Behind the headlines seeks to be ” a service that provides an unbiased and evidence-based analysis of health stories that make the news”. Its analysis of the Little et al paper on Alexander Technique and exercise for chronic lower back pain concludes:
“This well conducted randomised trial has strengths in that it involved a large number of participants with a sample size large enough to assess meaningful differences in the measured outcomes for each of the different treatments. It also followed the majority of these participants across the one year period. The study demonstrates the effectiveness of the Alexander technique, with and without exercise, in reducing disability score on a recognised scale.
A few points to consider:
Instruction and education in the techniques involved a large number of trained professionals (152) and there may have been minor differences in the treatments given across the sample.
The fact that the Alexander technique requires education by a registered professional does mean that referral is going to be affected by local care arrangements and resources across the country.
Although the effectiveness was measured up to one year, longer follow-up would be valuable to assess longer-term outcomes and possible adverse effects.
Assessments were by postal questionnaire and disability, quality of life and pain are highly subjective measures. How one person views their level of pain and disability is going to be different from another.
All people in the groups had chronic back pain and fulfilled certain criteria. Many that the researchers contacted initially were not eligible for the study. Importantly, this study has no implications for care of acute low back pain”.