Alexander Technique and Back Pain

Alexander Technique and Back Pain

The Alexander Technique is clinically evidenced to reduce chronic back pain. In a Medical Research Council trial published in the British Medical Journal, 24 one-to-one lessons reduced days of pain from 21 per month to just 3. This represents an 86% reduction in back pain, which was still present one year later. 

The Alexander Technique is now also shown to benefit people with chronic neck pain. 

Does the Alexander Technique work for back pain? 

Yes. The ATEAM trial (2008), funded by the Medical Research Council and the NHS, randomised 579 patients with chronic or recurrent low back pain across 64 GP practices in England. It compared 24 Alexander Technique lessons, 6 lessons, 6 massage sessions, and usual GP care. The Alexander Technique groups showed the largest and most durable improvements, with the benefit increasing between three months and one year.

What were the results? 

After one year, patients who received 24 Alexander Technique lessons reported only 3 days of pain per month, compared with 21 days in the usual GP care group - an 86% reduction. The 6-lesson group reported 11 days of pain, a 48% reduction. The 24-lesson group also showed a 42% reduction in disability (the number of everyday activities limited by pain). Six lessons followed by a walking prescription achieved 72% of the benefit of 24 lessons alone. No adverse effects were reported in either Alexander group. 

Is the effect long-lasting? 

Yes. The benefit of 24 lessons was greater at one year than at three months. The trial authors concluded: "One to one lessons in the Alexander Technique from registered teachers have long term benefits for patients with chronic back pain." This is unusual in pain research, where effects can fade over time. 

How is the Alexander Technique different from physiotherapy? 

Physiotherapy uses sets of specific exercises to strengthen, stretch, and restore mobility in the patient. The Alexander Technique involves no exercises, and the student becomes an active participant in their own recovery. It is a form of postural re-education that teaches you to become aware of and inhibit the habitually acquired patterns of excessive tension that can cause pain in everyday movement. The two methodologies work through completely different mechanisms and are not directly interchangeable, especially when applied to back pain and neck pain. 

What does the NHS say about the Alexander Technique and back pain? 

The NHS confirms that "regular long-term lessons in the technique may lead to reduced back pain-associated disability and reduce how often you feel pain." You can read more here: The Alexander Technique and Back Pain.

What about neck pain? 

A separate randomised controlled trial (ATLAS, 2015) found that 20 Alexander Technique lessons significantly reduced chronic neck pain compared with usual care, with effects maintained at 12 months. You can read more here: Alexander Technique and Chronic Neck Pain

Conclusions

The NHS is starting to realise that this preventative approach to back pain is the way forward. The Alexander Technique is distinct from other interventions, as the client is ultimately in charge of what they get out of it. Pain is a great motivator to learning the Alexander Technique, and many people find their way to it after having tried everything else they can think of. The unique approach of learning for yourself puts you in charge.

The trials by the Medical Research Council, published as the front-page story in the British Medical Journal (and widely covered in the national press), concluded that:

"One to one lessons in the Alexander Technique from registered teachers have long term benefits for patients with chronic back pain."*

Read what some of the papers had to say:
The Daily Mail, The Guardian.

To read full clinical details about the trial: British Medical Journal 

...or you can watch a short film (in two parts) about the research below.