Often MRIs and other imaging tools reveal no abnormalities in painful backs, while images of painless backs may show abnormalities. In about 10 to 20% of people with low back pain, the condition becomes chronic. This limits work, play, family life, and exercise. Chronic back pain is, unfortunately, often hard to treat.
Many people think that the best cure is bed rest or just sitting still, but this is not true. Study after study has shown that bed rest is the worst thing for low back pain, and that exercise can help. Indeed, studies show that exercise is one of the few clearly effective treatments in the long run.
New plan found to help
It's encouraging news that a team of researchers in England, as reported recently in the British Medical Journal, have come up with a promising plan. Their well-designed clinical trial lasting a year included 579 people (aged 18 to 65) with chronic or recurrent low back pain, all otherwise healthy. Several approaches were combined and compared: therapeutic massage administered in six sessions, an exercise program (brisk walking), and lessons in the Alexander Technique. This is a method of improving posture and reducing muscle tension, among other things, and requires formal training.
The outcome was pretty clear: those who learned the Alexander Technique (with or without the exercise program) experienced the greatest and longest-lasting improvements in physical functioning, as well as the most pain-free days. Massage, as well as exercise by itself, provided smaller, shorter benefits. People who had six lessons in the Alexander Technique and followed the exercise program did as well as those who had 24 lessons and no exercise. Alexander is not the only such approach - Feldenkrais, McKenzie, and Pilates are other types of movement training that show promise - but this is the best evidence so far about any movement therapy and back pain.
So what is the Alexander Technique?
Developed over a century ago by F. Matthias Alexander, an actor, the technique is neither massage nor exercise, nor physical therapy, but individualized training to improve posture, muscle tone, and movement. A teacher observes you carefully in each session, advising you on ways to move, sit, and stand efficiently, without undue strain. Alexander originally intended the technique for singers and actors needing to reduce vocal tension. Over the years it has been adapted as a treatment for various kinds of musculoskeletal pain.
What you can do:
If you have chronic or recurring back-pain, brisk walking for 30 minutes five times weekly (as in the study) is a good idea for many reasons, and you don't need a trainer. Massage is also worth trying. Lessons in the Alexander Technique may run to $100 a sessionnot always covered by insurance. Some physical therapists are certified in the Alexander Technique, and a referral from your physician may mean that insurance would cover the lessons. The American Society for the Alexander Technique can refer you to a certified teacher in your area.