Archives

Lordosis

Lordosis

Lordosis is the term given when there is an exaggeration of the natural curve in the lumbar region of the spine, which creates an over-arched lower back.  Some people are born with this condition but many  people develop it over time. Factors such as poor use and posture, and the wearing of high heels can contribute to this condition. For instance, many pregnant women carry their ‘bump’ – their babies – with a very pronounced curve in their lower backs, which could often be reduced if they used their bodies differently. They may then go on to carry the baby in their arms in such a way that they continue to increase the lumbar curve and then they experience lower back pain.

Lordosis can often result in the compression of the intervertebral discs between the lumbar vertebrae, causing  lumbago and even the severe pain of a prolapsed disc (slipped disc).

This sculpture at Kew Gardens shows a somewhat exaggerated lordosis in this young woman. In a real person, this pronounced arch may reduce when she stood upright or sat down, so the curve may lessen but frequently, if this is a way of habitually using the body, it tends to get fixed so lordosis develops into a condition, not just an arching movement.

Sculpture illustrating lordosis

Sciatica

Sciatica is pain in the sciatic nerve, the largest nerve in the body, which travels through the pelvis and then branches out into each leg. Sciatic pain radiates into the buttock and the back of the thigh, sometimes being felt through the whole leg and foot. Sciatica can be quite disabling, particularly if it is accompanied by numbness and weakness through the limb, which can last for several weeks.

The main cause of sciatica is the prolapsing of an intervertebral disc, a slipped disc, which then presses on the nerve at the spinal root. Occasionally, this comes about through an organic problem such as a tumour pressing on the nerve, so it is important to consult a doctor. Alexander Teachers are not able to make a diagnosis, unless also trained as a doctor.

Fortunately, the more common causes of sciatica are factors such as muscle spasms, prolonged habits of mis-use, or accidents. For instance, the habit of standing mainly on one leg, which distorts the alignment of the pelvis and puts pressure on the lumbar region of the spine, can reult in compressing the sciatic nerve. These can contribute to the condition by distorting the spine in a way that creates a downward and often uneven compression of the discs, which then lose their ability to act as shock absorbers between the vertebrae. However it is possible in Alexander lessons, providing damage to the discs is not too great, to learn how to inhibit such mis-use and to move in a poised way, so that the spine is better aligned and more freely lengthening. In this way, pressure on the discs is reduced, so many people can learn how to free themselves from the pain associated with sciatica.

For an illustration of the sort of mis-use which may well contribute to sciatica, you can visit my Blog to see a sculpture by Francesco Massina.

Scoliosis

Scoliosis

Scoliosis is a condition in which the spine twists and is curved over to one side.  Predominantly, this bend happens in either the thoracic or lumbar regions of the spine.

Scoliosis may be be a comparatively temporary but often painful problem, caused by such things as an unevenly tilting pelvis, an accident resulting in spinal injury, a prolapsed disc or general mis-use.  The condition may also cause sciatica.  If such a scoliosis is left unattended, the postural changes may become habitual, leading to long term pain and problems. However, by learning and applying the Alexander Technique, such an outcome can often be avoided.

Some people’s spines become distorted during development in the womb, so are born with congenital scoliosis.  Another cause is nerve and muscle disorders such as spinal cord injury and cerebral palsy, which can lead to neuromuscular scoliosis developing.

The most common type of scoliosis is when it develops later in childhood. The spine can deteriorate progressively whilst bones are still growing, becoming severely distorted. The cause for this idiopathic scoliosis is unknown but there may be a genetic component to the condition.

The spinal curvature of scoliosis often causes pain in the back and legs and people can find it difficult to stand up straight. Sometimes the spine tries to compensate for the curvature by creating a second bend in the opposite direction, thus creating a sideways S shape in the spine and torso.  In extreme cases, surgery may be required to straighten the spine.

