Relieve Low Back and Neck Pain with Pandiculation

Young yogi woman spreading hands wide open with city on background. Pain-free concept. Love and emotions, woman happiness.

Chronic back and neck pain are disabling conditions experienced by many people at some point during their lifetimes. A recent study demonstrates the efficacy of using pandiculation to relieve chronic back and neck pain by releasing chronic muscle tension.

The Global Problem of Back and Neck Pain

Concept of back and neck pain.

The Global Burden of Disease Study 2017 reports that 577 million people worldwide are affected by back pain at any time. In 2019, the CDC’s National Health Interview Study found that 39 percent of American adults had experienced back pain in the previous three months.

Lower back pain is the leading cause of disability worldwide, taking a financial toll on individuals and governments and contributing to rising health insurance costs, painkiller abuse, and mental health issues.

The Mayo Clinic Symposium on Pain Medicine reports that neck pain occurs in more than 30 percent of US adults yearly, and nearly 50 percent of these cases become chronic or recurring. In 2017, there were 288.7 million cases of neck pain worldwide, an increase of 75 percent from the 164.3 million cases in 1990.

Causes and Troublesome Treatment of Back and Neck Pain   Concept of Neck Pain

While the global population is aging, becoming less physically active, and experiencing rising levels of stress, these factors aren’t to blame for the entire problem of chronic back and neck pain.

Sadly, many back and neck pain patients receive inappropriate treatment. While most cases can be alleviated with physical therapies, patients are all too often prescribed opioid painkillers or encouraged to have costly surgeries that have inconsistent results. Not only do doctors and hospitals want to be reimbursed for treatment, but they also don’t understand the underlying cause of chronic musculoskeletal pain.

Addressing the Underlying Causes of Musculoskeletal Pain

Most chronic musculoskeletal pain develops due to learned motor patterns, or what we commonly refer to as muscle memory. As we repeat the same movements and postures over and over, they become deeply learned by our nervous system. Our nervous system starts to keep the muscles involved in those patterns somewhat contracted all the time to help us be efficient. Unfortunately, the side effects of developing muscle memory are chronically tight muscles, loss of muscular control, and loss of sensation.

Somatic education relieves chronic musculoskeletal pain by retraining these deeply learned muscular patterns. Types of somatic education include the Alexander Technique, the Feldenkrais Method®, and Hanna Somatic Education (HSE), also known as Clinical Somatic Education (CSE).

Research on Pandiculation and Clinical Somatic Education

Concept of pandiculation to help with back and neck pain.

While previously published studies have demonstrated the efficacy of the Alexander Technique and the Feldenkrais Method® for relief of back and neck pain, no studies of Hanna Somatic Education/Clinical Somatic Education have been published until now. Hanna Somatic Education/Clinical Somatic Education is unique in somatic education and all movement modalities because it uses the technique of voluntary pandiculation, which releases chronic muscle tension by resetting the gamma feedback loop.

Hanna Somatic Education/Clinical Somatic Education is a method of self-care in which each individual is taught how to retrain their nervous system to release chronic muscle tension and improve posture and movement. The intention of Hanna Somatic Education/Clinical Somatic Education is to empower people to take care of themselves and become experts in their musculoskeletal functioning.

About Qiuju Huang, the Author of the Study

Qiuju Huang worked at the Johns Hopkins Aramco Healthcare (JHAH) in Saudi Arabia as a senior nurse clinician for 20 years. A severe injury to her lower back caused disc protrusion, and the pain prevented her from exercising and limited her ability to work. After trying nearly everything to heal her pain, she discovered Hanna Somatic Education. Hanna Somatic Education exercises relieved her pain and allowed her to resume activity, so she enrolled in professional training at the Novato Institute for Somatic Research & Training to become a Hanna Somatic Educator.

Qiuju had many patients at the Employee Health Clinic with chronic muscle pain similar to hers. Their pain led them to take painkillers and visit the doctor regularly, with limited results. Many of them felt helpless. Hospital management supported Qiuju in teaching Hanna Somatic Education exercises to her patients with chronic pain, and she witnessed incredible improvements in their pain levels and functioning. She worked with hundreds of patients in the Employee Health Clinic. She ultimately completed this retrospective study on the effects of Hanna Somatic Education for patients with chronic neck and back pain.

