Manage Pain

Understanding persistent pain

Pain is not only a signal of injury or tissue damage. Modern pain science shows that pain is shaped by how the brain interprets information from the body, emotions, past experiences, and the current environment.

For many people, pain can persist even after physical healing has occurred. This happens when the nervous system remains in a heightened state of alert, continuing to protect the body as though danger is still present. Over time, this protective response can become habitual, contributing to ongoing pain and sensitivity.

Because of this, working with persistent pain requires a whole-person approach rather than focusing solely on injured tissues.

Pain, mobility, and everyday life

Ongoing pain often affects more than comfort. It can gradually reduce mobility, confidence, and quality of life.

Common experiences include:

• Avoiding certain movements or activities

• Stiffness or loss of range of motion, including shoulder restriction or “frozen” sensations

• Pain that fluctuates with stress, fatigue, or emotional load

• Disrupted sleep due to discomfort or tension

• Increased caution or fear around movement

Over time, these patterns can reinforce pain by limiting movement options and increasing protective tension.

Pain as a learned and adaptable experience

Scientists now understand that pain is influenced by many interacting factors, including:

• Stress and emotional load

• Habitual movement and posture

• Beliefs and expectations about pain

• Past experiences of pain or trauma

• Environmental and social context

This does not mean pain is “all in the mind.” All pain is real. However, it does mean that pain is changeable. By supporting the nervous system and changing unhelpful habits, it is possible to reduce the intensity and impact of persistent pain.

“After months of physio with little improvement, Cathy helped me change how I was walking. The pain started to fade and was gone not long after.”
— Bruce, Melbourne

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How the Alexander Technique supports pain change

The Alexander Technique does not aim to diagnose or treat pain. Instead, it helps people gently unravel and change how they respond to pain and how they use their bodies in daily life. Both of which strongly influence - and are influenced by - the nervous system.

Alexander Technique lessons and body–mind coaching can help to:

• Reduce unnecessary muscular tension that increases strain and discomfort

• Improve posture and coordination, reducing load on sensitive areas

• Support calmer nervous system responses, interrupting pain–stress cycles

• Improve movement confidence, reducing fear-based guarding

• Increase awareness of habits that exacerbate pain in daily activities

• Enhance recovery post-injury or surgery: relearning movement without protective tension can support healing and prevent long-term compensation patterns

• Support self-management in real time—during work, daily activities, and rest

Rather than trying to “fix” pain directly, people learn skills that support more adaptable, less effortful movement.

A gentle, respectful approach

Living with pain often involves frustration, uncertainty, and fatigue. Pushing through or forcing change can increase distress and sensitivity.

Cathy Dowden’s approach is calm, paced, and collaborative. Lessons are adapted to each person’s needs and comfort, whether sitting, standing, or moving slowly. There is no requirement to push into pain or “fix” the body. The focus is on reducing unnecessary effort and supporting safety and ease.   

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This work is suitable for people experiencing:

• Persistent or recurrent pain

• Pain associated with stress or anxiety

• Long-term conditions or sensitivity

• Pain influenced by past injury or trauma

• Fear or uncertainty around movement

Evidence and application

Research supports the role of Alexander Technique lessons in managing certain pain conditions. A landmark study published in the BMJ (2008) found long-term benefits for people with chronic back pain following Alexander Technique lessons.

More broadly, pain science research supports approaches that address nervous system sensitivity, movement habits, and stress regulation alongside physical care.  

Movement, biomechanics, and awareness

Biomechanical factors remain an important part of pain management. Poor coordination, inefficient movement patterns, or habitual postural strain can contribute to pain, particularly in the neck, shoulders, back, and hips.

Alexander Technique lessons integrate biomechanical understanding with awareness and attention, helping people:

• Move with better support from the whole body

• Reduce overuse of the neck and shoulders

• Distribute effort more evenly during everyday tasks

• Apply principles to walking, sitting, lifting, and reaching

This approach supports movement without forcing positions or prescribing exercises.

Supporting sleep, rest, and recovery

Pain often interferes with rest and sleep, which in turn increases sensitivity to pain. Learning to reduce habitual tension and respond more calmly to discomfort can support:

• Greater ease when lying down or changing position

• Reduced holding or bracing at rest

• Improved capacity to settle and recover

Many people find that improved coordination and reduced effort positively affect both sleep quality and daytime energy.

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Empowering self-management

A key strength of the Alexander Technique is that it equips people with skills they can use in real time — at home, at work, or during daily activities.

Rather than being a passive recipient of treatment, the individual learns how to influence their own experience of pain with greater awareness and choice.

This work can complement medical care, physiotherapy, psychology, and other pain management approaches.

The principles of the Alexander Technique underpin all of this work.

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Not therapy — practical, supportive education

The Alexander Technique does not diagnose or treat medical conditions. It offers practical, body-based education that supports people living with persistent pain.

The skills learned through Alexander Technique lessons can be applied throughout daily life—while sitting, standing, walking, working, resting, or responding to discomfort.

Over time, these skills can support greater comfort, confidence, and adaptability, even when pain has been present for a long time.