It is important that juvenile scoliosis is treated early on, to reduce the impact of the condition.  Over the years, wear and tear of the joints and intervertebral discs can result in degenerative scoliosis, or adult onset scoliosis. If there has also been overuse and misuse of the body for years, this will exacerbate the condition.  Alexander Technique lessons can help people reduce the discomfort and pain that scoliosis can cause and importantly, can help both children and adults to minimise the deterioration of the condition.

Repetitive Strain Injury (RSI)

Repetitive Strain Injury, Overuse Syndrome or Work Induced Upper Limb Disorders

These are all general terms that cover a variety of overuse injuries to muscles, tendons and nerves, predominantly of the forearm, wrists and fingers. Some of the conditions considered to be overuse syndromes, are bursitis, carpal tunnel syndrome, rotator cuff syndrome, tendinitis and tenosynovitis.

RSI is an increasingly common condition that affects many people who, for instance, use machines that vibrate constantly, play a racket sport, use a keyboard or play a musical instrument. Such activities require repetitive movements of the fingers and wrists, often at speed, for hours on end. One pupil recently told me that her tendinitis came after spending a whole day weeding her garden, which had involved her twisting and pulling on the weeds in a repetitive way for hours on end.

A recent report on the BBC news quotes Professor Peter Buckle, University of Southampton, as stating that his research has shown that ‘In some populations that we’ve studied, between 22% and 40% of people have evidence of RSI’. These figures are rising, with approximately 115,000 people in the UK having some form of RSI, which costs the economy 300m per year.

Symptoms

The symptoms of Repetitive Strain injury are pain, weakness and tingling in the muscles and joints of the fingers, wrists and forearms. These symptoms tend to worsen over time if the condition is not addressed and treated. Initially the discomfort may only be experienced for short periods, during the activity that initiated the condition. This is the point at which changes need to be made in the person’s habitual manner of use and probably in their conditions of work, so that some of the damage can be healed and the condition halted before it gets worse.

If the person with RSI ignores the early warning signals and continues to end gain, working or practising in the same habitual way, the pain can gradually become continuous, chronic and disabling. At this point, it may be extremely hard to heal the condition. This really is a case of prevention being better – and easier – than cure.

Unfortunately, many people do go on working without addressing the problems they are experiencing. BAPAM (the British Association for Performing Arts Medicine) is familiar with this problem in musicians, who are often afraid to ask for help in the early stages of RSI, in case they are seen as unfit to play and thus lose work. However this unwise decision often leads to severe problems developing and by the time performers eventually seek help, they find they have to stop playing, sometimes for months and occasionally completely.

As Elizabeth Langford so clearly puts it in her informative chapter which discusses how the Alexander Technique can help people with Repetitive Strain Injury ‘You… need to become receptive to warning signals before they become pain, before they become strain, before they become injury’

Elizabeth Langford ~ Mind and Muscle p.209

Causes

The causes of RSI are many and often interact to contribute to the condition. The most significant of these is perhaps the least recognized by the medical establishment: the manner in which we misuse ourselves so that we create movement habits and poor posture that interfere with our functioning and strain our musculoskeletal system.

A young man came to me for Alexander lessons, who had developed pain in the left shoulder. This had developed as a result of trying to teach himself to play the double bass, without having any lessons from a bass teacher or thinking about his body use whilst playing. He was twisting around and lifting his left shoulder, in order to reach over the instrument to the strings. He had also been over-practising and repeating phrases for hours on end, whilst using this tense and distorted position. This sudden increase and over-use of his muscles was bringing about the shoulder pain – and he had only been learning the instrument for one month. Without a change in his use and playing technique, it is likely that he would soon be unable to play because of the pain.

