- Back pain trial
- Neck pain trial
- Experience in pain clinics
- Other studies
- Review of evidence
- Ongoing research
Please note that this section includes links to PDF documents that require Adobe Acrobat Reader.
Back pain trial
A major clinical study has shown that lessons in the Alexander Technique lead to significant long-term benefit for people with chronic low back pain. After one year, compared with people who received usual GP care, those who had taken 24 Alexander lessons had significantly:
- less back pain (3 days of pain per month versus 21 days)
- less incapacity
- and improved quality of life. 1
Neck pain trial
A randomised, controlled clinical trial run by the University of York and funded by Arthritis Research UK, has shown that Alexander Technique lessons lead to long-term benefit for people with chronic neck pain, with reduction in pain and associated incapacity maintained 1 year after lessons began. 2
Experience in pain clinics
Two recent reports have highlighted how valuable Alexander Technique lessons can be for people with chronic pain. The first was a pilot study involving 43 people attending an NHS pain clinic and offered six one-to-one Alexander Technique lessons. The findings suggest that an Alexander teaching service in a pain clinic can help people reduce their pain and to better manage their condition. The study reported that after 3 months (following lessons) half the participants were able to stop or reduce their use of pain medications. 3
Read more about this study: poster summary (PDF format 620K).
The second study was an audit of an Alexander Technique teaching service in an NHS Community Pain clinic. More than 70% of the 158 patients with persistent pain reported that their Alexander lessons helped them ‘quite a lot’ or ‘very much’ to move more easily, improve their wellbeing and be empowered to be able to manage their condition better. 4
A large, randomised, controlled clinical trial (such as those in people with back or neck pain) represents the ‘gold standard’ in terms of evaluating new health interventions. In general, however, and unlike the situation for new pharmaceutical drugs, there has been little research funding available to support extensive studies into the Alexander Technique.
Nonetheless, a small randomised, controlled trial has shown significant benefits of Alexander Technique lessons for people with Parkinson’s disease in reducing associated disability. 5, 6, 7 In addition, there is evidence from one randomised, controlled trial and from two smaller studies for improvements in balance in older people following Alexander instruction. 8, 9, 10 Another study has suggested that lessons can lead to improved breathing capacity, 11 and several additional studies provide further supporting evidence for reduction in back pain. 12, 13, 14 Data from a pilot study showed reduced pain and disability following one-to-one Alexander lessons for people with knee osteoarthritis 15. Other, preliminary, data suggest benefits of lessons for those who stutter 16 and in improving posture. 17, 18
Research suggests that some of the benefit from learning the Alexander Technique may result from improving postural muscle tone, coordination, flexibility and balance. Thus, studies have shown that individuals who have undergone Alexander Technique training have increased adaptability of muscle tone with reduced stiffness, and improved postural coordination and balance. 13, 19, 20, 21 Other studies have shown a more poised state of head balance, with reduced muscular tension in the neck, as well as significantly less force required following lessons to perform everyday actions such as standing up from a seated position. 18, 22, 23, 24 Recent research has shown that older Alexander Technique teachers (60–75 years) not only show greater dynamic stability during walking than people of similar age who have no Alexander training, but also that they have gait (walking) patterns that are similar to those of younger adults. 25,26
The value of the Alexander Technique in the performing arts has long been recognised, and it is an integral part of teaching at several leading music and drama institutes (e.g. RADA and the Royal College of Music). A randomised study has demonstrated a reduction in performance-related anxiety and improved performance quality in musicians following Alexander Technique lessons. 27 These findings relating to performance are supported by the results of another study in pianists that showed improved evenness of touch when playing the piano following Alexander lessons. 28
Review of evidence
The evidence for the effectiveness of Alexander Technique lessons across different health-related conditions has recently been evaluated and published in the International Journal of Clinical Practice. 29 The review found strong evidence for the effectiveness of Alexander lessons for people with chronic back pain and moderate evidence in helping alleviate disability associated with Parkinson’s. Preliminary evidence was found across a diverse range of other health-related conditions.
You can read the submitted version (i.e. the pre-peer-reviewed version) of this paper by Woodman and Moore, or link to the published final form (note there may be a journal fee to access the final article but the submitted version, which is free, is very similar to the final one). The journal also invited us to produce a short video presentation summarising the main findings of the review. Both the video and the review are aimed mainly at health professionals but may also be of interest to some members of the public.
Ongoing research includes a pilot study with older people who have a fear of falling.
- 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. British Medical Journal 2008;337:a884.
- MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, Atkin K, Bland M, Eldred J, Essex H, Hewitt C, Hopton A, Keding A, Lansdown H, Parrott S, Torgerson D, Wenham A, Watt I. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain: A randomized trial. Annals of Internal Medicine 2015;163:653-62.
- McClean S, Brilleman S, Wye L. What is the perceived impact of Alexander Technique lessons on health status, costs and pain management in the real life setting of an English hospital? The results of a mixed methods evaluation of an Alexander Technique service for those with chronic back pain. BMC Health Services Research 2015;15:293.
