Some of you may have seen a news article on the BBC recently which said that posture exercises using the Alexander technique had been shown to help people with lower back pain. The BBC were reporting on a study that had just been published in the BMJ that looked at a large sample of people with chronic lower back pain (pain that had lasted more than 6 weeks).
The study design is a bit complicated but this is what they did. They spilt the group of 579 people up into 5 different groups. Each group was allocated one of these treatments:
1. Control – advice to stay active
2. Alexander technique 6 lessons
3. Alexander technique 24 lessons
5. Exercise with some support from a practice nurse to help with behaviour change.
In addition to this all the groups except the control were given exercises after the first treatment was completed.
The results showed that all the participants did better than the control group, there was a significant improvement in all the different treatment groups but the group that did the best at one year was the group that had posture exercises using the Alexander technique for 24 sessions. This was closely followed by the Alexander technique for 6 sessions combined with exercise, there was little to choose between the 24 weeks and the 6 weeks with exercise at one year.
I am very interested in this as for a long time I have been teaching my patients posture exercises to help them better manage their back pain. I teach about correct posture and nearly always start my treatment programme with suggestions for how to better manage posture.
The Alexander technique is a very through retraining programme to help you learn about and alter your movement patterns. I wonder if the short session of advice I offer to my patients is as useful? I would love to see a study compare a short postural advice session and exercise with the Alexander technique.
I am pleased that again there seems to be some reinforcement for the need to address the management of back pain. I am also pleased to see exercise playing an important role. If I find a patient is not responding well to my treatment I might suggest they try this type of treatment in the future.
Little P, Lewith G, Webley F, et al.Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ 2008; 337; a884
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