So some of the causes of RSI are:

  • Overuse and misuse of the same set of muscles whilst performing the same activity over and again, so that they become fixed and tense and the circulation becomes sluggish. Sometimes this can be linked to feeling ‘bored stiff’.
  • An end gaining, perhaps driven attitude towards work, which usually goes hand-in-hand with an intense manner of performance and overuse, along with a reluctance to take short breaks during the working day, let alone holidays. These habits will tend to escalate with high stress levels, so the person’s mind and body cannot unwind and free-up without help.
  • Poorly designed or badly placed equipment, or a musical instrument that is held in a way that hampers movement, can contribute to the condition.
  • Even with good ergonomically designed equipment, many people still have poor posture and general misuse which contracts muscles and reduces the capacity of the body to function properly. These muscle tensions can irritate the nerves and build up to RSI.
  • Over-long working hours and a too-heavy schedule put too many extra demands on people, so that they become exhausted and far less able to take care of their use whilst working and performing.
  • Cold temperatures can contribute to the condition – for instance, working whilst sitting under the cold draft from an air conditioning unit.
  • High stress levels can result in extra tension and ‘feeling down’ which can interfere with our poise, restrict our movements, create mis-use and sometimes lead to RSI.

In her book ‘Save Your Hands!’ Lauriann Greene describes how she had to give up her career as a massage therapist, because her training had left her with painful RSI. Greene also saw that other therapists had similar problems. This had come about largely because of institutional end gaining, with tutors omitting to consider the means whereby trainees were working.

Greene states that As I read texts on massage, it struck me that the emphasis was always on ensuring the comfort and safety of the client, not the practitioner’ p 4. Greene sees that an important part of helping other massage therapists to avoid such an outcome is to encourage them to work on their body alignment and to notice what is going on in their own body whilst they work, saying Movement centered disciplines like… Alexander Technique teach students how to move their body in less stressful ways to encourage overall health’ and ‘ can be extremely helpful for massage therapists’

Lauriann Greene ~ Save Your Hands! p 105.

Treatment

Medical treatment for Repetitive Strain Injury includes rest, anti-inflammatory medication, pain killers, steroid injections and physiotherapy, all of which treat the symptoms but do little to address the habits of mis-use the person has which usually causes the problem.

The NHS Direct Website also states that learning the ‘Alexander Technique… may help’ and the RSIA Website goes further, saying ‘The effectiveness of the Alexander Technique is well documented and has been the subject of several scientific studies. It is increasingly recommended by doctors, and many medical insurance companies will pay for lessons if these are prescribed by a consultant’.

It is important to remember that no amount of pain killers will actually change the condition. The work situation needs to be altered and the old habits, behaviours and thought patterns that helped cause the condition need to be inhibited, so that a new way of working may be learnt which puts less strain on the body. As can be seen from the testimonial at the end of this article, the use of the Alexander Technique can transform the way a person approaches their work, so that conditions such as RSI can be greatly alleviated.

A few simple things that you can begin to do which can begin to help RSI, particularly if you are using a computer, are listed here:

  • Make sure that furniture, equipment and instruments are well placed and suitable for your body size and movements. Place your monitor at eye height. If necessary, order different furniture and use voice-activated software until you learn how to change the way you compute and work. Vary the type of mouse you use, so that you use different sets of muscles.
  • When using a keyboard, use your arms with your elbows at a 900 angle and your feet resting comfortably on the floor, with your knees also at a 900 angle. If necessary use a footrest.
  • Take regular short breaks and vary the tasks and range of movements made, to help re-balance muscle usage. Make use of software that monitors your computer use and indicates when it is a good idea to stop for a while. Use the break to move around, let go of tensions and free-up your muscles.
  • Most important is to pay particular attention to your use and the means-whereby tasks are performed. This is most easily done with the help of an Alexander Teacher. Make sure you are poised, your movements are free and that you inhibit any urge to resort to being driven, contracted and tense whilst working.
  • Take regular exercise such as walking, which will help your general muscle tone and circulation, particularly if you pay attention to the manner in which you walk, so that you avoid creating different patterns of tension and allow your body to work freely as you move. (A workout at the gym may make matters worse if you push yourself too hard and end gain)
  • Avoid sitting in draughts and keep warm enough.

