Behavioral Counseling Technique Reduces Back Pain

Involves improvement in posture and neuromuscular coordination
By A. Agrawal, PhD
HealthDay Reporter

WEDNESDAY, Aug. 20 (HealthDay News) -- Teaching patients with chronic or recurrent back pain to improve their posture and neuromuscular coordination significantly reduces pain, in some cases without exercise, according to research published online Aug. 19 in BMJ.

Paul Little, M.D., from the University of Southampton in the United Kingdom, and colleagues randomly assigned 579 patients with chronic or recurrent lower back pain to one of four groups: normal care; massage therapy; six Alexander technique lessons; or 24 Alexander technique lessons. Half of each group was randomly assigned to exercise as advised by a doctor and to structural behavioral counseling by a nurse. The Alexander technique involves a personalized assessment to help individuals recognize, understand and avoid poor habits affecting posture and neuromuscular coordination.

As assessed by the number of activities impaired by pain, the researchers found that only exercise and Alexander technique lessons remained effective at one year. Exercise after six sessions of the Alexander technique was nearly as effective as 24 sessions alone (72 percent as effective), the report indicates. The Alexander technique and massage reduced the median number of days in pain by seven to 18 days in the past four weeks compared with usual care, the authors note.

"One to one lessons in the Alexander technique from registered teachers have long-term benefits for patients with chronic back pain," Little and colleagues conclude. "Six lessons followed by exercise prescription were nearly as effective as 24 lessons."

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