Long-term back pain can be relieved through encouraging sufferers to adopt good posture through the Alexander technique, say UK researchers.
The technique teaches patients how to sit, stand and walk in a way that relieves pain by focusing on their coordination and posture.
Until now there had been little evidence of the therapy's long term effectiveness.
The latest work is published in the British Medical Journal.
About half the UK population suffers from back pain during a year with up to 15% going on to have chronic problems.
It is the second biggest cause of sick leave, accounting for five million lost working days a year.
The trial was funded by the Medical Research Council and the NHS Research and Development fund.
Researchers from Bristol and Southampton universities used a combination of normal GP care, massage and Alexander technique lessons on 463 patients over the course of a year.
They found that by the end, the Alexander patients suffered just three days back pain a month.
This compared to 21 days for those receiving GP care, which tended to include regular consultations, pain killers and exercise regimes for some, and 14 for those who had massages.
The Alexander patients were split into two - one group received 24 lessons and one six.
Those who had 24 lessons were suffering just three days pain, compared to 11 for the other group.
Lead researcher Professor Debbie Sharp said using the Alexander technique should provide help to most people with back pain.
She added: "Lessons in the Alexander technique offer an individualised approach to develop skills that help people recognise, understand, and avoid poor habits affecting postural tone and neuromuscular coordination.
"It can potentially reduce back pain by limiting muscle spasm, strengthening postural muscles, improving coordination and flexibility, and decompressing the spine."
Dries Hettinga, researcher manager for Back Care, a charity which offers support and advice to people with back pain, said: "There is little evidence available about the effectiveness of the Alexander technique so this research is welcome.
"The Alexander technique is something we do recommend and the feedback we have got is good.
"But I would say that it may not be effective for everyone. Back pain is different for each person and you often need a combination of things to help relieve it."