Response to NYT article “Alternatives to Drugs for Treating Pain”, by Jane Brody
Regarding the Sept 11, 2017 NYT Well article: Alternatives to Drugs for Treating Pain
I applaud Jane Brody for presenting a great list of non invasive treatments for back pain – missing from this list is the Alexander Technique, one of the few methods that has been subjected to a large (n = 579) randomized controlled trial. Alexander Technique was effective for mitigating low back pain, both after treatment and at a 1-year follow up, as compared to both massage therapy and a no treatment educational control condition, See: Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain for details. More recently Alexander Technique has been shown to lower neck pain, and mitigate pain in knee osteoarthritis possibly due to improved gait mechanics, although admittedly the latter study has a small sample size, limiting the reliability of results.
Alexander Technique, in my opinion, is a superior intervention because it teaches mindful awareness AND a way of moving that is arguably far more efficient, that will prevent and heal the wear and tear on your body from poor movement habits, and encourage you to move more, because the act of moving has suddenly become pleasurable. To the extent that pain and muscle tension is caused by moving in an inefficient manner, Alexander Technique provides a solution. To the extent that pain and muscle tension results from mental stress, Alexander Technique also provides a solution.
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I’m always amazed how little the medical profession, much less the public, knows about the Alex. Tech. It’s a sad matter to me, because I know how helpful this can be for low back and neck pain! It’s not a miracle; one still has to learn the lessons and do the work practicing constructive rest, walking, standing and sitting at home, and consider the theory behind the technique. I’ve told my Kaiser PT and doctor, my face doctor, my pool lifeguard, and all my friends about the benefits I’ve experienced with Elyse: later onset of pain during the day, a strategy to prevent pain without or with minimal heavy pills, and an optimistic outlook when it’s so easy to become discouraged because I’m not yet well after 20 lessons.
For me at least, I think it takes that number of lessons and much more, plus I adore the lying down part of the class when Elyse puts her magical, gentle hands on me, and I feel the tension drop out and ooze out of me. I never really knew how to relax before these classes, or what kind of self-messaging I should be giving myself. More importantly I’ve learned to trust the process, not set immutable “deadlines” to be well again, and to be of good cheer and hope. Delaying jumping to conclusions or acting too soon is another psychological benefit carrying over into my daily life and interactions. Overall I feel calmer, tho my moods do go up and down to be sure! I always look forward to a calming session with Elyse, and telling anyone who will listen, about the potential benefits.
Sometimes healing takes more time that we wish. The cited study in the British Medical Journal suggested 24 lessons for back pain relief, although benefit was found in 6 lessons when combined with walking. For people in acute pain involving the neck, it can take longer. The American Society for Alexander Technique used to recommend between 20 – 40 lessons, which sounds like a lot, but if one considers that’s less than a year’s worth of weekly study countering a life time of habit, maybe it’s not so much. Some of the techniques I have been adding from the Reembody method – http://reembody.me/ – tend to work faster than classic AT alone, but healing, especially from a fairly severe injury, can take time. If there’s soft tissue damage, that can take a long time. If there’s emotional trauma around the injury, that can also take a while to clear. On the positive side, Alexander Technique teachers can help people learn how to reduce emotional stress and move better (in ways that don’t damage joints, crush nerves and strain muscles) – sometimes with dramatically positive results – while the body goes through it’s own healing process.
Finally, it’s worth saying that we live in a culture that promises quick fixes. Sometimes these happen, but if they don’t know that you are probably average, and the dramatic cure might have been the exceptional case.