Alexander Technique

Complementary therapies are an attractive option for people who seek new ways of managing chronic pain. Most complementary therapies can be traced back to ancient Eastern cultures, but the Alexander Technique is much newer… it actually only originated around 100 years ago thanks to a man born in Tasmania (see below).

The Alexander Technique is a method to improve natural poise and movement, and reduce problems caused by unwanted habitual tension patterns. It’s about retraining us to be more aware of our posture, helping us notice the bad habits we have picked up during our lifetime and showing us how to correct them. The pain caused by poor posture can be eased and we learn to move with less effort.

Brita Forsstrom has served as a council member and chair of the Society of Teachers of the Alexander Technique

Can it help people with arthritis?

“The Alexander Technique teaches people to become aware of habitual muscular reactions in the way they go about their everyday ordinary activities, and learn to prevent the inappropriate and harmful muscular tensions that put excessive pressure on joints,” explains Brita Forsstrom from The Society of Teachers of the Alexander Technique. “Lowering tension in the whole body and specifically near the joints affected by arthritis, can help reduce symptoms.”

A survey of Alexander Technique teachers in 2015 that reported on more than 4,500 clients, showed that musculoskeletal problems were the most common (62%) reason for beginning Alexander Technique lessons. But does the scientific research show that it works?

Alexander Technique lessons led to long-term reductions in chronic neck pain and improvements in self-care and the way people lived their daily lives in a study of 344 people (European Journal of Integrative Medicine, 2018). More research in the same year found that people with neck pain who attended 10 one-hour sessions of the Alexander Technique in a group setting had reduced neck pain and improved posture (Complementary Therapies in Medicine).

Good news also for people with knee osteoarthritis. Muscle strengthening is often suggested for people affected but a small study in 2016 suggests that the Alexander Technique could be an alternative (BMC Musculoskeletal Disorders). After 20 lessons in the Alexander Technique, people with knee osteoarthritis reported a 56% reduction in pain scores and this was retained after 15 months.

A large study published in the British Medical Journal in 2008 found that one-to-one lessons in the Alexander technique had long term benefits for nearly 600 people with chronic back pain. And the good news is that six lessons (followed by special exercises) were nearly as effective as 24 lessons.

For people with rheumatoid arthritis and other inflammatory form of arthritis, the Alexander Technique is unlikely to benefit the immunological condition directly. But through lessons people can learn how to carry out their daily activities with less effort, so may find they are generally less tired and able to do more.

Are there any side effects?

The Alexander Technique does not involve strenuous exercise and is non-invasive and gentle.

“The teacher will tailor the work to suit the individual, so there are no direct side effects,” Brita says. “However, if a person has been literally ‘holding’ themselves in a harmful, tense way for years, partly contributing to, and partly as a result of, the pain, there may be some confusion during the learning process,” Brita explains. “There may also be a case of having to unravel layers of built-up tension and therefore revisit some old pain. This tends to be less than previously and a passing phase. Teachers will talk to the person and work to avoid this happening in a way that causes discomfort.”

What should someone look for in a teacher?

The profession is not subject to statutory regulation, so the most important thing is to make sure that your teacher is properly trained and insured. There are about 1,000 teachers of the Alexander Technique in the UK; about 750 are members of the Society of Teachers of the Alexander Technique which is a good place to start. All teaching members of STAT have completed a recognised three-year teacher training course. And, of course, getting along well is important too, so make sure you pick someone you can work with.

What happens in a session?

The Alexander Technique is most commonly taught in a series of one-to-one lessons addressing the individual’s specific needs.

“The teacher uses gentle hands-on guidance and verbal explanation to help you become aware of the way you stand and move,” says Brita. “With expert hands, the teacher affects subtle changes to your balance by encouraging release of excess tension. The main focus in Alexander Technique learning is giving attention to the head and neck in relation to the rest of the back and torso, helping you to maintain a more poised and freer use of your whole body.

“This mindfulness of movement is applied to simple everyday actions such as getting in and out of a chair, walking, bending and lifting. Gradually the teacher may introduce more complex activities and you will to able to apply this new way of consciously guiding your actions for yourself.”

How much does it cost?

Some NHS trusts do offer the Alexander Technique as part of their referral process, so check with your GP in case it is available through the NHS in your local area. Usually it is only available privately though and cost varies depending on where you are in the UK. In London, expect to pay £35–£50 per session.

The bottom line

The Alexander Technique is not a magic wand that can make arthritis disappear, but it can reduce pain and stress, and enhance quality of life. Learning and applying the Alexander Technique enables people to have more choice over how they respond to the world and how to look after themselves better.

Further information

• The Society of Teachers of the Alexander Technique, visit www.alexandertechnique.co.uk or tel 020 8885 6524.
• The Interactive Teaching Method Association, visit www.alexandertechnique-itm.org.
• The Professional Association of Alexander Teachers, visit www.paat.org.uk or tel 02476 714 698.

Where it all began…

A Shakespearean actor from Tasmania who lost his voice just over 100 years ago, Frederick Matthias Alexander realised that his unexplained and rather embarrassing voice loss in performances was due to the way he tilted his head. After discovering how to rectify some inappropriate and habitual contracting in his neck and throughout his body, Alexander found that his problem was resolved.

Alexander believed that his finding could improve the health and wellbeing of all people, so he refined his technique and began teaching his discoveries to others. He published many books on the subject before his death in 1955.

His legacy lives on today, endorsed by the UK’s National Institute for Health and Care Excellence, which recommends Alexander Technique lessons for chronic lower back pain and Parkinson’s.

True story: Candida Doyle, aged 56 years old, London

I was diagnosed with rheumatoid arthritis aged 16 years old, one month after starting my period. I was told that when I went through menopause I may go into remission and that’s exactly what happened, but my joints have been damaged – some severely – and I now have osteoarthritis.

About 12 years ago I read about the Alexander Technique and found a teacher near me in London. Initially, I had sessions twice a week. When my symptoms began to improve I would go less often. Now if I leave it too long between appointments I often have a flare-up, reminding me I do need to go regularly.

After a session my pain and stiffness ease up and I find it much easier to walk. The Alexander Technique has made a huge difference to me.

NB I also recommend finding a good counsellor. As part of my training to become a counsellor, I had to have some counselling myself. I hadn’t realised how much my arthritis was affecting me on a mental level and now understand that chronic illness is as much a mental as physical issue.