Back pain affects millions of people worldwide, often leaving them frustrated and searching for relief.
Now, researchers in Australia are pointing to a new therapy that might finally provide long-term relief for those struggling with chronic lower back pain.
Unlike traditional treatments that focus mainly on medication or surgery, this method helps patients confront the movements that scare them, ultimately reducing pain and improving mobility.
Understanding Cognitive Functional Therapy
The therapy, known as cognitive functional therapy (CFT), is designed to help patients gradually take on movements that trigger their pain.
Over three months, participants meet with trained physical therapists to discuss their pain, explore its causes, and slowly practice activities they might normally avoid out of fear.
According to Dr. Matt Hancock, the lead physiotherapist at Macquarie University, CFT is “the first treatment for chronic disabling low back pain with good evidence of large, long-term effects on disability.”
He adds that it is a “high-value, low-risk intervention” that can offer real, lasting benefits.
How the Study Was Conducted
Nearly 500 Australians with chronic lower back pain took part in the study.
On average, participants were 47 years old, overweight, and had been managing their pain for around four years.
The study ran between October 2018 and August 2020 across 20 clinics in Perth and Sydney.
Participants were divided into three groups: one received CFT, another received CFT combined with biofeedback (using sensors to map movement), and the third followed typical care recommended by their doctors, such as over-the-counter painkillers or surgery.
What the Therapy Involves
Each participant in the CFT groups attended seven hour-long sessions over three months, plus a booster session six months later.
During sessions, patients first shared their pain experiences, helping both the therapist and themselves understand the root causes of discomfort.
Next, participants were guided through movements they previously avoided due to fear or pain.
This approach not only improved physical ability but also helped reduce the anxiety surrounding these movements.
Patients were also given advice on lifestyle habits, including exercise, sleep, diet, and social activity, which contribute to overall well-being.
Long-Term Benefits Revealed
Initial results, published in The Lancet Rheumatology, showed participants experienced a significant reduction in disability, moving from a moderate level of limitation to mild disability.
Mild disability means patients can perform daily activities with minimal issues, though lifting heavy objects might still be challenging.
Three years later, these improvements persisted. Participants who received typical care continued to experience moderate limitations, while those in the CFT groups maintained lower pain levels and improved mobility.
Interestingly, there was no significant difference between the standard CFT and CFT combined with biofeedback, suggesting the simpler approach is just as effective.
Why CFT Works
Researchers believe the success of CFT lies in its ability to reduce fear.
By confronting movements that once caused pain, patients become less likely to avoid them, improving both mobility and confidence.
The structured booster session ensures skills learned during therapy are reinforced, maximizing long-term benefits.
A Call for Wider Adoption
Given the study’s results, scientists are urging doctors to recommend CFT more broadly.
With an estimated 75 to 85 percent of Americans experiencing back pain at some point—and around 25 million currently suffering from lower back pain—this therapy offers a cost-effective, long-term solution.
As Dr. Hancock emphasizes, “These long-term effects are novel and provide the opportunity to markedly reduce the effect of chronic back pain if the intervention can be widely implemented.”
Changing the Way We Treat Back Pain
For decades, treatments have focused on masking pain with medication or invasive procedures.
CFT takes a different path, addressing both the physical and psychological aspects of chronic pain.
With promising three-year outcomes, it could redefine how back pain is managed worldwide, giving millions the chance to move more freely and live with less discomfort.
