FitPeo TeamFinding effective, long-term relief for back pain has always been a challenge. Many people cycle through medications, physical therapy, or even surgery—only to find temporary or minimal relief. But new research is offering hope.
A recent study has drawn widespread attention for its findings on a novel approach called Cognitive Functional Therapy (CFT). Adults suffering from disabling low-back pain who completed just eight CFT sessions experienced sustained improvements in both pain levels and activity—even three years after treatment.
What Is Cognitive Functional Therapy (CFT)?
CFT is a unique approach that blends physical therapy with psychological strategies. Instead of only treating the physical symptoms, it teaches patients how to interpret their pain, overcome unhelpful beliefs, and regain confidence in movement.
As pain researcher Chad E. Cook, PT, PhD, from Duke University explains:
“Teaching people to self-manage pain is the cornerstone of the approach. That’s why improvements are maintained years later—which is very uncommon.”
Key Findings from the Study
- Participants: 312 adults in Australia with moderate-to-severe back pain (average score of 4 or more on a 10-point scale).
- Treatment: Seven 30–60 minute sessions over 12 weeks, plus a booster session at 26 weeks.
- Results:
- More than 40% of participants improved their activity levels—sustained even after three years (compared to 17% with usual care).
- Average pain scores dropped by 2 points in the CFT group versus less than 1 point in the usual care group.
- Who benefited most? Those with the most severe pain showed the greatest improvements.
Why CFT Stands Out
- It works when other treatments fail
Many participants had tried multiple therapies with little success. CFT offered a turning point for them. - It’s low-risk and accessible
Unlike surgery or opioid treatments, CFT carries minimal risk. Sessions can be done in person or virtually. - It targets both mind and body
By addressing movement patterns and pain-related fears together, patients gain tools to take control of their recovery.
What Does CFT Involve?
A CFT program is highly personalized, but typically includes:
- Identifying pain triggers (such as sitting, climbing stairs, or past injuries).
- Challenging negative beliefs about pain (“I’ll never work again” or “my posture is permanently wrong”).
- Relearning everyday movements—like walking, sitting, or cycling—without fear.
- Training the body to relax instead of tensing up (reducing “muscle guarding”).
- Adopting strength training and lifestyle habits that support long-term back health.
- Building healthier internal dialogues, shifting from “I fear my pain” to “I can manage my pain.”
How to Get Started with CFT
Because CFT is still emerging, finding a trained clinician may be difficult. If a certified CFT therapist isn’t available, look for a physical therapist who describes themselves as a coach-like practitioner—someone who helps you understand your pain and build confidence in movement.
Meanwhile, here are some self-management tips inspired by the approach:
- Keep moving, don’t rest too much. Gentle activity helps reduce pain over time.
- Reframe pain as a warning sign, not damage. Movement, when done gradually, usually makes things better.
- Prioritize lifestyle factors. Good sleep, a balanced diet, and stress management all support recovery.
The Bottom Line
Low-back pain affects more than 1 in 4 U.S. adults, and most conventional treatments fall short. Cognitive Functional Therapy offers a fresh, evidence-based option that empowers people to move past pain—literally and figuratively.
Before giving up on treatment, consider speaking with a CFT-trained clinician or a progressive physical therapist who can guide you in taking back control of your body and your life.
