Symptoms can continue following the virus

What is Long Covid?

Long Covid is the name used when symptoms from a Covid infection last longer than 12 weeks and can’t be explained by anything else. These symptoms can come and go, change over time, and affect different parts of your body. You don’t need to have been seriously ill with Covid to get Long Covid.
Common symptoms include feeling tired all the time (fatigue), trouble thinking clearly (often called brain fog), pain in different parts of the body, poor sleep that doesn’t feel restful, feeling out of breath when doing things. Some people may also have an upset tummy, sore throat or ears, fast heartbeat, changes in mood, or skin problems.

Post viral tiredness

Long Covid fatigue

Fatigue is the most common symptom people get with Long Covid. It’s not the same as normal tiredness and doesn’t improve with sleep. It can feel like a heavy, overwhelming exhaustion that seems worse than the activity you’ve done.
There are two main types of fatigue:
Physical Fatigue – You might feel very tired, heavy, or drained. Even small tasks like getting dressed or walking a short distance can take a lot of energy.
Mental Fatigue– This affects how your brain works. It might be hard to focus, think clearly, remember things, or find the right words. Learning or processing new information can also feel difficult.
Fatigue in Long Covid is complex because it involves many systems in the body that help make, use, and manage energy. Normally, your body systems work together, and your brain helps keep everything in balance. But when they are under too much stress or pressure, they can get “dysregulated,” which means they stop working properly. This can lead to low energy and ongoing tiredness.
Long Covid fatigue may be caused by a mix of the virus itself and how your immune system reacts to it. Some of the ways people manage ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) can also be helpful for managing Long Covid fatigue, since both conditions share many of the same symptoms.

ME Association
How we can work with you?

Your first assessment

What to expect following referral to the Long Covid Fatigue service:

You can choose where your appointment takes place — either in person at a local venue or over the phone. You’re welcome to come alone or bring a friend or family member. The appointment will last about 45 minutes. During this first appointment, we’ll ask you questions about your fatigue symptoms and how they affect your life.

After your assessment, we may offer more support. We offer both individual sessions and group programmes to help you manage fatigue from Long Covid.

The Long Covid Fatigue Group Programme:
The group programme is a great option for people who want to learn how to manage fatigue while connecting with others who are going through the same thing. The focus is on learning and practising strategies to help lessen the impact of fatigue in your life. It’s a friendly and supportive space.

The group is led by two members of our team, and there are usually around 20 people in each group. Each session lasts 2.5 hours, and the programme runs for 6 weeks.After finishing the group, you can also join refresher sessions to keep practising and improving your skills.

Individual Sessions:
Individual sessions last about 30 minutes and are usually with the clinician who assessed you. During these sessions, we talk about topics like understanding fatigue, managing activities, taking quality rest, physical activity, the emotional impact of fatigue, sleep, and nutrition.
We typically offer 3 to 6 individual sessions, which can be face-to-face, by phone, or via video call. If the options above don’t suit you, we can offer an open appointment. This means you can contact us in the future if you need further support.

Meet the team!

Caroline Neal

Clinical specialist therapist

I am a Cognitive Behavioural Therapist, and Occupational Therapist. I am also the clinical lead for the non-medical part of the service I work with patients with long term pain, ME/CFS and Long Covid fatigue providing guided self-management support both individually and in groups.

In addition to this I offer individual support and short-term therapy to people for whom pain, or fatigue are the main driving factors in low mood or anxiety problems.  I also support our multidisciplinary medications review clinics.

I have a special interest and the psychological impact of pain and fatigue in people lives. In working together with you I hope to support you reducing the impact of pain and fatigue in your life.

Rachel Valentine

Clinical specialist therapist

I completed my degree in Physiotherapy in 2007. Since then I have worked in Nottingham, completing my junior physiotherapy rotations at Nottingham University Hospitals before specialising in working with people living with persistent pain in 2010. I joined PICS in 2018. I work with people individually and within groups, supporting those with pain to live full valued lives. Over the past few. I have also specialised in Fatigue Management and in particular treating people with Long Covid and ME/CFS. I have recently started a Masters degree in Public Health.

