Private Long Covid rehabilitation in the UK, built around pacing, not pushing.

Only if post-exertional malaise is genuinely absent. Where PEM is present - a delayed, disproportionate crash after exertion - NICE guidance advises against fixed incremental exercise programmes, because pushing through can lower your baseline durably. Pacing within an energy envelope comes first, and any increase in activity follows symptoms rather than a schedule.

A worsening of symptoms after physical or cognitive exertion that is disproportionate to the activity, typically delayed by 12 to 48 hours and lasting days or longer. It is the defining feature of ME/CFS and is present in a substantial proportion of people with Long Covid. Screening for it explicitly is the most important part of the assessment.

A rehabilitation medicine consultation runs £250–£450 and a full screening blood panel £250–£500. Lung function is £300–£600 and a cardiology review with echocardiogram £500–£900. Therapy sessions are £80–£180 each. A full assessment with bloods and consultation is typically £600–£1,200.

Most people improve substantially over the first six to twelve months, though improvement is rarely linear and setbacks are normal. A minority remain significantly affected for years. Honest expectation-setting is part of treatment - plans built on an assumption of rapid linear recovery tend to leave people feeling they have failed.

Postural orthostatic tachycardia syndrome is diagnosed when heart rate rises by 30 beats per minute or more within ten minutes of standing, with symptoms and without a blood pressure drop. It is common after COVID, straightforward to test for with an active stand test, and genuinely treatable with fluid and salt loading, compression garments, recumbent conditioning and, where needed, medication.

Usually breathing pattern disorder - a disrupted, upper-chest breathing rhythm that persists after the acute illness. Oxygen levels and lung function are normal, which is why it is often dismissed. It responds well to breathing retraining with a respiratory physiotherapist, and improvement is often noticeable within weeks.

Most have little or no evidence behind them. Blood washing or apheresis, hyperbaric oxygen, high-dose intravenous vitamins and unlicensed antivirals are all sold for Long Covid, often at considerable cost. We will tell you plainly when something has no evidence base rather than arranging it because you asked.

Yes. NHS post-COVID services operate across England, with referral usually through your GP, though provision and waiting times vary considerably by area. Where the local service is good and the wait is reasonable, that is often the better route, and we will say so. Private care is most useful for speed of investigation and for coordinating a multidisciplinary plan.

Many people return to work, often initially on reduced hours or with adjustments. Early occupational health involvement, a phased return and formal reasonable adjustments under the Equality Act make a substantial difference. Returning too fast, at full hours, is one of the commonest causes of relapse.

Chest pain, fainting or near-fainting, severe or sudden breathlessness, an oxygen saturation below 94 per cent at rest, or new calf pain and swelling. Clotting risk stays raised for months after COVID, so those symptoms need same-day assessment rather than a rehabilitation appointment.