An interesting case study by Pedro de Alcantara, an Alexander Teacher who describes working with a pianist with RSI, is to be found in his book Indirect Procedures (p 22).

By taking a course of Alexander Technique lessons, someone with RSI who is willing to allow themselves to change their way of working can learn how to manage their condition, let go of entrenched habits of misuse, reduce and sometimes even eliminate pain in the process. I have taught several people who have done just that and importantly, they are also able to use the Technique to help prevent the condition from recurring.

“When I first visited Hilary I was in constant pain and could not even hold a cup of tea, let alone play the guitar. None of the medical professionals I visited had offered me a diagnosis, much less a cure. After my first session the pain was greatly relieved and six months later I’m playing the guitar again, albeit very carefully…..”

Andy Hopkins ~ Composer and Guitarist

You may read the full testimonial here.  Andy is now able to work full time as a composer for TV and film, using computers and many musical instruments plus coping with frequent deadlines and ‘rush jobs’.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) comes about if the sensitive median nerve is compressed as it passes from the forearm through the narrow space of the carpal tunnel in the wrist, before entering the hand. The size of the carpal tunnel is variable, it is a rigid structure which also houses the nine tendons which bend the wrist and fingers. So space is limited and if the tendons are tense and swollen from overuse, they can irritate or put pressure on the nerve.

Carpal Tunnel Syndrome is often included under the umbrella term of Repetitive Strain Injury. Women are more prone to the condition than men and it is mainly found in people aged between 40 and 50.

Symptoms

The symptoms of carpal tunnel syndrome can affect one or both hands and include pain, numbness and tingling in the thumb and three fingers. The little finger and the outside of the fourth finger are not affected. The pain sometimes radiates up into the forearm and may be worse at night, or during specific activities such as driving, where the steering wheel is often held with great tension, with the wrist bent at an angle.

CTS is progressive, and as impulses gradually reduce in the median nerve, there can be a loss of sensation, then weakness in the thumb with a resulting loss of grip. People with the condition may lose some manual dexterity and experience some clumsiness when carrying out tasks which require fine movements, such as playing a musical instrument or sewing.

Causes

There are many factors which can contribute to the median nerve being compressed. Some of these you can have some control over and would be wise to avoid, so that you look after your hands. Many of these habits of mis-use are subtle, hard to recognize and change but this process would be made easier with the help of an Alexander Teacher.

Some of the causes of CTS are:

  • Activities which require constant flexion and extension of the wrist can lead to a build up of fluid within the carpal tunnel, which creates congestion, putting pressure on the median nerve. If such movements are done with tension and mis-use, or the wrist is held for long periods of time bent at an angle, for instance whilst pushing a heavy pushchair, the pressure on the median nerve will be increased.
  • Working with a negative attitude, or a tendency to be driven, will increase the likelihood of such tension and mis-use.
  • The combination of flexion, plus pressing the wrist onto a hard surface such as a desk whilst computing, can be particularly damaging.
  • Constantly vibrating power tools can cause carpal tunnel syndrome and this is a recognized industrial injury.
  • Pregnancy, obesity and conditions such as diabetes may also cause water retention in the wrist.
  • Arthritic conditions, fractures and dislocation of the wrist can cause inflammation and swelling.
  • Hormonal changes that occur during the menopause, with thyroid problems, or with the combined contaceptive pill, can contribute to the condition.
  • Cysts or swelling of blood vessels and tendons are likely to cause congestion and inflammation.
  • Bending and contracting down over work surfaces such as a desk, so that extra weight and pressure is put on the hands and wrists.

It is possible for similar neurological problems to be experienced in the hands as a result of certain diseases, from lesions, or pressure being put on the upper section of the median nerve in the neck or the brachial plexus. Such problems may come about, for instance, after accidents or from poor posture and general mis-use. For instance, holding the neck forwards with tense, rounded shoulders, which can put pressure on a variety of nerves.

