The Alexander Technique: How it Helps Alleviate Chronic Pain

by Adam Bailey

The Alexander Technique is a century-old educational process in which the student learns a set of skills that he or she can apply in all facets of life. One of the assumptions underlying this educational process is that most people carry more muscle tension than they need in order to carry out activities. The first skill that students learn, then, is how to lessen these areas of undue muscle tension. Second, they learn that, without the interference of the tension, they can cultivate a more natural alignment of their head, neck and spine that has associated with it qualities of balance, strength and coordination. Overall, knowledge of these skills allows students to move and carry out activities with greater ease and less effort.

There are three categories of chronic pain that the Alexander Technique addresses:

I. First, it helps to address conditions that are the result of something a person is doing. Examples might be long hours of work at a computer; work with heavy objects or heavy machinery; or spending long hours on one's feet, to name just a few. Some people who work in these situations develop such conditions as repetitive motion syndrome, carpal tunnel syndrome, and other similar conditions. Certain types of sports injuries and injuries suffered by performing artists also fall into this category. As you might imagine, the assumption underlying the Alexander Technique is that, in some cases, these conditions result because the person is approaching the activity with undue muscle tension, with the result that s/he is interfering with the natural alignment of his/her head, neck and spine. The teacher’s objective in these cases would be to help the person undertake a reeducation process in relation to the activity, as an alternative to giving up the activity altogether.

II. The second category of conditions that the Alexander Technique addresses are conditions that might not result from an activity but that nonetheless do result from excess muscle tension. Examples of this are certain types of back pain, such as that resulting from a herniated disc; sciatica; tension headaches and certain types of migraine headaches; and certain types of joint pain, among other conditions.

Let me go into more detail about one of the above examples. On a number of occasions, I've worked with people who have suffered from a herniated disc. My experience is that this condition, along with sciatica, results from a shortening of the spine - which in turn is the result of a contraction of the related muscles. These people experience a dramatic improvement in their symptoms once they learn how to lengthen those muscles.

One person I worked with, who had a herniated disc, is a horseback riding instructor and horse trainer, presently in her mid-forties. During the "blizzard of 1978", she threw her back out shoveling snow (she was in her mid-twenties at the time). Then, for the next eleven years, her back would go out every year or two, with more or less pain on each occasion. Finally, in a two-month period in late 1989, her back went out three more times; unfortunately, during these episodes, the pain was much worse than it had ever been before, and in the third episode, it was accompanied by shooting pain, followed by numbness, in her right leg. At this point, she sought medical help and was diagnosed as having a herniated disc between her fifth lumbar vertebra and her first sacral vertebra. (Incidentally, the first of the final three episodes began when she was outside walking her dog and she sneezed.)

In retrospect, her sense is that this entire history of back-pain was caused by undue muscle tension throughout her body, and in particular in the muscles associated with her spine. She understands now that this muscle tension gradually increased over time, below the level of her awareness, until finally it reached a threshold, at which point a relatively minor event, such as a sneeze, could precipitate a major episode of pain.

Incidentally, you may wonder how tension throughout a person's body can lead to a disc problem – that is, a problem in one discreet area. What students of the Alexander Technique learn is that muscle tension comes in patterns, and that tension in one area can lead to tension in a seemingly unrelated area. For example, this student discovered, among other things, that she carried a lot of tension in her hands and arms and that this tension exacerbated the tension in her back.

Unfortunately, many people have the kind of overall muscle tension that this student discovered. This tension exists as a kind of background to everything that they do. (Luckily, not everybody ends up experiencing the kind of pain that she did, however.) The best analogy for understanding the nature of this background tension involves the refrigerator in your kitchen. (Bear with me while I explain the metaphor!) We’ve all had times when we were sitting in our kitchen, with our mind focused on something we were doing. Suddenly, the refrigerator shuts off. What we realize when that happens is that the refrigerator was making a noise – a kind of background hum – and we weren’t even aware of it. It’s only when the refrigerator shuts off, and we "hear" the silence (or more accurately we hear the contrast), that we actually become aware that there was a hum.