Methodology of the Low Back and Neck Pain Study

This retrospective study included 103 patients aged 27 to 71 years old who had experienced lower back and neck pain for over two months. All patients participated in between two and five private sessions of Hanna Somatic Education throughout 2 to 8 weeks. Qiuju Huang, a certified Hanna Somatic Educator, taught all sessions.

In the Hanna Somatic Education sessions, Huang taught the patients how to practice self-care exercises that utilize the technique of voluntary pandiculation. Voluntary pandiculation involves first slowly contracting muscles in a concentric contraction, then slowly allowing the muscles to lengthen while resisting the force of gravity or hands-on resistance provided by the educator (an eccentric contraction). The purpose of the Hanna Somatic Education sessions was to teach the patients how to practice these self-care exercises regularly on their own at home.

The patient’s pain levels were recorded before and after each session of Hanna Somatic Education. The pain levels were assessed using the Wong-Baker FACES Pain Rating Scale on a scale of 0–5 (0 = no pain; 5 = the worst possible pain). Medication use and the number of doctor visits before and after the Hanna Somatic Education intervention were also recorded.

3 Positive Results Found in the Study

Group of diverse people are joining a yoga class practicing restful and helpful Child's Pose.

  1. Pain Levels

    After completing a mean of 2.8 Hanna Somatic Education sessions, the mean lower back pain rating decreased from 3.3 to 0.6, a decrease of 81 percent. The mean neck pain rating dropped from 3.1 to 0.6, a reduction of 80 percent. The mean pain rating of patients with lower back and neck pain decreased from 3.4 to 0.7, or 79 percent.

  2. Use of Pain Medication

    After six months, the number of patients (out of 103) using pain medication decreased from 53 to 14, a reduction of 73.5 percent. The decline in the use of medication for patients with lower back pain was 87.5 percent, with neck pain was 73 percent and with both neck and lower back pain was 61.5 percent.

  3. Number of Doctor Visits

    The mean number of doctor visits six months before receiving Hanna’s Somatic Education sessions was two. This was reduced to a mean of 0.5 visits in the six months following the Hanna Somatic Education sessions. The reduction in the mean number of doctors’ visits for patients with lower back pain was 84 percent, with neck pain was 83 percent, and with both lower back and neck pain was 61 percent.

Conclusions From the Studies

African-american woman stretching, practicing pandiculation while sitting on her bed. A great way to start a day and help prevent back and neck pain.

The study found that patients significantly reduced lower back and neck pain after completing about three sessions of Hanna Somatic Education and practicing the exercises regularly at home. The six-month follow-up showed that pain reductions were sustained, as 73.5 percent of patients stopped using pain medications, and the mean number of doctors’ visits was reduced overall by 75 percent.

The study authors write: “The findings of this study indicate that Hanna Somatic Education is an effective and sustainable method of reducing spinal pain…Further investigations are recommended regarding the evidence-based treatment of Hanna Somatic Education in patients with muscle pain.”

This is the first study of Hanna Somatic Education/Clinical Somatic Education and voluntary pandiculation published in a peer-reviewed academic journal. Since the findings were so significant, it is hoped that this research will lead to future studies exploring how Hanna Somatic Education/Clinical Somatic Education and voluntary pandiculation relieve various chronic musculoskeletal pain.

You can read the complete study here: Effect of Hanna Somatic Education on Low Back and Neck Pain Levels.

Reprinted with permission from
sarah warren

Sarah Warren is a Certified Clinical Somatic Educator and the author of the book The Pain Relief Secret. She was trained and certified at Somatic Systems Institute in Northampton, MA. Sarah has helped people with chronic muscle and joint pain, sciatica, scoliosis, and other musculoskeletal conditions become pain-free by practicing Thomas Hanna’s groundbreaking method of Clinical Somatic Education. Sarah is passionate about empowering people to relieve their pain, improve their posture and movement, and prevent recurring injuries and physical degeneration.

Recent articles


Upcoming courses

Yoga for
every body

How to Avoid the Top 3 Pitfalls of Forward Bends

With Julie Gudmedstad

Recent articles


Sorry, You have reached your
monthly limit of views

To access, join us for a free 7-day membership trial to support expanding the Pose Library resources to the yoga community.

Sign up for a FREE 7-day trial