Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial
- PMID: 26524571
- DOI: 10.7326/M15-0667
Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial
Erratum in
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Correction: Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain.Ann Intern Med. 2016 Feb 2;164(3):204. doi: 10.7326/L15-0020. Ann Intern Med. 2016. PMID: 26829916 No abstract available.
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.
Design: Three-group randomized, controlled trial. (Current Controlled Trials: ISRCTN15186354).
Setting: U.K. primary care.
Participants: 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.
Intervention: 12 acupuncture sessions or 20 one-to-one Alexander lessons (both 600 minutes total) plus usual care versus usual care alone.
Measurements: 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.
Limitation: Practitioners belonged to the 2 main U.K.-based professional associations, which may limit generalizability of the findings.
Conclusion: 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.
Primary funding source: Arthritis Research UK.
Comment in
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Reported Outcomes of the Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain Article.Ann Intern Med. 2016 Mar 1;164(5):375-6. doi: 10.7326/L15-0633. Ann Intern Med. 2016. PMID: 26926697 No abstract available.
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Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain.Ann Intern Med. 2016 Mar 1;164(5):376. doi: 10.7326/L15-0632. Ann Intern Med. 2016. PMID: 26926698 No abstract available.
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In chronic nonspecific neck pain, adding Alexander Technique lessons or acupuncture to usual care improved pain.Ann Intern Med. 2016 Mar 15;164(6):JC29. doi: 10.7326/ACPJC-2016-164-6-029. Ann Intern Med. 2016. PMID: 26974729 No abstract available.
Summary for patients in
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Summaries for Patients. Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain.Ann Intern Med. 2015 Nov 3;163(9):I30. doi: 10.7326/P15-9033. Ann Intern Med. 2015. PMID: 26524582 No abstract available.
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