Alexander Technique Body Movement Method Works Better than Other Therapies for Back Pain, Even a Year Later

If you suffer from chronic back pain, you may want to consider a century-old, non-invasive, drug-free treatment method called the Alexander technique, which reeducates people on how to support and move their bodies. Recently an English study involving 579 patients with back pain put the Alexander technique to the test and demonstrated that it was effective and provided sustainable relief.

THE STUDY

Researchers established four groups of patients — one took six Alexander technique lessons… another took 24 lessons… a third group had massage therapy only… and the fourth group had what the study team called “normal care.” (Normal care was defined as care that would be offered by a general practitioner, and could include pain medications, non-mandatory referral to physiotherapy, etc.) All four groups were further divided in half, with one half walking briskly for 30 minutes a day and the others not exercising at all. Participants answered questionnaires about pain and function improvement at three months and one year. Results: The two Alexander technique groups reported significantly reduced back pain and improved functioning, including after 12 months, while there was little change in the massage and normal care groups. Among those who took just six lessons but who also did brisk walking, improvement was almost as great as those who took 24 lessons but did not exercise.

To find out more about the Alexander technique, I called Hope Gillerman, who has taught classes at physical rehabilitation centers and had a private practice in New York City for more than 25 years. Methods like acupuncture can offer immediate pain relief, notes Gillerman, but people with back pain also need a long-term, self-healing regimen — and that is what the Alexander technique is. Most back pain comes from incorrect posture, poor body mechanics and excessive muscle tension, which increases when people are fatigued, angry, upset or in one position for a long time. Under duress, tension automatically builds in the back of the neck and the shoulders, pulling the heavy head downward into the spine, which causes compression. The fact that the pain becomes chronic further exacerbates all of these problems, Gillerman points out… since pain is upsetting and stops people from doing things and moving as they normally would, people develop more harmful habits. The Alexander technique can be effective because it addresses and helps to correct not only the cause of the injury, but also those harmful habits brought on by the pain.

HOW IT WORKS

At the heart of the Alexander technique is learning to keep the spine erect and properly supported. Gillerman explains that most people are unstable and “collapsed” through their torso, and hold and move their limbs in a rigid and stiff pattern. Without proper muscular support, the spine compresses, harming joints and tissues.

Here are three ways Gillerman helps her students envision what to do…

  • She instructs students to envision their body as a tree — the trunk (the torso) rooted and stable, freeing the limbs to move easily. Students learn how different it feels to move with the torso thus stabilized and supported, with posture that lengthens the spine and opens the spaces between the vertebrae, enabling discs to function as shock absorbers.
  • For further illustration of what proper posture and body mechanics looks like, Gillerman points to elite runners — their torsos don’t move but their legs and arms move constantly, in a powerful yet flowing fashion.
  • To help students better understand the degree of tension they need for proper back support, she has them tightly grip a spoon. They then release their grip slowly until they can comfortably hold the spoon… but not loose enough to let it slip from their grasp. “We teach students how to achieve that amount of tension in their back,” she says.

HELPFUL TIPS

Regular exercise fits well with lessons in the Alexander technique, but the kind most people do at the gym, working on one muscle at a time, may not be effective. Abdominal strength is key, but workouts should include the muscles in the back and legs, not just pelvic muscles, Gillerman says. Crunches, for example, train the abdominal muscles to flex the torso — this is useful when you get out of bed in the morning, but does not train the abdominal muscle to keep the spine lengthened. Instead she says, people should exercise to train their muscles to lift and stabilize the spine, not crunch. Vigorous walking, with arms swinging, abdominals pulled in, is great for this and is an excellent way to practice the new body mechanics students learn through the Alexander technique.

Gillerman says that many students find Alexander technique lessons so pleasurable and relaxing, they take them for months or even years — but the real purpose of the technique is as a tool for change. People often feel better after just one lesson, but it is important to take a full introductory course of about 10 lessons over two to three months. Those who need yet more pain relief should take an additional six months of lessons. The technique works by changing neuromuscular patterns — the bad habits you have formed — and that takes time. “In the beginning students don’t feel like themselves because we take away their familiar habits,” says Gillerman. “When students get to the place that the old habits are the ones that feel wrong, they are ready to self-regulate.”

Gillerman suggests doing at-home exercises to help make the subtle adjustments that correct posture and change habits and reinforce new self-care techniques. Here is one to try that may soothe your back pain…

  • Lie down on your back on a mat or carpet, with your head resting on a telephone book.
  • Bend your knees, bringing your feet close to your hips.
  • Place your hands on your rib cage, elbows pointing out to the sides of your body.
  • Notice your breathing. Practice making your exhalation longer than your inhalation.
  • Visualize images that help you release muscle tension — for instance, your back melting into the floor… or the crown of your head sliding away from the shoulders. These are excellent ways to help correct the common problem of letting your skull sink into your neck.
  • Do 10 to 15 minutes every day, or more often if you need to relax.

You can find a qualified Alexander technique trainer by going to the American Society for the Alexander Technique. Costs vary greatly according to where you live and lessons are generally from 30 minutes to one hour. Though insurance does not cover these, Gillerman says that employee flexible spending accounts can be used to pay for them.