Learning the Alexander Technique helps back pain sufferers

Recent 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 Fund)

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.

Results
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 lessons alone.
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 AT lessons.

	Michael Hardwicke Tel: 015395 31781 E-mail: michael@fmalexandertechnique.co.uk		Newton Farm Cottage Newton-in-Cartmel Grange-over-Sands Cumbria, LA11 6JJ
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