Study after study has shown that bed rest is the worst thing for low back pain, and that exercise can help. Indeed, studies show that exercise is one of the few clearly effective treatments in the long run. But which types of exercise? One type that you may not be familiar with is the Alexander Technique, which has been shown in clinical studies to work.
In one 2008 study published in BMJ, a team of researchers in England studied 579 people (aged 18 to 65) with chronic or recurrent low back pain. Several approaches were combined and compared: therapeutic massage administered in six sessions, an exercise program (brisk walking), and lessons in the Alexander Technique. This is a method of improving posture and reducing muscle tension, among other things, and requires formal training.
A year later, the outcome was pretty clear: those who had learned the Alexander Technique (with or without the exercise program) experienced the greatest and longest-lasting improvements in physical functioning, as well as the most pain-free days. Massage, as well as exercise by itself, provided smaller, shorter benefits. People who had six lessons in the Alexander Technique and followed the exercise program did as well as those who had 24 lessons and no exercise. Alexander is not the only such approach—Feldenkrais, McKenzie and Pilates are other types of movement training that show promise—but this is the best evidence so far about any movement therapy and back pain.
What is it? Developed over a century ago by F. Matthias Alexander, an actor, the technique is neither massage nor exercise, nor physical therapy, but individualized training to improve posture, muscle tone and movement. A teacher observes you carefully in each session, advising you on ways to move, sit and stand efficiently, without undue strain. Alexander originally intended the technique for singers and actors needing to reduce vocal tension. Over the years it has been adapted as a treatment for various kinds of musculoskeletal pain.
What you can do: If you have chronic or recurring back pain, brisk walking for 30 minutes five times weekly (as in the study) is a good idea for many reasons, and you don’t need a trainer. Massage is also worth trying. Lessons in the Alexander Technique may run to $100 a session— not always covered by insurance. Some physical therapists are certified in the Alexander Technique, and a referral from your physician may mean that insurance would cover the lessons. The American Society for the Alexander Technique can refer you to a certified teacher in your area.