BJGP OPEN 2025. DOI: https://bjgpopen.org/content/early/2025/05/07/BJGPO.2024.0295
Little, J Geraghty A, Nicholls C, Little P
Background and aims: There are limited interventions available for neck, hip or knee pain, even though these are among the most common musculoskeletal conditions. This small study aimed to evaluate a programme consisting of mixed group and one-to-one Alexander Technique (AT) sessions for people with persistent or recurring pain in one or more areas.
Methods: Patients were recruited from GP practices and invited to attend a total of 10 Alexander sessions (6 group classes and 4 one-to-one lessons) over 10-12 weeks. The sessions followed a specified programme and included home practice and study (Alexander lying down practice and reading). Near the end of the course, participants were interviewed by a researcher experienced in qualitative research. They were asked about their experience of the AT and of group versus one-to-one teaching. Several quantitative outcome measures were also used (at baseline and at 3 months), although no statistical analysis was carried out due to the small number of participants involved.
Results: 25 patients were recruited, 23 undertook the course and 18 agreed to be interviewed. From these interviews, some common themes emerged. For participants who had pain in more than one place, some experienced similar benefit for their various issues and they often understood the AT as relating to the whole person. For others, varying degrees of benefit were experienced for their different issues. Those participants wo gained least benefit from the course were those who has knee pain and perceived this as being caused by underlying structural damage.
Overall, both group and one-to-one learning was found valuable, though some had a preference for one or the other. Learning in a group environment often enhanced understanding of the AT, as well as creating mutual support. One-to-one lessons were appreciated for the tailored teaching received.
Modest decreases were seen in the measures of pain and disability. The more holistic quantitative measures (enablement score and global improvement) showed the greatest change. This is reflected by the interview findings, as some participants felt that the quantitative measures did not adequately capture the benefits experienced, for example, improved recovery from pain episodes, ability to manage pain, and improved energy levels as a result of AT practice.
Conclusions: A course consisting of group and one-to-one lessons shows promise for people living with recurring / persistent neck or hip pain, as well as for those who do not perceive their knee pain as being caused by underlying structural damage. The findings complement previous clinical trials which demonstrated that one-to-one Alexander lessons enabled people to better manage their neck or back pain.
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https://bjgpopen.org/content/early/2025/05/07/BJGPO.2024.0295.long