Key Takeaway
24 Alexander Technique lessons provided long-lasting relief for chronic back pain, reducing disability days from 21 to 3 per month at one-year follow-up.
Summary
This large NHS-funded randomized controlled trial compared Alexander Technique lessons, massage, and exercise for chronic back pain. It remains the most rigorous study of Alexander Technique to date.
24 Alexander lessons provided the best long-term outcomes, with patients reporting only 3 days of pain per month at one year compared to 21 days at baseline. Six lessons combined with exercise prescription was also effective. Benefits persisted after lessons ended.
Methods
- 579 patients with chronic/recurrent back pain
- Randomized to: Normal care, massage (6 sessions), Alexander (6 or 24 lessons)
- Half of each group also prescribed exercise
- Primary outcome: Days with activity-limiting back pain
- Follow-up at 3 months and 1 year
Key Results
- 24 Alexander lessons: 21→3 days pain/month at 1 year
- 6 Alexander lessons + exercise: Nearly as effective
- Massage: Short-term benefit only
- Exercise alone: Modest benefit
- Effects persisted 1+ year after lessons ended
- 42% reduction in Roland Morris Disability score
Figures
Figure 1
Limitations
- Cannot blind participants to treatment
- Some dropout (addressed in analysis)
- UK population may differ from others
- Cost-effectiveness borderline