Back pain causes more disability than almost any other condition in Western societies, but very few effective long-term treatments are available to patients.

Previous research shows that the Alexander technique and massage may help relieve back pain in the short-term, but little has been known about the long-term outcomes.

The Alexander technique is an alternative therapy based on hands-on movement, which is said to relieve chronic pain, improve breathing and posture and even manage conditions like asthma and panic attacks.

Now, a team of researchers from the University of Southampton and the University of Bristol have compared the effectiveness of massage, exercise and the Alexander technique for the relief of back pain over one year.

The researchers randomly split 579 patients with chronic or recurrent back pain into groups, either receiving normal care, massage, six Alexander technique lessons, or 24 Alexander technique lessons. Half of the patients from each of the groups were also prescribed an exercise programme (brisk walking for 30 minutes per day, five times a week).

The findings showed that after one year, exercise combined with lessons in the Alexander technique significantly reduced pain and improved functioning, whereas massage offered little benefit.

After one year of Alexander technique lessons, patients reported fewer days with back pain over the past four weeks. Patients receiving normal care reported 21 days of back pain, compared to those who received 24 Alexander technique lessons, who experienced just 3 days of pain. Those who had six lessons reported 11 days of pain and those having massage said they had 14 days of pain.

In addition, patients receiving Alexander technique lessons reported improved quality of life.

Interestingly, six one-to-one lessons in the Alexander technique followed by exercise had nearly as much benefit as 24 lessons in the Alexander technique alone.

The researchers concluded that although massage may be helpful in the short term, the Alexander technique retained effectiveness after one year, making it a useful choice for patients with chronic or recurrent back pain.