An economic evaluation published in the BMJ has concluded that Alexander Technique lessons are an effective and cost-effective option for the NHS[1].

The evaluation found that a series of six Alexander Technique lessons followed by an exercise prescription is more than 85% likely to be a cost effective option for primary care providers treating patients with chronic non-specific low-back pain.

The independent research, carried out at the University of Bristol, evaluated results of a recently published trial that showed Alexander Technique lessons have significant long-term benefits for back pain[2].

The analysis looked at NHS costs for the intervention, primary care contacts, outpatient appointments, in-patient hospital stays and medication, as well as personal and societal costs.

Significantly, researchers found that an prescription alone has only a moderate effect on the number of days a patient is in pain and massage is unlikely to provide a sustained improvement, whereas Alexander Technique lessons are effective in the longer term over a range of outcomes. It was concluded a series of six Alexander Technique lessons followed by an exercise prescription is the most effective and cost-effective option for the treatment of back pain in primary care.

The report’s author, Sandra Hollinghurst, says: “The Alexander Technique could have a more lasting effect than either massage therapy or an exercise prescription due to the active teaching method used in the Alexander Technique lessons, which equips patients with life skills they are more likely to be able to use beyond the intervention period”.

Back pain is one of the most costly reasons for patients to consult in primary care[3] – the research conservatively estimates annual UK production losses due to back pain are in excess of £3,000m. Non-specific back pain accounts for up to five million lost working days per year[4] and its overall cost on the NHS, business and the economy is £5 billion a year[5]. It is one of the most common conditions managed in primary care, a common cause of disability and affects general well-being and quality of life.

Kamal Thapen, chair of The Society of Teacher of the Alexander Technique (STAT) says: “We are delighted with the results of this report and hope policy makers will recognise the benefits the Alexander Technique can bring to the NHS. Patients with back pain should be offered one-to-one lessons with a STAT teacher, which will improve their body use, natural balance, co-ordination and movement skills, and to recognise and avoid poor movement habits that cause or aggravate their pain.”

The evaluation compared the cost and outcomes of courses of six and 24 Alexander Technique lessons, six sessions of massage therapy and a GP prescription for home-based exercise with a nurse follow-up. Costs to the NHS were evaluated against the Roland Disability/Function score, which measures a patient’s quality of life, days in pain and Quality Adjusted Life Years (QALYs).

Benefits of Alexander Technique lessons:

The Alexander Technique is a taught self-help method that helps people recognise, understand, and avoid poor habits affecting postural tone and neuromuscular coordination. Lessons involve an individualised approach designed to provide lifelong skills for self care that can lead to a wide variety of benefits.

1. Society of Teachers of the Alexander Technique (STAT)

The Society of Teachers of the Alexander Technique (STAT) was founded in the UK in 1958. It is the world’s oldest and largest professional body of Alexander Technique teachers.

STAT Teaching members (MSTAT):

• Are certified to teach the Technique after successfully completing a three-year, full-time training course approved by the Society or an affiliated society.
• Adhere to the Society’s published Code of Professional Conduct and hold professional indemnity insurance.

2. Economic Evaluation

Economic evaluation of the MRC ATEAM randomised controlled trial of Alexander Technique lessons, Exercise and Massage for chronic or recurrent back pain.

Sandra Hollinghurst, Debbie Sharp, Kathleen Ballard, Jane Barnett, Angela Beattie, Maggie Evans, George Lewith, Karen Middleton, Frances Oxford, Fran Webley, Paul Little

1. Academic Unit of Primary Health Care, University of Bristol, UK
2. Primary Care group, CCS Division, University of Southampton, UK
3. The Society of Teachers of the Alexander Technique, UK

Funded by The Medical Research Council ISRCTN: 26416991 (2000 – 2005)