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Alexander technique offers major back pain benefits

By Nigel Praities

Alexander technique provides significant benefit over usual care for patients with chronic low back pain, say the authors of the first long-term UK trial in the area.

In a landmark trial likely to be considered in NICE guidelines for back pain due for release next year, 24 sessions of Alexander technique resulted in a 86% reduction in days in pain and a 42% reduction in disability compared with usual care after one year.

The educational technique helps patients improve postural tone and muscular co-ordination and is currently not routinely funded by the NHS, but this study found compared with other interventions in nearly 600 patients with chronic back pain it was more effective than exercise or massage alone.

A combination of six sessions of Alexander technique and exercise was almost as effective as 24 sessions of Alexander technique, but adding exercise to 24 sessions of Alexander technique had no additional benefit.

Professor Paul Little, lead author and professor of primary care research, said his study showed Alexander technique was a low-cost alternative to currently available care and was also effective when combined with moderate exercise.

‘If I had chronic pain I would be something I would very seriously invest in. This is a big study and the patients have been followed long term, so it is pretty unlikely to be an aberrant finding.

‘GPs should consider recommending Alexander technique to their patients,' he said.

Professor Little, who is also a GP in Hampshire, said he was currently working on a cost-effectiveness analysis that he hoped would lead to a recommendation from NICE for Alexander technique, encouraging PCTs to fund the treatment on the NHS for patients with chronic back pain.

Dr Graham Archard, a GP in Christchurch, Dorset, and an author of the book 'A Simple Guide to Back Pain' said the study should be considered by NICE, but warned against any rash conclusions on the back of one study.

‘I am very much in favour of any medication or treatment that alleviates symptoms, but I have had some of my patients who have found Alexander technique very beneficial, but others who have found it no good whatsoever.' he said.

The study is published early online in the British Medical Journal.

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