Movement-Based Approaches Outperform Standard Exercise + Education for Chronic Low Back Pain

Article: https://bjsm.bmj.com/content/54/13/782

This multicentre clinical trial compared Cognitive Functional Therapy (CFT) to standard exercise and education for chronic low back pain. CFT — a system centred around movement retraining, exposure, and reducing protective guarding — produced superior improvements in pain, disability, mood, and movement confidence.

Participants learned to move with less fear and more awareness, gradually restoring natural movement variability. The improvements were sustained at 12-month follow-up, indicating durable, long-term behavioural change.

The trial also emphasised that changing someone’s relationship with movement, posture, and breath has more impact than focusing on sets, reps, or isolated strengthening. Pain reduction corresponded with changes in movement patterns and nervous system sensitivity.

How this connects to FP Brisbane:
FP shares the same foundation: teach the body to move differently, not harder. We address the whole system — breathing, ribcage mechanics, gait sequencing, hip rotation, and trunk control — to reduce protective patterns and improve confidence. This study demonstrates that a movement-centred, whole-body approach aligns with the best outcomes seen in chronic pain care.

Key takeaways:

• Movement retraining improves long-term outcomes

• Pain is influenced by movement confidence and exposure

• Changing the pattern changes the pain

• FP fits within an evidence-supported shift toward whole-body retraining