Wrists flexed

Wrists, when flexed for long periods, can compress the median nerve

Prevention’s better than cure

Prevention is always better than cure, so being aware and looking after the way you use yourself whilst performing tasks, may help you avoid carpal tunnel syndrome or other forms of RSI altogether.

You can begin by asking yourself, what is your attitude towards work? Why are you so tense – are you stiff with boredom? Or are you intense, always on edge, perhaps feeling driven, so you think you need to work harder and faster than others, without taking any breaks? If so, observe how much pressure you put on yourself mentally and physically. How do you use your hands, wrists and arms – do you recognize how much tension you create in them? Maybe you don’t need to live and work like that.

Take regular breaks and use them to calm down, undo the tension in your arms and allow your wrists to freely lengthen as much as possible. Try out a wrist support and see if it helps reduce the pressure whilst computing. The more aligned and poised you are when you work, the less of a downward drag and pressure will be put on your arms, allowing them to move more easily. If your furniture and equipment is hampering your ability to work in a poised manner, make sure some changes are made so that you have a chance to look after yourself. If you can no longer find a way of freeing-up, then you would be wise to seek the help of someone like an Alexander teacher who can work with you on these issues.

If CTS does begin to develop, the sooner carpal tunnel syndrome is recognized and action is taken, the more possible it is to stop the condition from getting worse. Left untreated, there can be permanent damage to the median nerve.

Treatment

Medical treatments for carpal tunnel syndrome generally treat the symptoms, not the cause and may include: anti-inflammatory drugs, cortico-steroids and ultrasound to reduce pain and inflammation; diuretics to reduce water retention; in severe cases, surgery is possible. Physiotherapists may provide wrist splints, to rest the wrist and maximize the space in the carpal tunnel and they may also teach patients some finger exercises. If someone is obese they will be encouraged to lose weight, in order to reduce fluid retention and therefore put less pressure on the median nerve.

Sometimes, temporary relief may be found by massaging or shaking the hand, which will free the wrist for a while. However, if the underlying causes are not addressed, the pain will return.

In Alexander Technique lessons, we do not treat people but pupils are helped to become aware of their general thought patterns, tension, poor posture and mis-use that generally underlie the causes of CTS and other conditions. Someone with CTS could also be helped to recognize and let go of, any specific habits that involve holding the wrist at an angle, which would irritate the condition. In this way the pupil can begin to modify the way they move and their perceived need to work so intensely, for instance. As a result of these changes, they will begin to free up their muscles and avoid compressing the median nerve.

If we take the example of a guitarist who has a habit of bending the wrist acutely whilst plucking his instrument, this could compress the median nerve and cause carpal tunnel syndrome. Such a manner of playing often goes with the guitarist curling down over the instrument somewhat intensely, in order to see his hands, to make sure he gets it right. This downward thrust can put pressure on muscles and nerves in the neck and shoulders, plus create a twist in the torso, all of which could contribute to other problems and interfere with his playing.

An Alexander teacher would help the guitarist to become aware of such habits and attitudes, so that he could learn to inhibit them. This would take time but would be very worthwhile. He would gradually become calmer and more poised, allowing his arms and wrists to be free and less angled whilst playing. These changes would help reduce the pressure on the median nerve and thus the pain of CTS. It would also enable his arms to move around his instrument more freely and fluidly which will surely help his music making.

Alexander Technique can help Low Back Pain

Over the last hundred years, many people have found that learning the Alexander Technique is an effective method to use in order to reduce chronic and recurrent back pain and to enhance other aspects of musculoskeletal health.

In August 2008, a major research paper was published in the British Medical Journal, the BMJ, that supports this theory. The results of the ATEAM trial have been heralded in the media and the implications of the research have been discussed by many eminent medical professionals, by Alexander Technique teachers and by various health organisations.

I will only outline the main findings of the research here but if you are interested, you may find the full research article via the link to the BMJ below.

ATEAM Research Trial

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain

The ATEAM research trial was funded by both the UK Medical Research Council (MRC) and the NHS Research and Development Fund.

