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, making cost savings to the NHS.
UWE Bristol researcher Dr Stuart McClean working in collaboration with Dr Lesley Wye from 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 Michael’s Hospital, Bristol.
The service evaluation project funded by the Avon Primary Care Research Collaborative (APCRC) 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.
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 Michael’s Hospital’s Pain Clinic.
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 ‘students’ incorporate it into their everyday life, emphasising self-management so that the benefits last after lessons end.
Dr Stuart McClean who led the evaluation explains, “We 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% 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.”
Dr Peter Brook, the lead consultant at St Michael’s Pain Clinic (University Hospitals Bristol, NHS Foundation Trust) said, “I’m pleasantly surprised by the positive outcomes of the evaluation. I’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 they’re happier, and their pain is unchanged or slightly better, then that’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.”
A participant in the study, writing to Dr Brook, said, “It is so good to know that there are brilliant people like you in the world whose belief in holistic approaches to pain management and recovery can see people like me finding the tools and strength to get well again without resorting to invasive surgery. Thank you so much.”
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 to their pain.
· Awareness and increased understanding of pain also led to some behaviour change and changes in self-knowledge from the patient.
Eileen Armstrong, Chair of STAT said, “Users of the Alexander Technique are well aware of the benefits of learning to identify poor posture and movement habits to reduce pain and undo tension and stress. We are delighted that this study within a clinical environment has proved to make such a significant difference to the pain management of those who took part.”
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, “The 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.”
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