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Learning the Alexander Technique helps back pain sufferers
clinical research, published in the British Medical Journal,(August 2008)
demonstrates that the Alexander Technique provides long-term benefit for
chronic back pain sufferers.
The clinical research, led by Professor Paul Little at Southampton University,
found that chronic back pain patients who received a course of 24 Alexander
Technique lessons from a STAT certified teacher experienced an average
of three days of back pain per month, compared to the control group who
experienced 21 days of back pain per month. Significantly, this improvement
was still reported after one year.
The multicentre clinical trial was funded by the Medical Research Council
(£585,000) and the NHS (£186,000 from the Research and Development
The AT is a taught life-long self-help method that can enable patients
with chronic or recurrent non-specific low back pain to reduce number
of days in pain and overcome associated incapacity. Experience shows it
can also help patients avoid recurrence. One-to-one Alexander Technique
lessons teach an individual how to recognize, understand and avoid pain-producing
behaviour related to poor postural and movement habits that interfere
with the functioning of postural and motor control systems. Learning and
using the Alexander Technique leads to improvements in postural tonus,
co-ordination, functioning, mobility and balance - and to significant
reduction in non-specific low back pain.
The cost of back pain
Up to 80% of the population suffer from back pain at some stage of their
life, at a cost of more than £1 billion annually to the NHS.
Clinical trial details in brief
579 patients with chronic/recurrent non-specific low back pain were recruited
from 64 general practices. They were randomly allocated to four groups:
a) a control group receiving normal GP care, b) six (6) classical massage
sessions, c) six (6) Alexander Technique lessons and d) twenty-four (24)
Alexander Technique lessons. Half of each group received a GP prescription
for aerobic exercise with behavioural counselling from a practice nurse.
All trial participants in the Alexander Technique lesson groups were taught
by experienced STAT teachers using hand contact together with verbal explanation
and advice to educate the participants' awareness of their postural support
and movement patterns.
Two main outcome measures were used, the principal one being the Roland-Morris
scale, the 'industry standard' outcome measure for back function. It consists
of 28 statements representing the ways that back pain affects a patient's
life. It asks people what they are not able to do from a list of daily
tasks such as how far a person can walk without pain, whether sleep or
appetite is disturbed by back pain and difficulties in getting out of
a chair. The number of statements agreed with, is the score. The lower
the score, the better is the patient's condition.
The second main outcome measure required patients to record how many days
of back pain they had in the last four weeks.
Other outcome measures were also used.
One-to-one Alexander Technique lessons provide significant and
important benefit for low back pain patients.
Trial results clearly show that taking one-to-one lessons in the Alexander
Technique led to long term benefits: a reduction in the number of days
in pain and significant improvement in function and quality of life.
Of the approaches tested, lessons in the Alexander Technique provided
the most benefit. The research reveals that following 24 Alexander Technique
lessons, the average number of activities limited by low back pain had
fallen by 42%, and the number of days in pain had decreased from 21 to
3 days per month one year after the trial started.
Since the effect of massage on activities was no longer significant by
one year, but the effect of Alexander Technique lessons was maintained,
the trial authors concluded that the long-term benefits of taking Alexander
Technique lessons are unlikely to be due to placebo effects of attention
and touch and more likely to be due to active learning of the Technique.
Significantly, a series of 6 Alexander Technique lessons followed by GP-prescribed
general exercise was about 70% as beneficial as 24 Alexander Technique
There were no adverse effects recorded in the trial by any of the 288
participants in the AT groups that together received a total of over 2,400
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