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 Alexander Technique involves hands-on lessons for self-care in
everyday activities, aimed at reducing poor posture, excess muscle
tension, poor coordination, stress or pain.
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, said lead author Hugh
MacPherson of the University of York in the U.K.
“Treatment was completed at around four to five months after
entering the trial,” MacPherson told Reuters Health by email. “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.”
Both methods help patients increase their “self-efficacy,” that is,
their ability to reduce their pain levels using self-care methods
that do not involve medication, he said.
The study included 517 people with neck pain that had lasted at
least three months, and an average of six years. Their neck pain was
rated based on questionnaires at the outset, three months in, six
months in, and 12 months after the study began.
The participants were randomly assigned to 12 50-minute acupuncture
sessions, 20 30-minute one-on-one Alexander Technique lessons, or
usual care, which included prescription pain medication, doctors
visits and physical therapy.
The acupuncture or Alexander sessions were offered within the first
five months of the study, and participants had the option of paying
privately for additional sessions thereafter.
On average, acupuncture participants attended 10 of their 12
sessions and Alexander participants attended 14 of their 20
sessions.
Based on the symptom questionnaires, pain had reduced by more than
30 percent from the beginning of the study to the 12 months point
for those in both treatment groups, the authors reported in the
Annals of Internal Medicine.
There no serious adverse events related to either intervention,
according to the authors.
Stuart McClean of the University of the West of England in Bristol,
U.K., who was not involved in the study, told Reuters Health that
chronic pain can develop through fear avoidance of movement and
pain, but also because patients catastrophize, and they don’t know
how to ease their own pain.
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Acupuncture and Alexander Technique probably work differently to
reduce pain, but they may be similar in that they help patients
change past behaviors and habits and lead towards improved coping
strategies and self-care, he said.
There was some benefit in both groups due to “non-specific”
components of treatment, or placebo effect, as occurs with any
intervention, MacPherson said.
“However the long-term nature of the benefits are not typical of a
placebo response, and the data on self-efficacy provide a better
explanation of these long-term benefits,” he said.
Both treatments are usually paid for out-of-pocket, although they
are covered by insurance or national healthcare systems in some
countries, he said.
Patients should look for a licensed or registered practitioner for
these therapies, he said.
“No other single treatment is known to provide long-term benefits,”
MacPherson said. “However there is evidence that manual therapy when
combined with a tailored exercise program can provide similar
long-term benefits.”
SOURCE: http://bit.ly/1i46lF7 Annals of Internal Medicine, online
November 2, 2015.
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