Multiple dimensions across the biopsychosocial spectrum have relevance in the management of non-specific chronic low back pain (NSCLBP). Cognitive functional therapy is a behaviourally targeted intervention which combines normalisation of movement and abolition of pain behaviours with cognitive reconceptualisation of the NSCLBP problem, while at the same time targeting psychosocial and lifestyle challenges to recovery. This study sought to examine the effectiveness of cognitive functional therapy for people with disabling NSCLBP who are awaiting an appointment with a specialist medical consultant. Statistically significant improvements in both functional disability (p<0.001) and pain (p<0.001) were observed immediately post-intervention, and maintained over the 12 months follow-up period. These reductions reached clinical significance for both disability and pain. Secondary psychosocial outcomes were significantly (p<0.01) improved following the intervention, including depression, anxiety, back beliefs, fear of physical activity, catastrophising and self-efficacy.
These promising results indicate that cognitive functional therapy should be compared to other conservative interventions used for managing disabling NSCLBP in secondary care settings in large randomised clinical trials.