Sarah White

Clinical specialist therapist

I qualified as a Physiotherapist in 1998 and have specialised in the management of persistent pain for over 20 years. I have been involved in the development and delivery of individual and group pain management and mindfulness-based programmes in Nottingham for over 18 years. In addition to my physiotherapy background, I have undertaken additional training in Acceptance and Commitment therapy and Mindfulness based treatments and have experience in using these therapeutic approaches to managing long term physical and mental health conditions. I am a trained Mindfulness teacher and have completed Mindfulness Based Cognitive Therapy and Youth Mindfulness training and I have taught adults, young people and children in a variety of health, educational and workplace settings. I have been working as part of the multi-disciplinary team at PICS Community Pain and CFS/ME service since 2020 and I have a special interest in providing individual and group based holistic programmes for young people who experience persistent pain and fatigue.

Anna Ruskin

Clinical specialist therapist

I qualified as a Physiotherapist in 1999 and worked at Nottingham University Hospitals for many years, gaining experience in outpatient and orthopaedic physiotherapy. Since 2009 I have specialised in the management of persistent pain, working for the Nottingham Back and Pain Team for 9 years before moving to PICS in 2018. I now work as a Pain Practitioner and am one of the lead clinicians for the Living Well with Pain Programmes in Greater Nottingham. I have a particular interest in mindfulness-based approaches in pain management and I am a fully qualified and BAMBA registered mindfulness teacher.

Catherine Woods

Clinical Specialist Nurse

I have worked in pain management  for many years and really enjoy working with patients to improve their quality of life, which can involve optimising painkillers or changing regimes.

Beth Warburton

Clinical specialist therapist

I am a registered Occupational Therapist and qualified in 2015 from Sheffield Hallam University. In the last 7 years I have been employed in an NHS Mental Health Trust, within different services including Mental Health Liaison in an acute hospital in Lincolnshire, on secondment in Primary Care based in a GP practice delivering proactive care, supporting patients with long term conditions with a whole person approach. I worked in an NHS Staff Wellbeing service providing individual and group mental health support for health and social care staff in Lincolnshire, in response to the physical and psychological impact of the Covid-19 pandemic. I joined PICS in 2022, and really enjoy working with people in the long term pain, ME/CFS and Long Covid fatigue pathway, providing guided self management support both individually and in groups. My special interests in the pathway are managing fatigue, quality rest, sleep and gut health. I hope people will gain a better understanding of their condition and feel well supported, enabling them to engage in active self management approaches, to improve their quality of life.

Jill Parrish

Clinical specialist therapist

I qualified as a Physiotherapist in 1997. Before my Physiotherapy training, I completed a BSc degree in Psychology. After working in a variety of areas within the NHS elsewhere in the UK, I developed an interest in persistent musculoskeletal pain and supporting people with their longer term self management I have worked as a Clinical Specialist in Pain Management within a multidisciplinary team since 2002. My role now also includes fatigue management support. I have worked within the PICS Community Pain & Fatigue Pathway since 2018. I am lead clinician for the ‘Moving On With Pain’ programmes. My work involves individual and group patient work.

Geeta Singh

Clinical specialist therapist

I qualified as a physiotherapist in 2002, working predominantly at Nottingham University Hospitals NHS Trust. I gained experience in many rehabilitation health settings, and this led to a specialist role (working with people diagnosed with Cystic Fibrosis); it was during this time that I gained insight, and developed an interest in working with people who had a life-long condition. In 2014 I began specialising in supporting people in managing persistent pain. As part of this journey, I qualified as a mindfulness teacher and gained experience in other therapeutic models used in this speciality.

I joined PICS as a Pain Practitioner in 2020. As well as leading pain programmes and supporting people individually, I now also assess and support people with ME/CFS and Long Covid fatigue. I have a specialist interest in using compassion focused approaches.

Lorraine Winter

Clinical specialist therapist

I qualified as a nurse in 1990 working on Specialised surgical wards in a General Hospital setting. In 2006 I became a Pain Nurse Specialist in the management of people who live with persistent pain as well as other long term health conditions. I joined PICS Community Pain Service in 2019 where I have a dual role, in that I support people with their persistent pain as well being part of the medication team, making medication recommendations to GP’s.

