Sufferers of chronic pain may benefit from learning the Alexander Technique in NHS outpatient pain clinics according to a new study. More than half of the service users in the study stopped or reduced their use of medications between the start of the lessons and three months.
Dr Stuart McClean, lead researcher from UWE Bristol in collaboration withÂ Dr Lesley Wye from the School of Social and Community MedicineÂ at the University of Bristol, health practitioners and The Society of Teachers of the Alexander Technique (STAT), carried out an 11-month exploratory study of a time-limited Alexander Technique teaching service, as an additional pain management option in the Pain Clinic at St Michaelâ€™s Hospital, Bristol.
The Alexander Technique is an educational approach taught by combined hands-on guidance and verbal explanation to help patients move with and achieve greater ease and poise by reducing unhelpful habits that get in the way of simple activities such as sitting, standing and walking. It requires attention and application on the part of the patient, or ‘student’. Once the technique is learned the â€˜studentsâ€™ incorporate it into their everyday life, emphasising self-management so that the benefits last after lessons end.
From June 2010 to May 2011, 43 patients with chronic or recurrent pain received six consecutive weekly one-to-one Alexander Technique lessons with a qualified and experienced STAT registered Alexander Technique teacher at St Michaelâ€™s Hospitalâ€™s Pain Clinic.
Funded by the Avon Primary Care Research Collaborative (APCRC) the project aimed to evaluate the effectiveness of the Alexander Technique service, the experiences of service users and clinicians, and highlight the potential of the service to the NHS.
Dr Stuart McClean who led the evaluation explains: â€œWe have seen from a previous randomised controlled trial that Alexander Technique lessons were found to be both clinically and cost effective for the management of low back pain in primary care. This study builds on those findings to evaluate the provision of Alexander Technique lessons within a hospital out-patient Pain Management Clinic. It focused on a group of 43 patients with chronic or recurrent pain, 75 per cent of which had back pain. All 43 were not getting better or responding to conventional treatment and all expressing an interest in Alexander Technique lessons as a pain management approach.â€
Dr Lesley Wye said: “The results suggest that for some patients in this study, especially those with the commitment to incorporate the Alexander Technique into their daily routine, it can make a difference to how they manage their pain. Importantly, we found this led to a substantial reduction in their use of pain medication and other NHS pain-related costs.”
Dr Peter Brook, the lead consultant at St Michaelâ€™s Pain Clinic (University Hospitals Bristol, NHS Foundation Trust) said, â€œIâ€™m pleasantly surprised by the positive outcomes of the evaluation. Iâ€™ve seen a few service users who used the Alexander Technique and they seemed to have enjoyed the experience and their wellbeing is improved. If more than half of them have significantly reduced their medication and theyâ€™re happier, and their pain is unchanged or slightly better, then thatâ€™s a very good result. The fact that their pain is the same or slightly better on half as much medication is an enormous improvement.â€
Key findings of the evaluation are:
- An Alexander Technique teaching service in a pain clinic can make a difference to how people manage their pain and reduce their pain related NHS costs including medication, tests and investigations and consultations with GPs and hospital doctors.
- Most patients liked the Alexander Technique lessons and benefited in terms of their day-to-day relationship with pain.
- Awareness and increased understanding of pain also led to some behaviour change and changes in self-knowledge from the patient.
The study recommends that Alexander Technique lessons should be considered by NHS commissioners who are interested in providing a useful, cost-saving addition to pain clinic service provision, particularly as a useful service for those who are seeking a long-term educational approach to chronic pain.
Dr Stuart McClean added, â€œThe encouraging results of this pilot service evaluation provide a good basis for planning and obtaining funding for a multi-centre study in the UK with larger numbers of patients to extend these findings by including groups having more than six Alexander lessons and some having follow-up group classes in the Alexander Technique.â€
For the full report – McClean, S and Wye, L (2012) Taking charge, choosing a new direction: A service evaluation of Alexander Technique lessons for pain clinic patients (SEAT): An approach to pain management. Visit the UWE Research Repository
For further information on the Alexander Technique visit www.stat.org.uk