News Flash: New clinical trial supporting Alexander Technique’s effectiveness in reducing chronic neck pain is published.
On 2nd November 2016, The journal ‘Annals of Internal Medicine’ published a research entitled “Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomised Trial”. The key findings show patients who attended Alexander Technique sessions had significant reductions in pain over the 12 month period.
The study recruited patients from the vicinity of York who had neck pain for three moths or more. The average pain duration was six years.
517 patients participated over 12 months. The impressive number of patients involved and the significant duration of the study led the authors to conclude the results were “statistically robust”, i.e. there was a consistent enough result to remove any doubt about the validity of the findings.
All participants received conventional care, including doctor’s visits, physiotherapy and medications. Participants were randomly assigned into three groups who receptively received conventional care only, 12 acupuncture sessions of 50 minute or 20 Alexander Technique sessions of 30 minutes. Each additional modality was allowed 600 minutes.
The additional intervention were completed within the first 4 moths of the trial. 20% of at the acupuncture group and 9% of the Alexander Technique group paid their own way to continue their sessions beyond the allocation. The average attendance was 10 out of 12 for Acupuncture, and 14 out of 20 for Alexander Technique. Data was collected at 3, 6 and 12 months from 150 acupuncture patients, 146 Alexander patients, and 146 receiving only the usual care.
Patients taking Alexander Technique lessons and those receiving acupuncture both experienced more than a 30% reduction in their chronic neck pain. A 25% reduction in pain is considered clinically significant. As Time points out in their coverage of the study, physical therapy and exercise lead to only about a 9% reduction in pain. Neither alternative modality appeared to perform better than the other. The scale used for these assessments was the Northwick Park Questionnaire (NPQ).
The lead author of the study was Hugh MacPherson of the University of York’s Department of Health Sciences in the UK. Dr MacPherson acknowledged that there is unavoidably some placebo effect with any additional intervention, but concluded that the long standing improvements reported indicated the placebo effect was not significant.
“Treatment was completed at around four to five months after entering the trial. Then at 12 months, well after the end of treatment, we found sustained reductions in pain of around 30 percent on average for both those receiving acupuncture or Alexander Technique lessons.”
“Single interventions for chronic neck pain do not on average provide long-term benefits, so the positive results with acupuncture and Alexander Technique lessons were surprising. Most trials looking at neck pain show the benefits wear off after a time, but we were finding these [participants receiving Alexander Technique or acupuncture] sustaining benefits.”
In response to the study, Stuart McClean (of the University of the West of England in Bristol, U.K), a doctor not involved in the research, commented that chronic pain is complicated by fear of movement, and that patients don’t know how to manage their own pain. He stated that Acupuncture and Alexander Technique help patients change past behaviours and habits and lead towards improved coping strategies and self-care.
“That might be because treatments like the Alexander technique and acupuncture try to engage patients in their own recovery through lifestyle changes that typical care doesn’t” commented Dr MacPherson. "The patients that embedded the changes that they were asked to make by their acupuncturist [or Alexander Technique teacher] did better.”
While the treatments themselves had an effect, what the patients learned about integrating the lessons of acupuncture or the Alexander technique into their lives is what likely made a difference over the long term, he suggested. "If you are not getting a benefit from your traditional therapy and you do not want to keep taking medication and you want a more self-help physical therapy that will involve long-term changes, then acupuncture and Alexander technique would be good options,".
The authors concluded no associated contraindications for any intervention.
The research was funded by a grant of £720,000 from Arthritis Research UK
This is the first study of its kind to be published since the ATEAM study of back pain published in the British Medical Journal in 2008. That study found that back pain sufferers experienced significant relief from as few as 6 Alexander Technique lessons.
Sources, media representation and relevant links:
The most detailed report is at Medscpe:
The original publishers, Annals of Internal Medicine prepared a summary and abstract, with links to fhe full report for subscribers:
Free summary: http://annals.org/article.aspx?articleid=2467959
The Sun Daily: http://www.thesundaily.my/news/1604717