How does Alexander Technique reduce chronic neck pain?
Jeremy Woolhouse
A recent clinical trial published in The Annals of Internal Medicine has produced results concluding that Alexander Technique is effective in reducing pain for those with chronic neck pain. The report on the study doesn’t go into any depth on how exactly the process achieves these results. This article is intended to demystify somewhat just how Alexander Technique sessions have produced such an impressive result in the study.
Working with the whole
Alexander Technique teachers are trained to to work from a set of very deep principles. When a student presents with chronic neck pain, the teacher will base instruction on these principles. Pathological and mechanical conditions are considered from the perspective of how training can progress without posing a threat to these conditions. Alexander Technique however, does not address this directly. Rather, it works indirectly, in accordance with its principles.
The indirect procedure is one reason the authors of the trail (“Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomised Trial”) found “no serious adverse events” associated with Alexander Technique.
Use affects functioning
In any chronic neck pain, or in any other condition, there exists a force working for or against the resolution of pain. FM Alexander described it as “use affects functioning”. The way in which we use ourselves in any activity is what defines “use” in this context. It is the mannerisms, posture, tensions - any habit of poise or movement which influences our coordination. How we move, sit, stand etc all have an impact on the quality of our coordination.
‘Function’ is referring to the effectiveness of our movement or poise for whatever task is at hand. The presence of pain is usually associated with poor functioning. Good functioning is characterised by grace and ease.
An indirect proceedure
Based on this principle, the Alexander Technique teacher will work on improving the way the student uses him or herself. Although the neck may be the focal point of significant pain, Alexander Technique considers it inauspicious to treat the neck in isolation, or to treat it directly. The muscular tone required for positive balance of the head on the neck for example, is highly dependant on the poise of the rest of the body.
Managing habit
The Alexander Technique brings the whole person into a positive balance. This provides more support for the neck and head, and excessive tensions become redundant. In the case of chronic pain, the resting level of tension in the affected area is bound to be not only excessive, but habituated.
Awareness of habitual tension is a significant part of an Alexander Technique training. Through verbal and manual guidance, the teacher will provide a context for the student to become aware of habits of tone, posture and movement. The manual guidance ensures that the student can experience a poise outside of his or her prior experience. The teacher can often guide a student with comfort and ease through a historically painful movement.
The verbal guidance helps the student recognise patterns of thinking which may be contributing to the habituated interference with natural coordination. It provides a framework where the pupil can independently engage in the process which is associated with improvement.
Sustained improvement
This is one of the factors leading to the head author Hugh MacPherson (University of York, UK) to be impressed by the sustained improvement over the 12 months of the study. He said "Most trials looking at neck pain show the benefits wear off after a time, but we were finding these sustaining benefits…. 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.”
Alexander Technique is, true to its name, a technique. It can be employed in daily activity andleads to an improvement in ease and efficiency in any work undertaken. One fully committed to it will find that the technique manifests subtle changes in attitude in any and every task. This is not something which is demanded, rather something which arises naturally as awareness improves.
Re-education
The Technique then, is a re-education of the way we use ourselves. In lessons, the form of this re-education may be in a lying down position, sitting, standing or actively doing some task - be it specialised skill or daily chore. Over a course of sessions, most of these forms will be included, but since each case still gives scope for the improvement of use to improve functioning, there exists great flexibility in the manner of approach. This is a great strength of the Alexander Technique as it means whatever condition a pupil is in, and whatever degree of disability is present, one can still apply the principles to reduce pain.
A unique experience
There is a persistent challenge in describing Alexander Technique to those who haven't had personal experience. It is analogous to describing colour to a blind person. The changes in quality and poise which the teacher works with are beyond the perception of most who haven't had a lesson. There is nothing mysterious about it though, as with training anyone can learn to attune themselves to their own patterns of use and appreciate the changes Alexander Technique trains. The process can be effectively replicated and, as seen in the study, the results are positively quantifiable.
Continue to explore this website to discover more about how Alexander Technique works, but to experience it yourself through the guidance of a qualified teacher will give you the deepest appreciation.
Related posts:
A consideration of the clinical trail on chronic neck pain and Alexander Technique
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