Best Bet For Neck Pain?

I heard that the Alexander Technique and acupuncture are the best treatments for chronic neck pain. Can you tell me about these approaches? Which one would be best?

– February 1, 2016

Results of a recent study from the UK indicted that both acupuncture and the Alexander Technique worked better than drugs and traditional physical therapy over the course of a year to help patients with long-standing neck pain. Researchers at the University of York randomly assigned 517 patients who had been suffering from chronic neck pain for an average of six years. The participants were divided into groups to receive 12 acupuncture sessions, 20 one-on-one Alexander Technique lessons or the usual treatment consisting of medication and physical therapy. The patients who underwent acupuncture or attended the Alexander Technique lessons all received a total of 600 minutes of treatment.

The improvements the patients reported on a pain questionnaire demonstrated that acupuncture and the Alexander technique worked better than medication and physical therapy and as well as each other for long-term relief. Patients in both groups reported that their pain diminished by about 32 percent as a result of these two treatments over the course of the study. They also learned approaches to stress relief and improvement of posture and balance. No serious adverse side effects occurred with either of the two treatments.

It isn’t surprising that these approaches worked so well, particularly in light of a 2012 analysis from Memorial Sloan Kettering Cancer Center in New York City showing that acupuncture relieves chronic pain better than standard medical care. The investigators reviewed 29 earlier studies selected as the most rigorous ones available on the use of acupuncture for pain relief. Combined, these studies included data on nearly 18,000 patients, and all compared actual acupuncture with “sham” treatment – i.e., placement of needles in areas of the body that are not traditional acupuncture points. This allowed the researchers to determine whether pain relief really was due to acupuncture rather than to a placebo response. The studies also compared acupuncture with the usual medical treatments available for various types of chronic discomfort.

In addition to acupuncture, I’ve long recommended the Alexander Technique for addressing chronic pain as well as for acute muscle strain. It aims for proper positioning of the head and spine by correcting imbalances caused by tension and unhealthy body mechanics. The technique focuses on unlearning poor habits of posture, movement, breathing and body orientation and replacing them with tension-free, fluid movement. It teaches you to sense muscle tension and then release it through corrective thoughts, breathing and posture.

The only downside to the Alexander Technique for treatment of pain is that it generally isn’t covered by health insurance. According to the American Society of the Alexander Technique, costs usually range from $75 to $130 per session. To find a certified practitioner in your area log onto the Alexander Technique website. Some health insurance plans cover acupuncture. The cost per session is approximately $125.

Andrew Weil, M.D.


Hugh MacPherson et al, “Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain.” Annals of Internal Medicine, November 3, 2015; 163 (9): 653 DOI: 10.7326/M15-0667

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