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Purpose: Alexander Technique (AT) is an educational method aiming at increased sensory awareness and kinesthetic control to modify postural and movement patterns which might be associated with musculoskeletal disorders. It has been proven effective for chronic low back pain; however no study has yet determined its effects on chronic non-specific neck pain. Methods: A randomized controlled trial with 3 parallel groups was conducted. Patients were randomly allocated to either 5 weekly sessions of AT, heat pack application (HEAT) or guided imagery (GI) each. The primary outcome measure at week 5 was the neck pain intensity on a 100-mm visual analogue scale; secondary outcomes included neck disability, quality of life, satisfaction and safety. Analyses of covariance were applied on an intention-to-treat population testing ordered hypotheses AT vs. HEAT and AT vs. GI. Results: 72 patients were included (65 females, 40.7 -7.9 years), 52 of them received all 5 interventions. No significant group difference was found for neck pain intensity when AT was compared to HEAT (Difference 4.5; 95% CI: -8.1, 17.1; p = 0.48), but exploratory analysis revealed superiority of AT over GI (Difference -12.9; 95% CI: -22.6, -3.1, p = 0.01). Significant group differences were also found for physical quality of life in favor of AT vs. HEAT or GI (p < 0.05). Adverse events mainly included slightly increased pain and muscle soreness. Besides high levels of benefit from AT, patients also reported increased body awareness and control over the body, relaxing or stimulating effects and mood changes after the sessions. Conclusion: Five sessions of AT were no better than a heat pack application for relieving chronic non-specific neck pain. Therefore it cannot be recommended as routine intervention at this time. Since exploratory analysis revealed some improvements of AT further trials are warranted for conclusive judgment. Contact: Romy Lauche, r.lauche@kliniken-essen-mitte.de