The Society of Teachers of the Alexander Technique (STAT)
The Alexander Technique: What it is and how lessons can help people with chronic neck pain
What is the Alexander Technique?
The Alexander Technique is a self-care method that helps people improve the way they carry out their daily activities, move, stand, sit, work and play. Although the lesson experience itself is enjoyable, often leaving one feeling lighter, taller and less stressed, lessons should be viewed as a form of personal re-education, rather than as therapy. To gain lasting benefit, people need to incorporate what is being taught in lessons into their daily lives. In this way it becomes possible to reduce or manage pain that is related to negative reactions to life or to poor postural and movement habits that are often the underlying cause of problems.
Learning and applying the Alexander Technique can lead to improvements in balance, mobility, postural muscle tone, coordination, and general functioning − changes that can all contribute to a reduction in chronic or recurrent neck or back pain. Learning the Technique enables people to be more in control of their health and wellbeing and reveals how much the mind and body work together intimately as one.
Alexander Technique lessons
Teachers use skilled, sensitive hand contact together with spoken guidance to help people become calmer, improve overall postural muscle tone, let go of unwanted effort and allow free head poise. This enables subtle spinal lengthening, observable as a gradual reduction in undue spinal curvature, probably through changes in related muscle activity. The resulting more comfortable carriage of the head, neck and back is associated with improved postural tone and coordination that often bring relief from neck and back pain. People are shown how to continue looking after themselves while walking, using a computer, sitting etc. Lessons are individually tailored to meet needs and capabilities, and applied to the performance of daily activities. The aim is for people to develop sufficient skill and understanding to use the Alexander Technique in daily life on their own, so reducing their neck pain, and ultimately preventing it.
Lying in semi-supine with the head supported and the spine free to lengthen, provides an ideal situation for practising the fundamental Alexander thinking skills and observing the beneficial effects
The evidence
A randomised, controlled clinical trial (the ATLAS trial) at York University, funded by Arthritis Research UK, has shown that Alexander Technique lessons can result in long-term benefit for people with chronic neck pain. The trial involved people with neck pain lasting 3 months or more, with an average (median) of 6 years. Participants were randomised to one of three groups and offered 20 one-to-one Alexander lessons provided by STAT-registered teachers along with continued usual GP-led care; or acupuncture along with usual GP-led care1; or usual GP-led care alone.
1 In this trial, acupuncture led to benefits similar to those obtained from attending Alexander Technique lessons.
The trial showed the following long-term benefits for people who attended Alexander lessons:
• They experienced nearly a third less pain and associated disability (a 31% reduction) at the end of the trial, 1 year later.
• This reduction was significantly greater than that experienced by the group who received usual GP-led care alone, and was large enough to be considered clinically relevant.
• The extent to which people were able to manage their pain (‘self-efficacy’) increased more in the Alexander group than in the usual care alone group, and this increase in self-efficacy was associated with a greater reduction in pain and associated disability at 1 year.
• Following Alexander lessons, improvement was also seen in people’s mental health at 1 year, as revealed by a self-report quality-of-life questionnaire.
• No safety issues related to Alexander lessons were identified.
Other benefits of Alexander Technique lessons
Since Alexander lessons help people change the way they stand, sit, and move in everyday life, the benefits for chronic neck pain patients might also apply to sufferers of other chronic conditions when the way that someone performs these activities causes problems or makes existing ones worse. The Alexander Technique provides a means for addressing poor coordination generally. There is good evidence that taking lessons can lead to significant long-term reductions in chronic back pain. A large randomised trial showed an 86% reduction in back pain and a 42% increase in the number of everyday activities that could be carried out without being limited by back pain, one year after Alexander lessons began. There is also evidence that learning the Technique helps those with Parkinson’s to manage their condition better and reduce their level of disability. Preliminary evidence exists for benefits of Alexander lessons in several other areas, in addition to improvement in overall wellbeing.
References
MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, et al. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain: A randomized trial. Annals of Internal Medicine 2015;163 (In Press).
Cacciatore TW, Gurfinkel VS, Horak FB, Cordo PJ, Ames KE. Increased dynamic regulation of postural tone through Alexander Technique training. Human Movement Science 2011;30:74–89.
Little P, Lewith G, Webley F, Evans M, Beattie A, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. British Medical Journal 2008;337:a884.
Woodman JP, Moore NR. Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. International Journal of Clinical Practice 2012;66:98–112.
Stallibrass C, Sissons P, Chalmers C. Randomised controlled trial of the Alexander Technique for idiopathic Parkinson’s Disease. Clinical Rehabilitation 2002;16:705−718.
