Long COVID, Chronic Stress: One Source, One Massage Protocol

Tension headaches, cognitive decline, TMJ dysfunction, brain fog, sleep disorders, dizziness

From the author.
This overview will not be typical academic writing, but rather a logical, common-sense clinical and science-based discussion. I will not offer references here. Instead, at the end of this article I will provide links to my articles that include references and more detailed explanations.

Let’s start with reliable statistics.

Reliable statistics indicate:
• 75% to 90% of primary care visits are related to stress-associated conditions.
• Approximately 20 million Americans are currently living with Long COVID.
• More than 100 million Americans have been infected with COVID-19, with evidence suggesting an increased risk for cognitive impairment, including neurodegenerative conditions.

It is a massive pandemic size phenomenon.

During the last four years, I and most clinicians have started seeing clients suffering from combined symptoms: tension headaches, cognitive decline, TMJ dysfunction, brain fog, sleep disorders, and dizziness.

Little by little I came to the conclusion that the panic during the COVID pandemic—when the media constantly reported scenarios like the end of the world, and when schools and businesses were locked down and real social isolation occurred—placed the entire population under tremendous chronic stress for months and even years.

How I Came to the Conclusion That We Are Dealing With Chronic Stress-Related Disorders

My conclusion comes from years of experience working with Olympic teams.

These athletes were exposed to:
• Constant emotional pressure
• Extreme physical workload

Imagine a 23-year-old athlete with:
• A resting pulse of 45 beats per minute
• Training three hours, twice a day
• Not allowed to stop until the heart rate reached 220 beats per minute

The physical and emotional stress load was extraordinary.

If the assigned sports massage practitioner failed to provide quality post-event sports massage, some athletes developed what we informally called “burnout.”

They demonstrated:
• Emotional exhaustion
• Cognitive symptoms
• Sleep disturbances
• Autonomic irregularity (the most important biomarker)

When I began observing the massive rise of chronic stress-related disorders in the general population after COVID, I immediately recognized the similarity.

Importance of Recognizing the Difference

ACUTE STRESS

Imagine you are walking down the street and suddenly confronted by a large, aggressive dog.

Immediately the muscles of the neck, upper back, and diaphragm increase their tone and may enter spasm. Heart rate accelerates. Blood pressure rises. Adrenaline and cortisol—our primary stress hormones—are rapidly released. Respiratory rate increases.

This is the fight-or-flight response.

When the dog’s owner intervenes and the threat is removed, the body gradually returns to baseline. Muscle tone normalizes, heart rate slows, and physiological balance is restored.

This is acute stress—short-term, adaptive, and reversible.

CHRONIC STRESS

Chronic stress is fundamentally different. It represents prolonged exposure to threat or negative affect, producing the same physiological response as acute stress—but sustained over weeks, months, or years.

I would like to repeat: a clear example is the COVID-19 pandemic, during which prolonged uncertainty, social isolation, threat-based media exposure, and disruption of daily life kept millions of people in a persistent stress response.

Prolonged Chronic Stress and Hormonal Overdrive

Chronic stress leads to persistent activation of the fight-or-flight response, triggering sustained hormonal overdrive.

Chronic Stress Alters Neuroendocrine Regulation

The body’s primary stress-regulatory system is the hypothalamic–pituitary–adrenal (HPA) axis. In acute stress, this system mobilizes energy and maintains alertness.

With prolonged stress, however, the HPA axis becomes dysregulated:

• Chronic activation leads to impaired feedback mechanisms, receptor resistance, and paradoxical cortisol production patterns.
• Dysregulated cortisol signaling affects vascular tone, immune function, and metabolic balance.
• Over time, this maladaptive response contributes to abnormal cardiovascular regulation, including impaired blood pressure control.

Autonomic Nervous System (ANS) Dysfunction in Chronic Stress

Acute stress: sympathetic (fight-or-flight) activation raises heart rate and blood pressure.

Chronic stress: over time dysfunction develops in both autonomic branches:

• Sympathetic activity becomes poorly regulated
• Parasympathetic (vagal) tone may become dysregulated or excessively dominant
• Baroreflex sensitivity—the mechanism regulating short-term blood pressure—becomes impaired

PATHOPHYSIOLOGICAL CASCADE

• Sustained cervical and upper-thoracic muscle tension
• Impaired venous, lymphatic, and CSF drainage
• Increased intracranial pressure
• Reduced cerebral perfusion
• Neuroinflammation

Prolonged pathological tension in the neck, upper back, and diaphragm mechanically obstructs venous outflow, cerebrospinal fluid drainage, and glymphatic clearance.

The result is accumulation of venous blood and cerebrospinal fluid, increased intracranial pressure, and reduced cerebral blood perfusion—particularly affecting glucose and oxygen delivery to the brain.

