A type of psychotherapy known as cognitive functional therapy (CFT) has been shown to reduce disability from chronic low back pain for at least three years, according to a new study published in The Lancet Rheumatology.
This makes CFT the first treatment for this condition with strong evidence of long-term benefits.
Chronic low back pain is a common and often frustrating condition, marked by flare-ups that can return unexpectedly.
Most treatments to date have provided only small improvements, and these effects often fade within months.
CFT takes a different approach. Rather than focusing solely on physical treatments, it addresses how people think about and respond to their pain.
The therapy helps patients change unhelpful beliefs, reduce fear of movement, and build confidence in physical activity—key factors in breaking the cycle of chronic pain and disability.
The new trial, called the RESTORE RCT, involved 492 adults in Australia with chronic low back pain.
Participants were randomly assigned to one of three groups: usual care, CFT, or CFT combined with biofeedback.
Biofeedback involves using sensors to measure body functions like heart rate, with the aim of helping patients adjust them for better physical performance and relaxation.
Each treatment lasted for eight sessions. Researchers tracked participants’ ability to engage in physical activity for three years after treatment.
The results showed that people who received CFT—either alone or with biofeedback—were more active than those who received usual care. However, adding biofeedback did not provide a significant extra benefit compared with CFT alone.
These results mirror earlier findings from a previous study published in The Lancet, which showed that CFT was more effective than standard care for up to one year. The new research confirms that the benefits can last far longer, making CFT a promising long-term solution for many patients.
The study’s authors say the next step is to make CFT more widely available. This will require scaling up clinician training so that more health professionals can deliver the therapy effectively. They also stress the need for replication studies in different countries and health care systems to confirm the findings across diverse populations.
If implemented widely, CFT could offer a practical and sustainable way to help millions of people manage chronic low back pain, stay active, and improve their quality of life—without relying solely on medication or short-term fixes.
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Source: Lancet.