Professor Paul Little, who is an MRC research fellow in Primary Care, lead the research trial from Southampton University along with Professor Debbie Sharp, Professor of Primary Care at Bristol University. The Alexander Technique and the interests of the Society of Teachers of the Alexander Technique, STAT, were represented by Kathleen Ballard and Frances Oxford, who were involved in the ten years it took to plan and complete the research and were part of the trial management team, which also included a Professor of Health Psychology amongst others.

Details of the Research Trial

The research compared the effectiveness of different treatments for low back pain. The Alexander Technique component was taught by 59 STAT registered teachers, including myself, who had been teaching for three years or more. Through 1:1 lessons, the teachers used a combination of gentle hands-on guidance and verbal instructions to help the participants recognise and then avoid movements and behaviours that resulted in back pain as they sat, stood and walked around. Participants were also taught a lying down procedure which they were asked to practice daily.

The participants taking part in the trial were 579 NHS patients from 64 GP surgeries around the UK, all of whom had chronic or recurrent, non-specific low back pain. These participants were allocated groups: 144 received normal GP care and advice and they formed the Control Group; 147 were given 6 massage sessions; 144 had six Alexander lessons; 144 had 24 Alexander lessons.

Half of the participants in each of these groups were allocated, on a randomised basis, a GP prescribed prescription for aerobic exercise in the form of 30 minutes brisk walking per day, or something similar, plus some behavioural counselling from a practice nurse.

Main Outcome Measures

The Roland-Morris Disability Scale was used at three months and one year, to establish the number of activities that participants found to be impaired by the levels of back pain they experienced. This scale is so widely used that it has become the ‘industry standard’ outcome measure used to establish levels for back functioning and the levels of disability that chronic back pain creates.

The number of days that each person experienced pain was also recorded.

Results 

The results of the ATEAM trial are exciting for both Alexander Technique teachers and for the many people who suffer from lower back pain but have not known, until now, how to help themselves effectively with the condition.

Of the various groups in the trial, the greatest statistically significant long-term improvements were shown in those patients who took 1:1 Alexander Technique lessons, compared to those who were allocated either 6 sessions of classical massage or standard GP treatment.

The group who received massage showed some level of improvement for three months but did not sustain this at one year. The group that were prescribed exercise alone did show a slight improvement at one year but this was significantly less that the groups that took Alexander Technique lessons.

Just six 1:1 lessons in the Alexander Technique from a STAT registered teacher, followed by a prescribed exercise programme, resulted in some improvements that were maintained one year later. This improvement level was 70% of that shown in the group who took 24 A/T lessons. It is of interest that the exercise was prescribed after patients had already taken some A/T lessons, so they could apply their A/T learning and improve the way they used their bodies during exercising, which would also have helped their backs and their overall bodyuse.

The group that showed the greatest long term improvements were the people allocated 24 individual Alexander Technique lessons. This group, one year later, showed the most reduction in days they experienced back pain, along with the greatest improvements in functioning and in the quality of their life. The average number of days per month that they experienced back pain dropped from 21 days to 3 days per month, whilst the average number of activities that were limited by their low back pain dropped by 42%.

That is good news for anyone with chronic back pain. The addition of some prescribed exercise, to be taken after the Alexander Technique lessons, made no significant improvement to this group’s level of back pain. This suggests that their general level of use and co-ordination, after having 24 A/T lessons, had improved so much that exercise could offer no extra benefit to them.

Importantly, there were no adverse effects reported during the research trial by the 288 subjects who were allocated Alexander lessons. Between them, these participants had 2,400 A/T lessons.

Another significant result was that the long-term improvements in back pain, functioning and quality of life that were shown in these A/T groups, is unlikely to be due to any placebo effects resulting from the subjects receiving individual attention and touch with the hands-on work they received in their A/T lessons. The researchers concluded that the statistically significant improvements that were shown after one year, came about because people had learned the Alexander Technique and had applied it in their lives.

