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
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.
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.
