Pinched nerve, Tokyo: physical therapist or Alexander technique teacher?
February 26, 2013 7:06 PM   Subscribe

I'm asking this for a friend, A. A has a pinched nerve in the neck that isn't getting any better. He has bad posture and sits in a cubicle all day. He would like to see a physical therapist for this, but has also heard good things about the Alexander technique for correcting posture. Which would you recommend?

A works in Tokyo and is very stressed, and tends to hunch his shoulders. He says that his body is always tense, which I can tell easily from looking at him. He leans forward while walking and his neck is super sore. He had to use his cell phone to type often which has him always looking down.He is working on these things on his own, but is worried he is doing it wrong and would like a professional to help him do this correctly. He just bought an ergonomic chair, and is planning on buying a desktop for work (he was using an ipad with attachable keyboard which hurts his neck since he always has to look down).

He does not have health insurance, so a physical therapist would be about $130/hr while the Alexander technique teacher would be $40-50 for 45 minutes. He is intrigued by the Alexander technique, but has heard it takes more than one class to experience results and he would prefer more immediate relief from the pinched nerve pain, which he believes he might be able to get with a p. therapist. The difference in price is big for him, though - he isn't well off. Finally, he heard that the Alexander technique could help him with piano strain as well, since he often gets tense while playing. Then again, maybe the physical therapist could help too?

Has anyone tried either of these services? A would really appreciate advice on this subject if anyone has experience. He doesn't want to see a doctor again, he claims they were useless and a waste of money. Any recommendations for therapists would be most welcome as well. Thanks!
posted by Kamelot123 to Health & Fitness (8 answers total)
Man, I really hate to be the guy that doesn't answer the question asked, but: when I had a pinched nerve in my back/shoulder blade - in Japan, no less - I went to a regular doc, paid less than $100 USD, got a shot of a nerve block and told to take NSAIDs for inflammation. Pain was mostly gone by the end of the day, resolved completely by the end of the week.

IF he's already done that, then maybe just a really, really good massage to start off with? Cheaper than physical therapy.
posted by curious nu at 7:25 PM on February 26, 2013

Response by poster: Hi there curiousnu,

Like I said, he went to two orthopedic doctors- both told him to just let it 'rest' and to do stretches (which he says he is doing). It was all very vague advice from what he says,

As the pinched nerve is probably a result of repeating stressful postures day in and day out, he thinks it would be better in the long run to get his posture corrected so that he doesn't have more problems down the line.
posted by Kamelot123 at 7:38 PM on February 26, 2013

No idea if this would be any cheaper, but my doctor told me that yoga and/or massage would probably be as beneficial for my back pain as a physical therapist.
posted by something something at 7:40 PM on February 26, 2013

No idea if they have this in Japan, and it's expensive, but he could look into Rolfing. I've used it for similar posture/chronic tension stuff and found it more effective than anything else I've tried (including Alexander, Feldenkrais, yoga and massage). The standard course is ten sessions but some Rolfers will see you on a session-by-session basis for specific problems (and one session just might be all it takes).
posted by zeri at 7:48 PM on February 26, 2013

Well the thing is your friend is setting himself up for disappointment - even a great pt may need some time to figure out what's going on. I had huge, huge neck and shoulder issues once upon a time, my upper back hurt so bad i could barely work or sleep, with pain radiating down the back of my arm. this went on for months, but my gp just gave me painkillers, and a specialist (!) they sent me to gave me a frickin mri and a epidural (spinal) injection which only helped for a short while. thankfully, though, my gp referred me to a great physical therapist, who gave me strengthening exercises and specific stretches to do, and who did some intense spinal mobility work on me (i.e. jammed his elbow into my back like a piledriver). it took about a week, two weeks, but the back pain went away, the referred pain in my arm went away, done. been several years now, no recurrence, nothing. your friend's right (or could be right) about posture - for me, all of the problems i was having were a result of shitty posture, and all of them responded to improving my posture and correcting the resulting muscle imbalances. it turned out to be easy, but it was still 6 or 10 trips to the pt. i know people who have done alexander and loved it, but it's not pt, and there's no way i would try and use it as a cheap pt substitute.
posted by facetious at 8:07 PM on February 26, 2013

I think either or both would help in the long-run, but for immediate relief, in my own experience, muscle relaxants were most helpful. They got the pressure off the nerve. Massage could serve the same purpose, though I would be worried that it could accidentally cause more pain.
posted by three_red_balloons at 8:13 PM on February 26, 2013

Alexander technique takes time and quite a bit of attention to learn. It is a long term solution (if it is any sort of solution) to posture issues. It will not provider fast relief, and it will not provide relief in one session. Imagine a process of teaching yourself to sit and stand differently. I took a series of like 10 AT classes, and putting aside for a second my skepticism about how effective it would have ultimately been and of what I was "learning," it was clear that I would need much more practice, training, and attention to make any substantial changes to the way I carried myself.

A PT may need several sessions, but they will be working specifically in ameliorating the pain your friend is feeling. Per session cost is not the metric upon which to judge these two things.
posted by OmieWise at 5:37 AM on February 27, 2013

I've gotten amazing results from the Egoscue Method, which I've posted about before. (Summary: 15 years of recurrent chronic back pain that would at times get up to the cane + back brace + opiate painkillers level. After time on crutches sent me into the worst episode I'd ever had, I started doing the exercises in Pete Egoscue's book Pain Free. Within four days I was able to stop taking my Vicodin. I started going to their SF clinic and now, almost five years later, I haven't had another episode of back pain. As long as I do my exercises even semi-regularly, the pain is nonexistent.)

They have a clinic in Tokyo.
posted by Lexica at 6:12 PM on February 27, 2013

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