Rethinking Low Back Pain: How Movement Education Supports Lasting Change
Low back pain is one of the most common reasons people seek help from a healthcare provider. It affects over 600 million people globally and is the leading cause of disability worldwide. But when pain becomes persistent — lasting for more than 12 weeks — it’s no longer just a physical problem. It becomes a complex experience shaped by your body, your beliefs, your habits, and your environment.
Most cases of chronic low back pain (CLBP) are “non-specific”, meaning they can’t be traced to a clear structural injury or disease. Despite this, outdated views that focus solely on posture, alignment, or damage are still widespread — and often unhelpful. A growing body of evidence now shows that long-term pain is best understood through a biopsychosocial lens — one that considers the whole person and their unique context.
In this article, we explore how movement education — including approaches like Cognitive Functional Therapy (CFT) — helps people adapt, recover, and regain control of their bodies.
What Is Movement Education?
Movement education refers to structured approaches that help people explore, understand, and change the way they move — often while addressing the thoughts and emotions connected to movement and pain. It goes beyond just “doing exercises” and focuses on learning, awareness, and confidence.
You might have heard of methods like:
Cognitive Functional Therapy (CFT)
Feldenkrais Method
Sensorimotor training
Motor control retraining
These methods use movement as a tool for self-discovery, helping people shift unhelpful movement habits, beliefs, and fears that may be contributing to ongoing pain.
Why Do People with Chronic Pain Move Differently?
Research shows that people with chronic low back pain often adopt protective movement patterns: they brace, restrict motion, or avoid certain movements altogether. While this can be helpful in the short term, long-term over-protection can become maladaptive — leading to stiffness, deconditioning, and even more pain.
For example:
Muscles around the spine may become overactive.
Movement becomes more rigid and less variable.
Fear of movement (kinesiophobia) can increase, leading to avoidance.
These adaptations are real and valid responses to pain, but they can also reinforce a cycle of fear, disuse, and reduced confidence.
How Movement Education Helps
Rather than “correcting” posture or prescribing generic exercises, movement education works by:
Reframing beliefs about pain and movement
Encouraging safe exploration of previously avoided movements
Building self-efficacy — the belief that you can manage your pain
Promoting variability and confidence in how you move
One approach, Cognitive Functional Therapy (CFT), integrates pain education, guided movement retraining, and behavioural change into a flexible programme tailored to the individual.
In clinical studies, CFT has outperformed usual care and exercise in reducing pain and disability — especially when it focuses on the person’s unique story, beliefs, and movement behaviours.
The Role of Beliefs and Emotions
Pain is not just a physical sensation — it’s deeply influenced by how we think and feel. People living with persistent pain often carry unhelpful beliefs such as:
“My back is damaged.”
“I shouldn’t bend.”
“If it hurts, I’m making it worse.”
These beliefs can drive fear and avoidance, even when there’s no structural reason to limit movement. Movement education provides a safe space to challenge those beliefs, helping people realise that pain doesn’t always mean harm — and that their bodies are stronger and more adaptable than they think.
Real Stories, Real Change
In qualitative studies, people who took part in CFT or other movement education approaches often described profound mindset shifts:
“I don’t fear my pain now.”
“I’ve learned to listen to my body, not fight it.”
“I finally feel in control.”
These outcomes weren’t just about technique — they were about experiential learning, trusting the body, and being supported by a therapist who listened without judgement.
Why This Matters for Osteopathy and Rehab
Osteopaths and other MSK practitioners are well-placed to deliver movement education. It aligns with our holistic, person-centred values and provides a way to move beyond passive treatment models.
By integrating movement education into care, we help people:
Move with confidence, not fear
Engage in active self-management
Understand their pain in a more helpful way
Build resilience and adaptability
It’s not just about fixing a back — it’s about empowering a person.
Where We Go From Here
Despite promising evidence, challenges remain. Many healthcare settings still prioritise quick fixes or manual therapy alone. Wider implementation of movement education requires:
Better clinician training
Interdisciplinary collaboration
Supportive reimbursement models
More high-quality research on long-term outcomes
But as a growing number of practitioners and researchers advocate for change, there is a clear direction: toward care that is patient-active, evidence-informed, and deeply human.
Final Thoughts
Movement education isn’t a magic bullet — but it is a powerful tool in helping people with persistent pain adapt, recover, and regain trust in their bodies. It offers a framework for meaningful, long-lasting change that respects both the science and the lived experience of pain.
If you’re living with back pain, or work with people who are, it may be time to rethink the role of movement — not just as a treatment, but as a practice of awareness, learning, and self-discovery.