As a physical therapist, I’m always on the lookout for effective treatments for chronic low back pain. A recent systematic review and meta-analysis published in Physical Therapy journal has shed new light on the effectiveness of Cognitive Functional Therapy (CFT) for managing this common and debilitating condition.

Key Findings

The review, which analyzed 7 randomized controlled trials involving 1,011 participants, found that CFT shows promise in several areas:

1. Disability Reduction: Low to moderate certainty evidence suggests CFT is effective in reducing disability compared to other treatments, including usual care, across short, medium, and long-term time points.
2. Pain Management: Moderate certainty evidence indicates CFT is effective for pain reduction in the medium term, with low certainty evidence for short and long-term benefits.
3. Improved Self-Efficacy: High certainty evidence shows CFT increases pain self-efficacy in both medium and long-term follow-ups.
4. Cost-Effectiveness: One study found CFT to be more cost-effective than usual care.

What Sets CFT Apart?

CFT is an individualized biopsychosocial approach that targets pain-related cognitions, emotions, and behaviors. The review highlighted several factors that may contribute to its effectiveness:

• Extensive clinician training (80+ hours)
• Individualized treatment plans
• Focus on patient self-management

Implications for Practice

While these results are encouraging, it’s important to note that proper implementation of CFT requires substantial clinician training. The review found that factors such as the number of trained clinicians, their experience, and quality of training may influence the intervention’s effectiveness.

Looking Ahead

As a physical therapist, I’m excited about the potential of CFT for helping my patients with chronic low back pain. However, more research is needed to determine the critical elements of CFT training and implementation to achieve optimal results.

For those of us in Denver and other areas with active populations, CFT could be particularly beneficial for patients who enjoy activities like hiking, golfing, or playing hockey but are limited by chronic back pain.

As we continue to seek out the most effective treatments for our patients, CFT certainly warrants consideration as a promising approach to managing chronic low back pain.

Link to research:

Unavailable at this time

Citations:

Thiveos L, Kent P, Pocovi NC, O’Sullivan P, Hancock MJ. Cognitive Functional Therapy for Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Physical Therapy. 2024;104:pzae128.