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NICE to consider Alexander Technique back pain findings

By Nigel Praities

NICE is set to consider ‘unusually good' results from a landmark trial finding the Alexander Technique has dramatic benefits for chronic back pain.

The move raises hopes the institute will open the door to access on the NHS to the technique – which costs £30 a session – and address a severe shortage of instructors.

The Alexander Technique helps patients improve postural tone and muscular co-ordination – and is not currently funded on the NHS.

But the research, published online by the BMJ, found 24 sessions of the technique cut days in pain by 86% in a year compared with usual care.

Researchers on the study said they were working on a cost-effectiveness study aimed at persuading NICE of the benefits.

Study leader Professor Paul Little, professor of primary care research at the University of Southampton, said GPs should consider recommending the Alexander Technique to their patients. ‘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.'

The results of the trial, whose initial findings were revealed by Pulse two years ago, are likely to be considered in NICE guidelines on back pain due for release next year.

Dr Steven Vogel, a member of the NICE guideline development group and head of research at the British School of Osteopathy, said the research was an ‘unusually good piece of work' and would be considered if it fell within the scope of the guidance.

‘It is great to have some evidence that posture plays a role in back pain,' he said.

The study, of nearly 600 patients with chronic lower back pain, found 24 sessions reduced disability by 42% compared with usual care after one year, and were 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.

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.

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