Natalie Petzel

Clinical specialist therapist

I qualified as a Physiotherapist in 2004 from Coventry University, working in the area of Trauma and Orthopaedics in-patients up until 2022. Throughout my career I developed a strong interest in acute and persistent pain and how they are both managed. I have since moved into a specialised role in Pain Management with PICS in January 2023. I am totally committed to working with people to live better lives with persistent pain. I am passionate about the mind and body connection and how improving this can help manage the impact of persistent pain.

Sara Temperton-Sowerby

Clinical specialist therapist

I qualified as a physiotherapist from Sheffield Hallam University in 2011. After completing community junior rotations I worked for 10 years within musculoskeletal departments across Lincolnshire, North Lincolnshire and South Yorkshire in both junior and Senior roles. It was during my time working as a specialist musculoskeletal physiotherapist where my interest in persistent pain developed. I gradually focussed my learning and training more towards working with people with persistent pain and long-term conditions. I joined PICS in 2022 and now work supporting people living alongside persistent pain, ME/CFS and Long-Covid fatigue to empower patients towards optimizing their self-care strategies and improve quality of life.

I work with people on a 1:1 basis and also within our Moving On With Pain Programme. I am also working towards my Master’s degree in Advancing Professional Practice alongside my clinical role with an emphasis on the management of long-term conditions.

Mandy Buckley

Clinical specialist therapist

I am a physiotherapist, qualified in 1988 and have been working in the Mansfield area since 1990. After working nearly 20 years in the musculoskeletal field. I specialised in Pain at the Back Pain Unit at Kings Mill Hospital. I joined Pics in 2019. My skill lies in working with groups, but I also see patients individually in a variety of fields including pain, Long Covid, ME/CFS and our young person’s service. My aim in all my work is to help patients have a better quality of life and I find this work very rewarding.

What our patients say....

Testimonials

Meeting others with Long Covid has been really helpful to me personally as I felt very alone.  I enjoyed the group, learning together was great.  It was hard to make sense of fatigue and I felt I had lost so much because of it, I needed that support.  I am coming to terms with fatigue in my life and working with it better.

Phillip

“Feel more able to cope.  Doing the group has meant I met other people with Long Covid fatigue.  I felt very isolated before so this really helped.  The team were great and really understand fatigue.  I’ve learned a lot”.

Tony

“They have helped me enormously and changed the way I see my life going.  I never realised how complex fatigue is.  I am managing better now, and feel like I am making progress”

Sarah
Frequently asked questions

Some useful things to know

Yes! People tell us they feel heard and understood in our service.  They have found it useful to connect with others in a group setting and share their experiences.  People comment they understand fatigue more fully and are benefitting from implementing skills and techniques gradually and sustainably .

No.  We love to see you, (and your pets)! but joining the group doesn’t mean you need to have your camera on throughout.  We appreciate breaks are needed.  We’ll check in with you during sessions and always have a decent break in the group.

The groups are confidential, and we need to protect the confidentiality of everyone on the sessions so its important that you are alone on the virtual group.  Its also important that you have a quiet space, where you will not be disturbed and have protected some time for yourself to fully engage with sessions.

This is very common with fatigue.  We have a manual you can follow and use as a reminder between sessions, and also share with the people around who support you.

Individual sessions are tailored to fit your needs.  We usually offer between 3-6 sessions of around 30mins each.  These can be in person, telephone or virtual depending on your preference.  We will agree together what is most important for you, and you will have a manual to support these sessions.  There will usually be some time between sessions for you to implement skills and practice.

Following completion of a group or individual sessions we will invite you to group refresher sessions.  These are run virtually, last 90mins and run quarterly throughout the year.  There can be quite a lot of people on these sessions (we have had up to 40). They are an opportunity check in with yourself, connect with others, and refresh knowledge, skills and techniques learned on the sessions.

You also have an open appointment with the service and can contact us by phone or email for individual support for 12 months.

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If you have a specific query or would like to find out more, please contact us

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