Could new trials of Alexander Technique pave the way for future treatments on the NHS?
Back pain is debilitating. A slipped disc can be agony. Over two million people in the UK suffer from back pain regularly and it is the most common cause of days off work and GP visits. Back pain is one of those chronic conditions where holistic health treatments have much to offer with their study of the body and hands-on approach.
One of these disciplines has come under the spotlight of medical scrutiny. A study conducted jointly by Bristol and Southampton universities has concluded that Alexander Technique is more effective at alleviating backache than ordinary GP care. This is positive news for Spark readers. While our experience and traditions tell us complimentary treatments work, it is handy to have some science on our side.
The British Medical Journal published the results in August 2008. The randomised controlled trials were conducted in GP surgeries, involving nearly 600 patients with chronic or recurring lower back pain. The results were conclusive: those who had had Alexander lessons spent significantly less time in pain than those with the usual GP care. The benefits were long-term: one year after starting the lessons, they spent three days in pain compared with 21 days for those getting normal NHS care.
The study involved the Society of Teachers of the Alexander Technique (STAT), which tailor classes to the client’s requirements in the classic Alexander style. STAT teachers, trained full-time for three years, also use hands-on and verbal guidance. In the study they also taught patients how to lie down in the Alexander (semi-supine) position with the spine flat, head slightly raised with knees bent and feet flat (see picture). This allows the spine to elongate and the discs in between the vertebrae to plump up.
Back pain costs the nation an estimated £5 billion a year in sick leave and doctors’ visits. A health economics paper published in December showed Alexander classes were good value for the NHS. Analysing the Bristol/Southampton trial, researchers concluded a combination of six lessons in Alexander Technique lessons followed by exercise, mainly walking, was the most effective and cost effective option for the NHS.
The NICE government body (National Institute for Health and Clinical Excellence), which endorses NHS drugs and treatments, is publishing its new recommendations for back pain on the 27 May. Many are hoping they will include the Alexander Technique so it may become available on the NHS. STAT teacher Rachel Stevens, who takes referrals from NHS pain consultants at the Cherington Practice in Bristol, says, “Hands-on, individual Alexander Technique treatments fits the need to address the urgent national problem of back pain.”
Bristol-based STAT teacher Anita Bennett learned the Alexander Technique 30 years ago: “I had bad back pain and I wasn’t sleeping. My chiropractor told me I should study the Alexander Technique so that I wouldn’t need to keep seeing him. In addition to ending my back pain, Alexander transformed other aspects of my life. The Technique is about teaching people to inhibit, or stop, before responding to a stressful stimulus, such as answering the phone. The hands-on treatment helps people become aware of hunched shoulders, tight neck and breath-holding. It’s about breaking unthinking habits rather than choosing knee-jerk reactions. Many approaches can be successful and we would like greater cross-referrals in the natural health world: we can all work well together.”
Alexander Technique was developed in the 1890s by an Australian performer named Frederick Matthias Alexander. The Alexander Technique is a way of bringing conscious awareness to our everyday actions and reprogramming habits that are getting in the way of achieving our full potential. It can be used for back, neck and joint pain, stress, anxiety and low energy levels, poor posture, breathing and vocal problems. It can also be used to improve public performance and prevent injury in the arts and sport, as well as supporting women through pregnancy and childbirth and by all adults to increase their general body awareness and enhance sexual enjoyment.
The average cost of one session is £35 for a 30-45 minute lesson. A course of one-to-one lessons is required to see any real benefit, and length of courses vary according to the need, and motivation, of the student. Generally speaking, a minimum of five or six sessions would be needed to feel any long-term benefit and to start learning new habits. A sufficient number of sessions are required to change lifelong habits: some might liken it to the price of a good holiday – with longer-lasting health benefits.
Rob (not his real name) is 36 and works as a council officer. He says: “My GP surgery was looking for people with back pain to join the trial. After suffering severe prolapsed (slipped) discs and surgery, life was one long slog. The trial was random so I was lucky to get the intensive choice: two Alexander lessons a week for six months. Another choice was just having massage and another was exercise
“It is not an instant cure. I wouldn’t want someone to sign up for lessons and think they would be cured in three weeks. The Alexander Technique slowly changes awareness of the whole of your conduct.
“It was a breakthrough. Before I took the lessons I felt helpless. Alexander gave me ownership of the process rather than the pain. It was a revelation. After every session I felt better, because it was not just doing things differently, it’s a whole thinking process. You change and you open your mind to creative awareness: it impacts on your whole life. Basically, Alexander sows ideas and then something clicks and flows.
“The lessons helped in other ways, too. It helped with my general mental wellbeing, because pain can make you closed. I think in a better way now: I don’t just react automatically. I still experience pain, but the level is greatly diminished.
“I got to a position where life was far more manageable. After the GP trial I didn’t want to stop. I need to do this. I still see my trial teacher once a month and still learn new things. I can relax. It has made me more open, more receptive. It is this principle of letting go, stopping trying to achieve so much. Alexander makes everything work better.”
Ann Downton is 67. She first experienced back problems in her younger days, while she was carrying her son. She says:
“I was heavily pregnant with my son, which put a strain on my back and I now suffer with arthritis in my spine. My health centre put me forward for the Alexander Technique trial. I was a bit sceptical at first but I was willing to give anything a try. When I met my Alexander teacher, Bill McCaskie, I thought ‘He knows what he is doing. This is it.’
I had 24 lessons in the trial and began to feel benefits after four or five. I was lending out my book by Michael Gelb all the time, it was so popular. If you want something other than tablets to help back pain, it can get expensive. Alexander Technique should be available on the NHS.”
The Society of Teachers of the Alexander Technique (STAT)
The UK’s oldest and largest Alexander organisation. 0207 482 5135 www.stat.org.uk
Bristol STAT teachers
Anita Bennett 0117 942 4232 / 0777 978 6076 www.alexandertechniqueprinciple.com
Rachel Stevens www.backcareandposture.co.uk www.AlexanderTechniqueTeacherBristol.org.uk
Another Alexander Technique approach:
Established in 1993, the Interactive Teaching Method (ITM) has its largest UK base in Bristol. "What You Think Is What You Get" by ITM founder, Donald L. Weed (Sunwheel books).www.alexandertechnique-itm.org
Alexander Technique trial in the BMJ
Pain relieving benefits: www.tinyURL.com/BMJresearch/
Economic benefits: http://www.tinyurl.com/BMJvideo
Books used in the trial
• Body Learning by Michael Gelb (Holt)
• Illustrated Elements of Alexander Technique by Glynn MacDonald (Element Books)
First published issue 57 (Summer 2009)
Disclaimer – details were correct at time of going to press, but may now have changed. Please make your own checks.