A study published in a British medical journal last month indicates the Alexander Technique is more effective in relieving chronic back pain than massage or exercise.

The Alexander Technique was devised by Frederick Matthias Alexander, a late-19th-century Australian actor, as a way of dealing with his recurring laryngitis. After doctors told him there was no physical cause, Mr. Alexander started to watch himself in the mirror while he spoke. He discovered his vocal problem was due to muscular tension.

The Alexander Technique is practiced more in Britain, where Mr. Alexander went to teach in 1931, but is growing rapidly in popularity here.

"The Alexander Technique is not so much something you learn as something you unlearn," wrote Richard Brennan, who teaches the technique in Britain and Ireland. "It's a method of releasing unwanted muscular tension throughout your body, which has accumulated through many years of stressful living. The stressful living starts in childhood and, if left unchecked, can give rise in later life to common ailments such as arthritis, neck and back pain, migraines, hypertension, sciatica, insomnia and depression."

The Alexander Technique is similar to Feldenkrais, described in the Post-Gazette July 23.

"Interestingly enough, Moshe Feldenkrais studied with F.M. Alexander before he set off on his own," said Ben Miller, one of three certified Alexander Technique instructors in the Pittsburgh area, and a member of the board of the American Society for the Alexander Technique.

Mr. Miller was an actor in Los Angeles and New York City before coming to Pittsburgh. He teaches acting at Point Park University in addition to his practice.

"Feldenkrais is a movement system," said Lonna Wilkinson, who teaches the Alexander Technique at the University of Pittsburgh-affiliated Falk School, and in her private practice in Squirrel Hill. "The Alexander Technique has more to do with becoming aware of and directing the innate postural system."

Ms. Wilkinson was a professional dancer for 20 years before becoming an Alexander Technique teacher.

"The professional dancing life was no longer making sense to me, so I looked around for something that would still have a connection between thinking and moving," she said.

To become certified as Alexander Technique teachers, Mr. Miller and Ms. Wilkinson had to complete a three-year, 1,600-hour training program. The other Alexander Technique instructor in the area is Lisa Levinson of Squirrel Hill.

"My experience of the Alexander method is that it's more specialized in its limited focus in getting force off the spine," said Mark Shefsiek, a Feldenkrais practitioner at UPMC's Center for Integrative Medicine in Shadyside. "It's very good about helping people with basic fundamental movements. If the pain is really focused on bad posture, then the Alexander Technique can help a lot. But if there is a structural problem, it would be less helpful."

During a lesson, a teacher will use observation and gentle touching to redirect poor alignments or postures.

"The Alexander Technique uses as its central organizing principle that all movement is the relationship between the head, neck and back," Mr. Miller said. "If there is freedom of movement in the head, neck and back, it leads to efficiency throughout the body."

According to the British study, after a year, out of 579 subjects with lower back pain, the 144 who took 24 lessons in the Alexander Technique had an average 48 percent reduction in their Roland disability score, and an 86 percent reduction in their days of pain compared with the control group of 144 subjects, who had no intervention. (The Roland-Morris questionnaire is a self-administered disability measure in which greater levels of disability are reflected by higher numbers on a 24-point scale.)

The group of 144 that relied on exercise alone showed a 17 percent decline in disability, but no decline in the number of days in pain.

The group of 147 subjects who relied on massage reported 33 percent fewer days of pain, but no decline in disability.

Though 24 lessons in the Alexander Technique produced the best results, the results were nearly as good for those who took just six lessons, but exercised regularly, the British researchers said. People in this group reported a 42 percent decline in disability and an 86 percent decline in days of pain.

Mr. Miller said he charges between $50 and $100 for an hour session. He encourages students to commit to 10 lessons, but doesn't require it.

"Ideally, things really start making sense to the student around lesson four or five," Mr. Miller said.

Ms. Wilkinson charges $50 for a 45-minute lesson.

"It's sort of like a music lesson," she said. "If you want to learn to play a few tunes, that would be three to four lessons. If you want to play something more complex, that would be 10 to 20 lessons."

Dr. Nancy Lavelle, a clinical psychologist in Oakland, has had about a dozen sessions with Mr. Miller.

"I feel better," she said. "I have a more integrated sense of the mind-body connection. My stress level decreased. My muscle tension abated. I would walk in, in one state, and walk out with a lightness of being."