Aug. 19, 2008 -- The Alexander technique, a little-known type of physical therapy designed to reduce chronic pain, is more effective at reducing back pain than exercise alone or massage therapy, according to a new study.
The study, published in the journal BMJ, tested different back pain treatments using patients from 64 general practices in England. A total of 579 patients with chronic pain or recurrent low back pain participated; 144 were given "normal care," 147 had massages, 144 took six Alexander technique lessons, and 144 took 24 Alexander technique lessons. Half of each group was also prescribed an aerobic exercise plan, primarily walking.
The basic idea for the Alexander technique, according to the study, is to "reduce back pain by limiting muscle spasm, strengthening postural muscles, improving coordination and flexibility and decompressing the spine."
Lessons involve continuous personalized assessment of the individual patterns of habitual musculoskeletal use when stationary and in movement, paying particular attention to releasing head, neck, and spinal muscle tension. The teacher provides verbal and hand contact to improve musculoskeletal use.
The team of researchers, from the University of Southampton and the University of Bristol, evaluated participants before and after treatments by two primary measures.
First, researchers measured disability, based on questions about activities limited by pain. Secondly, researchers asked about the number of days in pain in the past four weeks.
The patients who saw the biggest improvement were the ones who took the Alexander lessons and also were prescribed an exercise plan. The improvements still held after one year, while massage's benefits waned after three months.
Patients, however, may not have to take the lessons long term to see benefits. The patients who took six lessons and had an exercise plan saw nearly the same improvement as those who took 24 lessons, according to the study.
"One-to-one lessons in the Alexander technique from registered teachers have long-term benefits for patients with chronic back pain therapy," the study's authors conclude, noting that back pain is one of the most common causes of disability in Western societies.