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Cognitive Muscular Therapy™ for low back pain: a pilot study.

Stephen J Preece1, Jason Smith2, Nathan Brookes3

  • 1Centre for Human Movement and Rehabilitation, School of Health and Society, University of Salford, Manchester, UK.

Musculoskeletal Science & Practice
|September 19, 2025
PubMed
Summary

Cognitive Muscular Therapy™ (CMT) shows promise for chronic low back pain (cLBP). This new therapy integrates biomechanical training and psychological techniques, leading to reduced pain and disability in participants.

Keywords:
Biopsychosocial rehabilitationChronic low back painElectromyographyPhysiotherapyPostural tone

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Area of Science:

  • Rehabilitation Medicine
  • Pain Management
  • Biomechanical Analysis

Background:

  • Chronic low back pain (cLBP) is a leading cause of disability.
  • Overactivation of abdominal and superficial paraspinal muscles is common in cLBP.
  • This may indicate an antagonistic flexor-extensor muscle tone imbalance.

Purpose of the Study:

  • To test Cognitive Muscular Therapy™ (CMT) as a novel intervention for cLBP.
  • CMT combines biomechanical training for postural tone with psychological pain management techniques.

Main Methods:

  • An observational case series of 15 cLBP participants receiving 7 weekly CMT sessions.
  • CMT included components like relaxation, postural deconstruction, and functional integration.
  • Electromyography (EMG) biofeedback monitored erector spinae activity during walking; qualitative interviews were also conducted.

Main Results:

  • Significant reductions in disability (Roland-Morris score -7), pain catastrophizing (-13.2), and fear of movement (-7.8).
  • EMG data indicated improved phasic erector spinae activation during walking.
  • Interviews revealed increased self-efficacy and enhanced pain management skills.

Conclusions:

  • This study presents the first evidence of CMT for cLBP, demonstrating promising reductions in pain and disability.
  • CMT offers a novel approach by integrating psychological strategies with biomechanical retraining.
  • Further research is needed to confirm its mechanism of action and clinical effectiveness.