Professor Little said that “This is a significant step forward in the long-term management of low back pain. The results of this study reveal that the Alexander Technique can help back pain. It probably does this by limiting muscle spasm, strengthening postural muscles, improving co-ordination and flexibility and decompressing the spine. This means that patients could have fewer activities or functions limited by back pain.”

Conclusions

The conclusions, as set out in the research paper were:

‘One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons’.

Or simply, quoting this popular author (who was not part of the research programme):

‘The Alexander Technique works… I recommend it enthusiastically to anyone who has neck pains or back pain’ ~Roald Dahl

Alexander Technique Lessons during the ATEAM Research Trial

As one of the STAT registered teachers selected to take part in this research, I have been awaiting the results of the study with some interest.

The teachers who took part in the research were asked to give verbal instructions to the patients, alongside their hands-on teaching, which is something I always do when I teach. We only taught the patients on a 1:1 basis, so that they could have our undivided attention, which is the standard and best way to learn the Technique. Teachers were also asked to complete report sheets about the range of A/T procedures included in each lesson and about the progress of the pupil. We sent the reports to the research team, who analysed them and included the information in the research data.

Pain is a good motivator and I found the patients that I taught on the ATEAM research trial were keen to learn the Technique and to take it on board, in order to relieve their back pain. However it was, and is, strange to refer to people as ‘patients’ as we normally refer to the people we teach as ‘pupils’. The Alexander Technique is a learning procedure of psychophysical re-education, not a treatment as such. The learning process is a partnership between teacher and pupil, requiring the pupil’s active participation in lessons and in using what they learn of the Technique, during their everyday life.

Traditionally, STAT has recommended that a course of at least 20 Alexander lessons is required, in order for people to bring about significant changes to their use and to develop a tool that can be used throughout their lives. Whilst this is still true, the ATEAM research trial makes it evident that even just six lessons can be worthwhile and that people can find a significant level of relief from back pain if they learn, practice and apply the Alexander Technique in their daily lives.

The occasional pupil that comes to me for Alexander lessons who just wants me to ‘make them feel better’ each lesson, does not progress in their learning. This is unfortunate, because they never really learn the Technique properly and therefore see few changes taking place in themselves. However, when pupils do become actively involved in their learning and apply the A/T to their everyday activities outside lessons, they frequently make profound changes to the way they act and move in the world so they reduce the number of days they have back pain and other problems. Importantly, Alexander teachers have also seen that pupils can also learn to avoid the recurrence of such pain.

It is gratifying that the improvements in low back pain that A/T teachers have frequently seen in pupils over the years, to whom we have given Alexander Technique lessons, has now been given some scientific validation. It is to be hoped that the ATEAM Trial will encourage further research into areas where experience has shown that the Alexander Technique can also be used, to help people with conditions such as acute back pain, RSI and breathing problems for instance.

Dr Stephen Vogel, head of research at the British School of Osteopathy and a member of the NICE guideline development group, said the ATEAM research was an “unusually good piece of work”, which is praise indeed. Dr Vogel suggested that the Alexander Technique might be considered in the NICE guidelines on back pain, which will be published in 2009, if it fell within the scope of the NICE guidance. (Pulse ~ 21 August ’08)

If the Alexander Technique could become available through the NHS, and if even more insurance companies would cover the cost of lessons, this would be very much welcomed.

 

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain ~ Published 19 August 2008, doi:10.1136/bmj.a884

BMJ 2008;337:a884

 

“I started Alexander Technique lessons with Hilary during a very stressful period at work when I was experiencing low back pain and sore shoulders. Now, nine months later, I attend only once a month and have no back pain. More importantly, I feel I have learnt to use my body in a different way and one in which I have greatly decreased my chances of developing immobilizing disability as I get older. I have found Hilary to be a sensitive, conscientious and effective teacher”.

Frankie (Journalist and Singer)