Significant long-term benefit for low back pain revealed

A major study led by a Southampton researcher has found significant evidence that the Alexander Technique can provide long-term benefit for people with chronic or recurrent low back pain.

The study, one of the first of its kind, is published online today by the BMJ at BMJ.com (20 August 2008).

It shows that lessons in the Alexander Technique provide an individualised approach to reducing back pain through the teaching of life-long self-care skills that help people recognise, understand and avoid poor habits affecting postural tone and neuromuscular co-ordination.

Up until now there has been no good evidence of the long-term effectiveness of Alexander Technique lessons.

But the latest research by Professor Paul Little of the University of Southampton, in conjunction with Professor Debbie Sharp, of Bristol University, shows that the technique can help long-term back pain.

The multi-centre clinical trial involved 579 patients and compared 24 Alexander Technique lessons, six Alexander Technique lessons, six sessions of classical massage and normal GP care.

Half of the patients allocated to each of these groups also received a GP prescription for aerobic exercise (30 minutes of brisk walking or the equivalent each day), followed by behavioural counselling from a practice nurse.

The study showed that 24 Alexander Technique lessons led to important improvements in function, quality of life and a reduction in the number of days the patients suffered pain.

One year after the trial started, the average number of activities limited by back pain had fallen by 42 per cent, and the number of days in pain was only three a month compared with 21 days in the control group.

Massage also helped over the three months but the effect on activities was no longer significant after one year.

Exercise prescription alone had significant but modest effects on activities at both three and 12 months. However, a series of six Alexander Technique lessons followed by GP-prescribed exercise was about 70 per cent as beneficial as 24 Alexander Technique lessons at one year.

Professor Little said: "This is a significant step forward in the long-term management of low back pain.

"The results of this study revealed that the Alexander Technique can help back pain; it probably does this by limiting muscle spasm, strengthening postural muscles, improving co-ordination and flexibility and decompressing the spine.

"This means that patients can have fewer activities or functions limited by back pain."

The trial was funded by the Medical Research Council and the NHS Research and Development fund.

(Source: British Medical Journal Online: University of Southampton: September 2008)