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Dr. Zorba Paster: Two options for chronic neck pain

Dear Doc: I’ve had neck pain for years and years – ever since I banged my head schussing down the hill trying to outdo my 9-year-old in a ski race. Let me tell you, never, ever try to beat a 9-year-old; they can zip and turn quicker than you can say “Jackie Robinson.”

I’ve taken ibuprofen, gone to physical therapy for exercises, tried warm compresses. They all work, but the pain still bothers me from time to time. Anything new going on?

– A radio listener from Chicago

This is a letter I received quite some time ago and held on to, just waiting for something new to come out. And now it has.

An article just published in the Annals of Internal Medicine shows that acupuncture and the Alexander Technique – I’ll explain what that is a bit further on – both help to reduce neck pain.

Researchers looked at more than 500 people with chronic neck pain lasting more than five years – so these were not acute injuries but people who had been suffering for a while.

Anyone who has had a stiff neck (and who hasn’t?) knows how troubling neck pain can be.

The people were put into three groups: One group got 12 acupuncture sessions, the next group got 20 Alexander Technique sessions, and the final group got the usual – take an NSAID (nonsteroidal anti-inflammatory drug) when you’re troubled and do your PT exercises.

Everyone knows what acupuncture is, but the Alexander Technique was news to me.

It is described as “self-care that helps people enhance their control of reaction and improve their way of going about everyday activities. Benefits depend on reducing habits associated with poor posture, excessive muscle tension, mal-coordination and stress.”

This is a one-on-one technique taught by book learning and hands-on experience. It was developed in the late 1800s to teach people how to avoid unnecessary muscular tension throughout their day – at work and at play.

The treatment was developed by Fredrick Alexander, who wanted to pursue acting but was hampered by too many muscular maladies. He had to relearn how to use his muscles.

It’s not a relaxation technique, per se, but rather a method to help you learn how to stand, sit and move efficiently in a more fluidlike manner.

Alexander thought if people could just learn to appreciate how their muscles worked, they could unlearn bad habits and learn good habits.

You might think of it as, “Change your posture, change your life.”

Now, in the study, each group was asked to report how they felt at three-month intervals during a 12-month period.

One year later, the people in both the acupuncture and Alexander Technique groups had reported improving significantly compared to those in the group following the usual care of PT exercises and medications as needed.

I find this very interesting because chronic pain is something we doctors have problems with.

One issue with the spike in opioid prescriptions – and I, for one, fell into that trend – is that people with chronic pain suffer and it’s our duty as physicians to help them whenever we can. We often reach for the prescription pad because it’s easier and for many with acute pain it works.

But chronic pain is a different beast. It’s harder to treat, and the chronic opioid medications are not as effective. These meds also have side effects and risks, so anything that can move us away from that treatment modality is, by definition, good.

The study shows an example of non-drug treatments that anyone with neck pain should consider. And I think this could easily be extended to chronic back pain, as well.

But before deciding if this is right for you, keep in mind that there were a limited number of treatments – 12 acupuncture and 20 one-on-one treatments using the Alexander Technique.

I think it’s worth giving these a shot, although there is no guarantee they will work for you. Just give them a good try.

Dr. Zorba Paster is a physician, professor, author and broadcast journalist. He hosts a radio program at 3 p.m. Saturdays on WBFO-FM 88.7; email him at zorba@wpr.org.