COVID-19 is the world health phenomenon we are still trying to wrap our collective heads around. While the days of lockdowns and COVID wards have ended, it seems the health crisis hasn’t, as our understanding of long COVID and the other impacts of such a wide-reaching crisis reveals itself in domains like mental health, economic impact and other aspects of life and living.
Chiropractic evidence has also begun to emerge, as case reports start to talk about Long COVID. We now have case reports discussing long covid in relation to hyposmia, parosmia, pharyngitis, glossopharyngeal neuralgia, fatigue, depression, and brain fog. As the long-term stressors of the pandemic linger, these case reports may represent just the tip of the proverbial iceberg.
This has given rise to long covid studies and discussion papers within the chiropractic research community. In time, we will have more clarity around what this means for our practice members. At present, what we do have is more case report evidence.
A new study has just been published in the Asia Pacific Chiropractic journal in which a patient sought care citing main concerns of long COVID with parosmia and exertional malaise. [1] While these were the main concerns, the 66-year-old male patient (who had suffered two bouts of the virus) also experienced chronic fatigue, muscle aches, pins and needles, brain fog and light-headedness. His fatigue was crippling, meaning that he even had to take an Uber to his appointment because of this deep and debilitating tiredness.
The issue of parosmia is an interesting one. Loss of smell was a common symptom of COVID-19, with most patients regaining their sense of smell post-infection. However, this has not been everyone’s experience. Approximately 60% of those with long COVID have been reported to experience parosmia or anosmia (loss of smell either completely or in episodes). Another study reported 47% of their 3,563-person sample experienced taste and smell loss. Of this number, 31% was severe, and 67% was mild to moderate. Whichever the most accurate number, its remarkably high. Given how important sense of smell is to olfactory function, as well as to alerting the person to safety issues like smoke or rotten food, it is a significant health issue. [2,3]
So too is the idea of post-exertional malaise (PEM), sometimes called exercise intolerance. This occurs when there is a significant decrease in a person’s ability to function, or an increase in other symptoms after an activity that would ordinarily be tolerated well. This isn’t a normal feeling of fatigue that one might have after running or walking around the block. It might last days, weeks or months, and commonly involves fatigue, pain, sleep problems, cognitive difficulties or flu-like symptoms. It is often linked to Myalgic Encephalomyelitis (the official name for Chronic Fatigue Syndrome). We now know this is a common symptom of long COVID, with one survey revealing that 89% of sufferers in a 610-person sample reported some degree of post-exertional malaise. [4]
All of this shows us that it is a serious issue for many people. The big question, then, is this: can subluxation-based chiropractic care contribute to recovery?
In this case, the answer was a positive one. In the comprehensive study (which can be found at the reference below, the patient was cared for using Applied Kinesiology Protocols as well as subluxation-based chiropractic care to correct multiple subluxations across the lumbar, thoracic and cervical spine regions. Post-exertional malaise was constantly monitored to ensure that the patient was not experiencing adverse reactions to care.
After four weeks of care, he reported an improvement in his sense of smell, and some improvements in post-exertional malaise (which may have led him to prematurely increase his daily step count, thus triggering PEM). After three months of care, the patient had achieved several significant improvements. He was not fully recovered, and this would undoubtedly take time, but his sense of smell had improved significantly, had been able to travel interstate for his fathers funeral and tolerated the exertion “pretty well”, and had increased his step count from 3,000 per day to 5000 per day.
Its one case of marked improvement in a short time span, which in addition to three other case reports, creates an initial picture that chiropractic may support optimal nervous system function which in turn may support recovery. It takes time. This is undeniable. But given the frustrations people experience living in the aftermath, it is significant. We’d love to see what future research has to say.
References:
1. Masarsky, C., and Todres-Masarsky, M., (2025). Long COVID with parosmia and exertional malaise: a case report. Asia Pacific Chiropractic Journal. https://www.apcj.net/papers-issue-5-4/
- Alkanat, H. Ö., & Arslan, S. (2024). Long-term smell loss experiences after COVID-19: A qualitative study.Health expectations : an international journal of public participation in health care and health policy,27(2), e14018. https://doi.org/10.1111/hex.14018
- June, JK., (2024). When loss of smell and taste occurs with long covid. Yale Medicine. https://www.yalemedicine.org/news/when-loss-of-smell-and-taste-occurs-with-long-covid
- Emerge Australia (2025). Post-Exertional Malaise. https://www.emerge.org.au/post-exertional-malaise-pem/