Well, for many of us, muscle tension plays the same role in our lives: it’s there all the time and we’re not aware of it. Lessons in the Alexander Technique, as you might imagine, play the role of "shutting off" the tension – and it’s only when we have an experience of the "silence" that’s possible in our body, that we realize how much tension there was all along. (Of course, the other time that we become aware of the tension is when it reaches a threshold, and, as in the case of this student, the result is pain.)

In any case, in early 1990, this student had surgery to remove the herniated disc. The surgery helped a lot, alleviating the worst of the pain, and, after some months of bed-rest and physical therapy, she was able to return to work. Unfortunately however, she continued to suffer from a good deal of pain in her back and at times had to limit her work or miss it altogether. What she understands now is that the surgery was successful in addressing the symptom – namely, the herniated disc – but that it did not address the cause of that symptom – namely the background muscle tension.

In 1992, she came to see me for Alexander lessons. The good news is that, after a course of lessons, she has eliminated her back-pain by addressing the underlying tension and learning how to lengthen her spine. As of today, she often rides between four and six horses a day! She wishes she had had Alexander lessons as part of her rehabilitation after surgery, as she thinks that would have sped up her recovery. Moreover, she wonders what might have happened if she had had lessons five or seven years before the surgery. It’s possible that she could have prevented the surgery altogether.

III. The third category of conditions I want to consider is joint pain, which I also mentioned under the first section above. When it comes to this category, there is an important distinction to be made: there are certain types of joint pain that the Alexander Technique does not directly address. Among these are congenital arthritis leading to degeneration of a given joint or joints, as well as injuries leading to ligament or tendon damage. Although the Alexander Technique does not help directly with those conditions, what it does do is to help the person with movement in his/her daily life, given the pain. That is, the technique helps the person to deal with the original pain without causing pain or tension in other parts of the body.

Let me offer two examples, given the second and third categories of pain. I recently worked with a retired businessman in his seventies who came to me complaining of pain in both knees. At the same time, he had a painful arthritic hip. After a course of lessons, his knee pain lessened dramatically - to the point where he could stop taking pain pills and he was able to put away his knee braces. It was clear that the knee pain was the result of muscle tension in his thigh and calf muscles, as well as in his upper body. (He was especially pleased when he was able to go to a wedding, which involved sitting, standing and moving around over a period of hours, and he experienced no knee-pain afterwards.) On the other hand, the lessons did not lead to a lessening of the pain in his arthritic hip. He eventually underwent hip replacement surgery, and as a result his pain was eliminated and his range of movement was dramatically increased.

The second example involves a pediatrician in his mid-50’s with whom I've worked for a period of time. As a child, he suffered from a condition known as aseptic necrosis of the femoral head, which affected his left hip joint and femur. At the time, he was in a full-body cast for 9 months, and the long-term result is that his left leg is slightly shorter than his right leg and he suffers from chronic arthritis in his left hip joint. As you might imagine, the Alexander Technique does not help directly with this person’s arthritis and the resulting pain. Nonetheless, he has been a diligent and committed student of the Alexander Technique because it has helped him to discover that he had developed a certain level of background muscle tension throughout his body. This tension was the result of a number of factors. First, there were his attempts to deal with and compensate for the original necrosis (a traumatic event even for the most resilient child). And second, he has to deal with chronic pain in his everyday life. For example, he has discovered that he often favored his left leg and put extra weight on his right leg; this led to undue tension in his right leg. And finally, there are the normal stresses of adult life. Over time, the Alexander Technique has helped him to lessen the background tension in his body, and in turn this allows him to deal much more successfully with those stresses, as well as the on-going pain in his arthritic hip.


Adam Bailey is a teacher of the Alexander Technique. He lives and works in the Boston area. He can be reached at or at (978)461-0946. Website:

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