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Physical Therapy Edges CBT for Chronic Lower Back Pain Function
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Physical therapy beats CBT on function for chronic lower back pain, but only modestly, and neither treatment touched pain levels more than the other. That's the finding from a 749-person randomized trial published in the Annals of Internal Medicine in April 2026, where eight weekly sessions over ten weeks gave PT a slight functional edge. Both are already first-line recommendations over medication, so this doesn't change the menu, but if you're deciding between the two, the function gap is worth raising with your doctor.
Full analysis
A randomized controlled trial published in the Annals of Internal Medicine in April 2026 compared physical therapy and cognitive behavioral therapy (CBT) — a talk-based approach that addresses how thoughts and behaviors affect pain — in 749 adults with chronic lower back pain. After 10 weeks of eight weekly sessions, physical therapy produced a slightly greater improvement in physical function than CBT, though neither treatment was meaningfully better than the other at reducing pain itself. Current guidelines already recommend both approaches as first-line treatments over medication. For people managing chronic lower back pain, this study suggests physical therapy has a modest functional edge, which may be worth raising with a doctor when deciding between the two options.
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