COMPIN (Feasibility study)
Research type
Research Study
Full title
COgnitive Muscular therapy versus psychologically informed Physiotherapy In non- specific chronic Neck pain: a feasibility study (COMPIN)
IRAS ID
339104
Contact name
Nathan Brookes
Contact email
Sponsor organisation
University of Salford
ISRCTN Number
ISRCTN14479543
Duration of Study in the UK
1 years, 2 months, 1 days
Research summary
Chronic neck pain (CNP) is a common long term condition resulting in pain, disability and reduced quality of life. It is the fourth leading musculoskeletal cause of disability in the UK, yet it receives less research attention compared to other common conditions like low back pain. Current management typically involves a combination of advice, pain relief, and physiotherapy. However, recent reviews suggest that while this approach may result in short-term improvements, long-term effects are limited, requiring more effective interventions.
Emerging research has highlighted increased levels of muscle tension and altered pain signalling mechanisms in CNP, leading to generalised pain sensitivity and altered pain tolerance. Emotional responses further contribute to pain experiences and affect participation in physical activity. Current mainstream physiotherapy approaches for CNP do not prioritise psychological aspects of the pain experience. However, early research suggests their significance, therefore these factors warrant further consideration.
Current physiotherapy mainly focuses on manual therapy (massage/ manipulation) and exercise (strength, stretches). This approach does not directly target muscle overactivity and psychological involvement in pain, possibly explaining limited success. Research has demonstrated that electromyography (EMG) biofeedback shows promise in reducing CNP. Therefore, interventions combining biofeedback and psychological elements may be important.
A novel approach, Cognitive Muscular Therapy (CMT), combines psychologically informed practices with muscle biofeedback training to reduce muscle overactivity and alter pain-related beliefs. Initial application on five CNP patients demonstrated substantial improvement in pain and function using the ‘Neck Pain Disability Index’ (NDI) with participants acknowledging newfound insights into their pain experiences.
Our proposed study aims to conduct a feasibility study comparing CMT with psychologically informed physiotherapy (education, pacing, exercise and self management) for CNP patients at risk of long-term disability.In summary, CNP management requires new approaches that address its complex nature. CMT shows promise but further rigorous evaluation is required through comprehensive clinical trials.
REC name
London - Riverside Research Ethics Committee
REC reference
24/LO/0291
Date of REC Opinion
9 May 2024
REC opinion
Further Information Favourable Opinion