- Hawksley H, French K, Benson C, Hemphrey L. Alexander Technique in the management of chronic pain: an audit cycle in a community pain service. British Pain Society Annual Conference. Liverpool, UK 2012.
- Stallibrass C; Frank C; Wentworth K. Retention of skills learnt in Alexander Technique lessons: 28 people with idiopathic Parkinson’s disease. Journal of Bodywork and Movement Therapies 2005;9:150-7.
- Stallibrass C; Sissons P; Chalmers C. Randomized; controlled trial of the Alexander Technique for idopathic Parkinson’s disease. Clinical Rehabilitation 2002;16:695-708.
- Stallibrass C. An evaluation of the Alexander Technique for the management of disability in Parkinson’s disease – a preliminary study. Clinical Rehabilitation 1997;11: 8-12.
- Gleeson M, Sherrington C, Lo S, Keay L. Can the Alexander Technique improve balance and mobility in older adults with visual impairments? A randomized controlled trial. Clinical Rehabilitation 2015;29:244-60.
- Dennis RJ. Functional reach improvement in normal older women after Alexander Technique instruction. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1999;54:M8-M11.
- Batson G, Barker S. Feasibility of group delivery of the Alexander Technique on balance in the community-dwelling elderly: preliminary findings. Activities Adaptation and Aging 2008;32:103-119.
- Austin JHM and Ausubel P. Enhanced respiratory muscular function in normal adults after lessons in proprioceptive musculoskeletal education without exercises. Chest 1992;102:486-90.
- Vickers AP; Ledwith F; Gibbens AO. The impact of the Alexander Technique on chronic mechanical low back pain (unpublished report). 2000.
- Cacciatore TW. Improvement in automatic postural coordination following Alexander Technique lessons in a person with low back pain. Physical Therapy 2005;85:565-78.
- Little P, Stuart B, Stokes M, Nicholls C, Roberts M, et al. Alexander Technique and supervised physiotherapy exercises in back pain (ASPEN): a four-group randomised feasibility trial. Efficacy Mech Eval 2014;1(2).
- Preece, SJ, Jones RK, Brown C, et al. Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis. BMC Musculoskeletal Disorders 2016; 17:372.
- Schulte D, Walach H. F.M. Alexander technique in the treatment of stuttering- a randomized single-case intervention study with ambulatory monitoring. Psychother Psychosom. 2006;75(3):190-1.
- Reddy PP, Reddy TP, Roig-Francoli J et al. The impact of the Alexander Technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study. Journal of Urology 2011;186:1658–62.
- Barlow, W. Psychosomatic problems in postural re-education. Lancet 1955;24 Sep:659-64.
- Cacciatore TW, Gurfinkel VS, Horak FB, Cordo PJ, Ames KE. Increased dynamic regulation of postural tone through Alexander Technique training. Human Movement Science 2011;30:74–89.
- Cacciatore TW, Gurfinkel VS, Horak FB, Day BL. Prolonged weight-shift and altered spinal coordination during sit-to-stand in practitioners of the Alexander Technique. Gait Posture 2011;34:496–501.
- Cacciatore TW, Mian OS, Peters A, Day BL. Neuromechanical interference of posture on movement: evidence from Alexander Technique teachers rising from a chair. Journal of Neurophysiology 2014;112:719–29.
- Jones FP and Gilley FM. Head balance and sitting posture: an x-ray analysis. J Psychology 1960;49:289-93.
- Jones FP, Gray FE, Hanson JA and O’Connell DN. An experimental study of the effect of head balance on patterns of posture and movement in man. J Psychology 1959;47:247–258.
- Stevens C, Bojsen-Moller F, Soames RW. (1989) The influence of initial posture on the sit-to-stand movement. European Journal of Applied Physiology & Occupational Physiology. 58 (7): 687-92.
- O’Neill MM, Anderson DI, Allen DD, et al. Effects of Alexander Technique training experience on gait behavior in older adults. Journal of Bodywork and Movement Therapies 2015;19:473–81.
- Hamel KA, Ross C, Schultz B, et al. Older adult Alexander Technique practitioners walk differently than healthy age-matched controls. Journal of Bodywork and Movement Therapie 2016;20:751–60.
- Valentine ER; Fitzgerald DFP; Gorton TL; Hudson JA; Symonds ERC. The effect of lessons in the Alexander Technique on music performance in high and low stress situations. Psychology of Music 1995;23:129-41.
- Williamson M; Roberts N; Moorhouse A. The role of the Alexander Technique in musical training and performing. Proceedings of the International Symposium on Performance Science 2007; Porto; Portugal. Eds. Williamson A and Coimbra D. ISBN 978-90-9022484-8. Available from the International Symposium on Performance Science.
- Woodman JP and Moore NR. Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. International Journal of Clinical Practice 2012;66:98–112.