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Back Pain

2008 UK Back Pain Study

An old cure for a modern malaise: Alexander Technique can beat chronic back pain

By Jenny Hope
Last updated at 8:51 AM on 20th August 2008 

Back pain costs the UK economy £5billion each year in lost working days

A method of relaxation developed more than 100 years ago can help ease chronic back pain, researchers say.

The Alexander Technique, formulated by an Australian actor after he lost his voice, has been proved to be effective in clinical trials.

The discovery could help British firms save vast sums of money. Each year back pain accounts for up to five million lost working days, and costs the economy an estimated £5billion. 

A study of almost 600 patients suffering chronic or recurrent back pain found significant improvements after a year among those having lessons in the Alexander Technique.

They spent just three days in pain each month, compared with 21 days for those getting normal NHS care.

And a short course of six lessons, combined with exercise, produced almost as much benefit as a full regime of 24.

This is the first long-term study of its kind into the technique, which was originally devised to help its founder, actor Frederick Matthias Alexander, get over losing his voice during recitals.

He believed his problem was caused by the way he stiffened his whole body as he prepared to speak.

The technique has been taught in the UK since 1904, but until now there has been no thorough investigation into its long-term effectiveness and doctors have complained of the lack of evidence to support it.

Its aim is to make people more aware of how they use their bodies, and to get them to stop bad habits and excessive muscular tension.

In the latest study, published online in the British Medical Journal, a team from Southampton and Bristol Universities recruited 579 patients with chronic or recurring back pain from 64 GP areas in the south and west of England.

They were allocated one of four types of treatment  -  normal care such as painkillers, physiotherapy or GP referral, massage, six Alexander technique lessons, or 24 AT lessons.

Half of the patients from each group were also prescribed an exercise programme, consisting of brisk walking for 30 minutes a day five times a week.

The £750,000 study, partly funded by the NHS, showed that lessons in the technique provided an individualised approach to reducing back pain.

Participants were taught on a one-to-one basis. They learned to sit, stand and move correctly, and they also worked on their posture.

All the patients involved in the study were sent questionnaires after three months and one year asking which everyday activities were limited by their back pain.

After a year, the researchers found that exercise combined with AT lessons significantly reduced pain and improved functioning, while massage offered little benefit after three months.

Those having AT lessons also reported fewer days with back pain over the previous four weeks.

Patients getting normal care had 21 days of back pain, compared with four among those having a full 24-lesson course of the Alexander Technique.

Those who had six lessons had 11 days of pain and those having massage had 14.

Co-author Professor Paul Little of the University of Southampton 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 coordination and flexibility and decompressing the spine.'