These conditions directly contribute to neuroinflammation and impaired brain function.

AUTONOMIC DYSREGULATION

A fundamental question must be asked:

Can the brain function normally under these conditions?

The answer is no.

Attention, memory, sleep regulation, and emotional stability are compromised.

Autonomic imbalance develops, initially characterized by sympathetic overactivity with suppressed parasympathetic regulation. This stress-hormone overdrive ultimately leads to autonomic dysregulation.

In my clinical view, autonomic dysregulation is a key biomarker of brain dysfunction. Normalization of autonomic balance serves as measurable evidence of neurological recovery.

Long COVID

I do not want to repeat myself; below you will find articles describing how I discovered that we can successfully treat cases of Long COVID.

During the pandemic, as I mentioned, we were all under tremendous chronic stress with the side effects I described above and in the articles linked below.

Now we all remember that especially during the first years of the pandemic, everyone who became infected with the COVID virus was not only exposed to chronic stress but also to significant psychological trauma. At that time, being diagnosed with COVID often felt like a death verdict.

Of course, chronic stress doubled the negative effects, including increased tension in the neck, upper back, abdominal, and diaphragm muscles; further obstruction of cerebrospinal fluid and venous drainage; increased intracranial pressure; and decreased perfusion of blood, glucose, and oxygen to the brain.

Yes, this virus damaged small blood vessels. As you will be able to read in my articles, chronic stress also damages small vessels.

Recently I spoke with a neurologist who told me:

“Boris, with all due respect, you are clinically proving the effect of your treatment, but please do not simplify. Are you aware that this virus caused strokes and brain hemorrhages?”

My answer was yes, I had read about this. However, not a large percentage of people infected with COVID experienced stroke or hemorrhage.

Then I asked the doctor: what is the main cause of strokes? Isn’t it hypertension?

When someone receives the news that they have been diagnosed with COVID, it is possible that this stressor significantly raises blood pressure and may trigger a stroke.

I understand that we cannot oversimplify. However, I also observe that many people with chronic stress-related illnesses and Long COVID respond positively when we decrease intracranial pressure by accelerating drainage of cerebrospinal fluid and venous blood while increasing blood supply to the brain.

We see significant improvement, and many times we give people their lives back.

This does not mean we are simplifying. It is simply clinical reality.

A Window of Opportunity

Neuroinflammation causes brain dysfunction, but it does not necessarily mean degenerative brain disease.

By increasing blood supply to the brain and reducing inflammatory conditions, we may help prevent irreversible degeneration of the brain, including dementia and movement disorders.

Upcoming Webinar

My upcoming webinar is the most comprehensive class I have ever taught.

In addition to theoretical concepts, I will demonstrate introductory massage, techniques to release fascia and muscles, techniques influencing the neurotransmitter acetylcholine, and methods that stimulate mitochondrial activity.

I will also teach special techniques for dizziness, acupressure for tension headaches, techniques to accelerate drainage of cerebrospinal fluid and venous blood, and abdominal massage.

All of these basic techniques address the side effects of chronic stress and Long COVID, helping restore normal brain function and rebalance autonomic activity.

In one educational webinar you will learn multiple massage protocols.

I am confident it will be the best $80 you ever spend on your education.

Keep in mind that this is an introductory price and will most likely increase in the future. Take advantage of it.

This webinar will be limited to 20 participants only. We currently have eight spots remaining.

Please click the link to read more about the webinar and to register:
https://www.medicalmassage-edu.com/products/long-covid-chronic-stress-related-disorders.htm

Click this link to read my articles related to this overview:
https://www.medicalmassage-edu.com/blog/restoration-of-cerebral-perfusion-in-chronic-stress-and-post-viral-long-covid-syndromes.htm

In conclusion:

One critical question we must clarify for ourselves—and be able to explain to our patients and fellow healthcare professionals—is this:
Why, three years after the pandemic, are millions of people still suffering from chronic stress-related disorders, even though one might say the crisis is “over”?

This brings us back to the difference between acute and chronic stress. Chronic stress is not adaptive. During prolonged periods of constant stress, muscles and fascia continue to adapt until a vicious cycle is established. Fascial connective tissue builds excessive tension, creating persistent irritation that cannot resolve naturally without therapeutic intervention.

As you now understand, this leads to impaired cerebrospinal fluid and venous drainage, insufficient glymphatic flow, and reduced perfusion—particularly decreased delivery of glucose and oxygen. Autonomic dysregulation becomes sustained, and the body continues to deteriorate, potentially leading to degenerative brain diseases, autoimmune disorders, and other serious conditions

Best wishes.

Boris Prilutsky