title: Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial.
abstract: BACKGROUND
  Management of chronic neck pain may benefit from additional active self-care-oriented approaches.
  
  
  OBJECTIVE
  To evaluate clinical effectiveness of Alexander Technique lessons or acupuncture versus usual care for persons with chronic, nonspecific neck pain.
  
  
  METHODS
  Three-group randomized, controlled trial. (Current Controlled Trials: ISRCTN15186354).
  
  
  METHODS
  U.K. primary care.
  
  
  METHODS
  Persons with neck pain lasting at least 3 months, a score of at least 28% on the Northwick Park Questionnaire (NPQ) for neck pain and associated disability, and no serious underlying pathology.
  
  
  METHODS
  12 acupuncture sessions or 20 one-to-one Alexander lessons (both 600 minutes total) plus usual care versus usual care alone.
  
  
  METHODS
  NPQ score (primary outcome) at 0, 3, 6, and 12 months (primary end point) and Chronic Pain Self-Efficacy Scale score, quality of life, and adverse events (secondary outcomes).
  
  
  RESULTS
  517 patients were recruited, and the median duration of neck pain was 6 years. Mean attendance was 10 acupuncture sessions and 14 Alexander lessons. Between-group reductions in NPQ score at 12 months versus usual care were 3.92 percentage points for acupuncture (95% CI, 0.97 to 6.87 percentage points) (P = 0.009) and 3.79 percentage points for Alexander lessons (CI, 0.91 to 6.66 percentage points) (P = 0.010). The 12-month reductions in NPQ score from baseline were 32% for acupuncture and 31% for Alexander lessons. Participant self-efficacy improved for both interventions versus usual care at 6 months (P < 0.001) and was significantly associated (P < 0.001) with 12-month NPQ score reductions (acupuncture, 3.34 percentage points [CI, 2.31 to 4.38 percentage points]; Alexander lessons, 3.33 percentage points [CI, 2.22 to 4.44 percentage points]). No reported serious adverse events were considered probably or definitely related to either intervention.
  
  
  CONCLUSIONS
  Practitioners belonged to the 2 main U.K.-based professional associations, which may limit generalizability of the findings.
  
  
  CONCLUSIONS
  Acupuncture sessions and Alexander Technique lessons both led to significant reductions in neck pain and associated disability compared with usual care at 12 months. Enhanced self-efficacy may partially explain why longer-term benefits were sustained.
  
  
  BACKGROUND
  Arthritis Research UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: MacPherson
authors.forename: Helen
authors.initials: H
authors.lastname: Tilbrook
authors.forename: Stewart
authors.initials: S
authors.lastname: Richmond
authors.forename: Julia
authors.initials: J
authors.lastname: Woodman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ballard
authors.forename: Karl
authors.initials: K
authors.lastname: Atkin
authors.forename: Martin
authors.initials: M
authors.lastname: Bland
authors.forename: Janet
authors.initials: J
authors.lastname: Eldred
authors.forename: Holly
authors.initials: H
authors.lastname: Essex
authors.forename: Catherine
authors.initials: C
authors.lastname: Hewitt
authors.forename: Ann
authors.initials: A
authors.lastname: Hopton
authors.forename: Ada
authors.initials: A
authors.lastname: Keding
authors.forename: Harriet
authors.initials: H
authors.lastname: Lansdown
authors.forename: Steve
authors.initials: S
authors.lastname: Parrott
authors.forename: David
authors.initials: D
authors.lastname: Torgerson
authors.forename: Aniela
authors.initials: A
authors.lastname: Wenham
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods; D059350:Chronic Pain / Q000191:economics / Q000628:therapy*; D005260:Female; D005102:Health Expenditures; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000191:economics / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data; D010349:Patient Compliance; D055553:Prescription Drugs; D012648:Self Care / Q000009:adverse effects / Q000379:methods; D020377:Self Efficacy; D016896:Treatment Outcome
chemical_list: D055553:Prescription Drugs