Imagine living with chronic lower back pain that makes everyday tasks a struggle, from bending to pick up a grocery bag to simply walking around the house.
A new study out of Australia suggests there’s hope: a therapy that helps patients face the movements they fear could provide relief for years — not just weeks.
What is Cognitive Functional Therapy
Researchers asked nearly 500 adults dealing with chronic lower back pain to participate in a three-month program called cognitive functional therapy, or CFT.
Unlike traditional treatments, CFT isn’t just about masking pain with medication.
Instead, patients describe their discomfort to trained therapists to understand its root causes, then gradually tackle the movements that trigger their pain.
The goal is to build confidence and teach strategies to manage pain long-term.
Results That Last for Years
During the first three months, participants who underwent CFT reported noticeable improvements in both mobility and pain levels compared to those receiving typical care like over-the-counter painkillers or surgery.
Remarkably, even three years later, these patients continued to report lower pain levels and fewer restrictions on movement, highlighting the therapy’s long-term effectiveness.
Dr. Matt Hancock, a physiotherapist at Macquarie University leading the study, emphasized: “CFT is the first treatment for chronic disabling low back pain with good evidence of large, long-term effects.
It’s high-value, low-risk, and can offer lasting benefits for those suffering persistent pain.”
Why Doctors Should Take Note
The researchers are urging physicians to recommend CFT more broadly, describing it as a cost-effective way to reduce back pain.
In the U.S., an estimated 75 to 85 percent of people experience back pain at some point, with around 25 million currently living with lower back pain.
Conventional approaches typically include painkillers, physical therapy, surgery, and sometimes cognitive behavioral therapy (CBT), though CBT’s effects are often short-lived.
Inside the Study
Participants in the Australian study were on average 47 years old, overweight, and had been seeking care for four years.
They reported moderate back pain that limited daily activities like moving quickly or lifting heavy objects.
The study ran between October 2018 and August 2020 across 20 clinics in Perth and Sydney.
Patients were divided into three groups: one received CFT alone, another received CFT with biofeedback using sensors to track movement, and the third followed typical care plans.
Both CFT groups attended seven one-hour sessions over three months plus a booster session at six months.
How the Therapy Works
During CFT sessions, patients first share their personal pain stories to better understand their discomfort.
They then gradually perform movements previously avoided due to fear or pain, learning practical ways to manage their condition.
Lifestyle guidance is also provided, including advice on exercise, sleep, diet, and social engagement, to support long-term wellness.
Lasting Impact on Daily Life
When first measured, participants had moderate disability from back pain, meaning basic daily tasks were slowed or more challenging.
Three years later, those in the CFT groups reported only mild disability, where movement is easier and everyday activities are mostly unaffected.
There was no significant difference between CFT with or without biofeedback.
Meanwhile, the typical care group continued to experience moderate disability.
Why the Therapy Works
The researchers say CFT’s success lies in reducing fear around painful movements, helping patients face what they once avoided.
The involvement of trained therapists and a follow-up booster session at six months reinforced these skills, supporting lasting change.
In their latest publication, the team concluded: “CFT produces clinically important effects for activity limitation at three-year follow-up.
These long-term effects are novel and provide the opportunity to markedly reduce the impact of chronic back pain if widely implemented.”