Back pain is one of the most common yet perplexing conditions encountered by the medical profession. Whether the cause (disc protrusion, muscle tension, arthritis, spinal curvatures, etc.) is difficult or easy to determine, providing effective treatment is often the major problem.

Herein, I believe, lies the explanation: most patients with back pain need to be educated in addition to receiving any indicated treatment, educated in correct use of the back in daily activities. Such instruction should be an integral part of all treatment programs. Few people with back pain realize that often they sit, stand or bend incorrectly and thereby re-injure the back and prevent it from healing.

During the many years I have worked as a physical therapist, teaching the Alexander Technique to patients with back pain has proved to be one of my most rewarding experiences. The benefits of Alexander's work are manifold. There are a few ways in which I find it of particular value to back pain sufferers. The first has to do with an important discovery Alexander made while developing his Technique: he was having a problem with the way he used one part of himself, the voice, but found he could not solve this problem without correcting the way he used his total self. This approach -- dealing with the totality to solve a specific problem -- is particularly valuable when treating back pain. A problem may manifest itself in one part of the back (lumbosacral disc, to give a common example), but cannot be expected to become better permanently unless the entire body is used in a well-organized way during all activities. In helping resolve a back problem, a teacher of the Alexander Technique emphasizes correct use of the entire body, and simultaneously helps increase the beneficial effects of any physical therapy or other treatment prescribed.

The Alexander Technique provides a solution to another problem relevant to back pain. It is true that many back problems are caused or aggravated by mechanical stresses placed on our vertical spines. However, I disagree strongly with those medical specialists who believe back pain is the inevitable price we pay for the luxury of walking on two feet. The fault lies not with gravity or our uprightness, but with inadequate use of an evolutionary gift: that of conscious awareness and control of our supporting musculature. With the Alexander Technique, we can use this conscious awareness to eliminate harmful use and replace it with beneficial use. This skill is valuable for all to have. For those with back pain, it is a necessity.

Perhaps the most dramatic way Alexander's work benefits people with back pain is by eliminating the feeling of helplessness many of them experience. With most back pain cases, the ultimate responsibility for getting better lies with the patient, not the physician. Alexander's work gives the patient the tools needed to take on this responsibility. Correct use of the entire body during all daily activities is, for many, the real remedy for an ailing back. Often, the best "medicine" is actually education. © 1997

Deborah Caplan (1931- 2001) was an Alexander teacher and physical therapist. She studied with F.M. Alexander as a child and as an adult and was a founding member of the American Center for the Alexander Technique. She was affiliated with New York University Medical Center in the early years of her physical therapy career. Her book, Back Trouble: A New Approach to Prevention & Recovery, (Triad, 1987), can be purchased through AmSAT Books.

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