Story 1: Case Study on Back Pain

It was the last week in October 1986 when my office phone rang. The caller was typical: a man introduced himself as one who had been suffering from chronic back pain for 20 years. Tom was asking for my help.

I am an Alexander teacher. I am also a physical therapist. This man was calling because his doctor had heard from other patients that I practiced "an unusual form of physical therapy" that he didn't understand, but that seemed to be helpful. The caller described himself as "at the end of his rope." Plagued by pain for nearly half his lifetime, he was willing to try anything.

Tom's medical, social and emotional histories were remarkable. He had had a lifting injury in the army at the age of 25. The injury was in the lumbar spine and initialy seemed minor, but pain persisted. Over the course of 20 years, he had several unsuccessful surgeries: a lumbar laminectomy followed by two spinal fusions. He also had tried acupuncture, hypnosis and other alternative approaches. Nothing had given him relief.

Tom was 45 years old, married and the father of a 10-year-old son. He worked for IBM and, despite his limitations, led an incredibly productive life. But his limitations were enormous. Tom could drive no longer than the short distance to and from work. He worked at a standing desk because pain made sitting impossible. He enjoyed no extra-curricular activities. His daily pain was so great he could not sit to eat a meal with his family. He managed his pain with analgesics that barely got him through his days. Miserable, he was looking for help to improve the quality of his life. He couldn't stand for long, could sit only for short periods, and had great difficulty walking. He described his life as "living in a tunnel where I push to get through the necessary work, and then collapse."

After our first meeting the following day, Tom began Alexander lessons. I explained that the Technique was a mind/body approach to his chronic back pain. Tom was a willing student, highly motivated and open to a new way of thinking about the cause of his pain. The key word is thinking. Each week, Tom began taking two Alexander Technique lessons and one physical therapy session to guide him gently into increased physical activity.

The lessons revealed something remarkable: to cope with his daily pain, Tom had spent the last two decades divorcing his mind from his body. Twenty years of suffering had made him an expert at blocking the experience of his pain. His skill at mind/body separation was excellent. Now I was asking him to focus on this connection, but in reverse. I wanted Tom to be acutely aware of his discomfort and use it as a feedback mechanism. It worked. Tom became facile at reconnecting his mind to his body. This feedback and my guidance toward a new way of moving helped him. I taught him what it was like to sit, stand, and function in a different way.

Tom studied the Alexander Technique for most of a year. During that time, some of his significant milestones were:

1. at three weeks:

a. The pain in one leg disappeared almost completely.
b. Tom sat with comfort for most of Thanksgiving dinner with his family.

2. at three months:

a. Tom no longer took any pain medication.
b. He returned to work on a regular basis and was able to sit at his desk.
c. He no longer wore a back brace.
d. He was walking two miles a day, pain free.

3. at four months

a. Pain was no longer the central theme of his life.
b. He could control his pain by using the principles of the Alexander Technique.

4. at nine months

a. He was experiencing life outside "the tunnel."
b. He was coaching his son's Little League team.

 The interaction between mind and body is a recognized medical phenomenon which has been applied to alter heart rate, blood pressure, skin temperature and brain waves. The Alexander Technique utilizes this same mind/body connection to achieve improved conscious control of the neuromusculoskeletal system. If back pain persists without objective physical findings, we can assume that the pain is the result of poor postural habits. Exploring these habits and increasing one's conscious awareness of how these habits create musculoskeletal imbalance opens the door to controlling back pain.

The Alexander Technique is a process of awareness and thought which, when applied by people like Tom to control musculoskeletal tension, can bring significant pain control or pain relief. For those who suffer from chronic pain syndrome, the Technique is a relatively untapped resource for the medical community.

©Judith C. Stern, MA, PT, Certified Teacher of the Alexander Technique