-ups and setbacks

People sometimes report getting a little stuck with their energy management at a certain level.

Sometimes there are clear reasons why a flare-up or setback has occurred – it could be that you had an exceptionally busy time, you had another mistake, or things got a bit stressful, as sometimes life does.

We know that long Covid has a vacillating nature.

Recovery isn’t a smooth line, and it can feel like you’re taking two steps forward and one step back. This can be incredibly frustrating.

But it may be that this is the level things need to be at now, and that’s okay at this stage of your recovery.

  • TIP: You may need to slow things down a notch or two for a short time, allow your body to recover, and then slowly pick up the pace again.

The Long Covid Self Help Guide: Practical ways to manage symptoms from the specialists at Post-Covid Clinic, Oxford is now available (Green Tree, £13.49)

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