Cognitive Functional Therapy Effective for Chronic Low Back Pain at Three Years

Cognitive functional therapy, with or without biofeedback, more effective than usual care for chronic disabling low back pain

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 6, 2025 (HealthDay News) — Cognitive functional therapy (CFT), with or without biofeedback, is more effective than usual care for treating patients with chronic disabling low back pain, according to a study published online Aug. 5 in The Lancet Rheumatology.

Mark Hancock, Ph.D., from the Spinal Pain Research Center at Macquarie University in Sydney, and colleagues conducted a randomized, three-arm parallel-group phase 3 trial to compare the long-term effectiveness of CFT, delivered with or without movement sensor biofeedback, and usual care for the treatment of chronic low back pain. Adults with low back pain lasting more than three months, with at least moderate pain-related physical activity limitation, were recruited and randomly assigned to usual care, CFT only, or CFT plus biofeedback (165, 164, and 163 patients, respectively). Overall, 312 participants were successfully followed up at three years.

The researchers found that compared with usual care, CFT only and CFT plus biofeedback were both more effective in reducing activity limitation at three years (mean difference, −3.5 and −4.1, respectively). Small and nonsignificant differences were seen between CFT only and CFT plus biofeedback. CFT only and CFT plus biofeedback were also more effective than usual care for pain intensity at three years (mean difference, −1.0 and −1.5, respectively); small and nonsignificant differences were seen between CFT only and CFT plus biofeedback.

“CFT produces clinically important effects for activity limitation at three-year follow-up,” the authors write. “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.”