As part of my ongoing professional development, I’ve been doing an 8-week course bringing together all the latest scientific advances in the understanding of pain [1]. One of our assignments this week was to try and briefly explain to someone living with pain how the Alexander Technique could help them. I thought I’d share what I’ve written with you, as it’s possible you are one of the estimated 20–40% of the adult population who is living with long-term (persistent) pain [2].
The first thing I’d like to say is that if you’re experiencing pain that is significantly affecting your life, it’s important to get checked out by a medical professional. Alexander teachers do not give medical diagnoses nor treatment.
If you are living with pain, and particularly if this has been for some time, then it’s certainly worth considering learning the Alexander Technique as it can be helpful in so many different ways. To understand how, it’s first useful to know that there have been huge advances in pain science over the past few decades and that the new understanding of pain is completely in line with the approach that is the Alexander Technique.
As everyone knows, pain is there to protect us as it alerts us to a risk of injury or damage. So, for example, if I sprain my ankle the pain that I feel will encourage me to care for myself and to rest until I start to recover.
However, it’s now clear that sometimes pain can persist, even after the tissues may have completely healed. In other words, our helpful protective system has gone off balance and is warning us of danger that may no longer even exist. It’s so important to understand that all pain is real – it’s not the case that somebody is imagining their pain or somehow making it up! It’s just that the persistent pain that someone is experiencing may no longer be serving a useful protective function.
What has also become really clear is that pain is an experience of the whole person and whether, when, and how much pain we experience depends on a whole range of factors related to how we think (e.g. our beliefs and previous experiences), and to what’s going on for us in our lives (relationships, work etc), as well as what’s happening biologically. Pain science also tells us that pain is not fixed – our brains, nervous system and tissues are constantly changing (‘bio-plasticity’), so pain can either worsen or resolve depending on what changes occur. So we need something that enables us to influence the direction of change towards a spiral of recovery instead of a vicious circle of continued and worsening pain – and this is where the Alexander Technique can come in to enable us to navigate our way back to recovery. How does it do this?
Well, one thing that is extremely important for recovery is to keep active, and of course pain is a powerful disincentive to any movement that hurts. An Alexander teacher can guide us on how to move safely, smoothly and with less effort. At the same time that our balance and coordination are improving, our postural support system is also toning up through the Alexander work. Hand in hand with this, we gain a better sense of ourselves (for example, a more accurate sense of where we are in within space and where different parts of ourselves are in relation to each other). This is important because our sensory system can also become less accurate with ongoing pain and that has knock-on effects. We also learn how to direct our attention more usefully so that we can acknowledge pain without constantly being drawn down into it.
Through the Alexander Technique we gain practical thinking tools that we can use in our daily life so that we feel more in control, less stressed, and better able to manage our pain. Research backs this up, demonstrating that taking Alexander lessons increases people’s self-efficacy i.e. their confidence in their own ability to reduce their pain [3]. And, of course, there are two large randomised controlled trials demonstrating that one-to-one Alexander lessons with STAT-registered teachers lead to significant and long-term reductions in pain and disability in people living with persistent back or neck pain [4,5]. The Alexander Technique is not a quick fix but it empowers us to be in charge of our own recovery – it’s probably the most helpful self-care method you’ll ever discover.
[1] Pain science for Alexander Technique teachers. Devised and led by Mari Hodges MScMed (Pain Management), MAMSAT, and Tim Cacciatore PhD, MSTAT https://webinars.alexandertechniquescience.com/
[2] Cohen et al. Chronic pain: an update on burden, best practices, and new advances. The Lancet 2021;397:2082–2097; and James et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2018;392:1789–1858.
[3] Woodman J, Ballard K, Hewitt C, MacPherson H. Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial. European Journal of Integrative Medicine 2018;17:64-71. doi: 10.1016/j.eujim.2017.11.006.
[4] 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.
[5] MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, et al. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain: A randomized trial. Annals of Internal Medicine 2015;163:653-62.