title: Efficacy of the Alexander Technique in treating chronic non-specific neck pain: a randomized controlled trial.
abstract: OBJECTIVE
  To test the efficacy of the Alexander Technique, local heat and guided imagery on pain and quality of life in patients with chronic non-specific neck pain.
  
  
  METHODS
  A randomized controlled trial with 3 parallel groups was conducted.
  
  
  METHODS
  Outpatient clinic, Department of Internal and Integrative Medicine.
  
  
  METHODS
  A total of 72 patients (65 females, 40.7±7.9 years) with chronic non-specific neck pain.
  
  
  METHODS
  Patients received 5 sessions of the Alexander Technique--an educational method which aims to modify dysfunctional posture, movement and thinking patterns associated with musculoskeletal disorders. Control groups were treated with local heat application or guided imagery. All interventions were conducted once a week for 45 minutes each.
  
  
  METHODS
  The primary outcome measure at week 5 was neck pain intensity on a 100-mm visual analogue scale; secondary outcomes included neck disability, quality of life, satisfaction and safety.
  
  
  METHODS
  Analyses of covariance were applied; testing ordered hypotheses.
  
  
  RESULTS
  No group difference was found for pain intensity for the Alexander Technique compared to local heat (difference 4.5mm; 95% CI:-8.1;17.1; p=0.48), but exploratory analysis revealed the superiority of the Alexander Technique over guided imagery (difference -12.9 mm; 95% CI:-22.6;-3.1, p=0.01). Significant group differences in favor of the Alexander Technique were also found for physical quality of life (P<0.05). Adverse events mainly included slightly increased pain and muscle soreness.
  
  
  CONCLUSIONS
  The Alexander Technique was not superior to local heat application in treating chronic non-specific neck pain. It cannot be recommended as routine intervention at this time. Further trials are warranted for conclusive judgment.
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia r.lauche@kliniken-essen-mitte.de.
authors.forename: Romy
authors.initials: R
authors.lastname: Lauche
authors.affiliation: Department of Anesthesiology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Schuth
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany Migräne- und Kopfschmerzklinik Königstein, Königstein im Taunus, Germany.
authors.forename: Myriam
authors.initials: M
authors.lastname: Schwickert
authors.affiliation: Karl and Veronica Carstens-Foundation, Essen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Lüdtke
authors.affiliation: The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Science, Uit The Arctic University of Norway, Tromsö Norway.
authors.forename: Frauke
authors.initials: F
authors.lastname: Musial
authors.affiliation: Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Kyung-Eun
authors.initials: KE
authors.lastname: Choi
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000628:therapy*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy*; D010147:Pain Measurement; D010353:Patient Education as Topic; D011187:Posture; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Alexander Technique; Neck pain; chronic pain; clinical trial; guided imagery; kinesthetic control; local heat; randomized controlled trial; sensory awareness