• Posted August 12, 2025

Psychotherapy Might Be Key Treatment For Low Back Pain

A type of psychotherapy appears to provide long-lasting relief for people suffering from chronic low back pain, a new clinical trial says.

Back pain patients who underwent cognitive functional therapy (CFT) were able to move more freely with less pain for up to three years later, according to results published recently in The Lancet Rheumatology.

“CFT is the first treatment for chronic disabling low back pain with good evidence of large, long-term (>12 months) effects on disability,” concluded the research team led by Mark Hancock, a professor of physiotherapy at Macquarie University in Australia. “It offers a high-value, low-risk intervention with long term benefits for patients with persistent, disabling low back pain.”

Cognitive functional therapy teaches patients to better understand their pain, according to the International Association for the Study of Pain.

After talking through their pain, patients gradually expose themselves to activities and movements that might cause discomfort, building up their resilience and confidence, the IASP says. They also are taught exercises and lifestyle skills that can make their pain more manageable.

“CFT is more of a ‘doing’ therapy — building trust, confidence and awareness in the body," Hancock told Newsweek.

"Mind and body approaches are key because beliefs impact our behaviors and pain experience,” Hancock said. “If people believe their back is fragile, unstable and damaged, they brace and avoid activity. This sets off a negative spiral."

For the clinical trial, nearly 500 people were randomly assigned to one of three groups.

One group received CFT. Another received CFT plus biofeedback, which teaches patients to use body responses to pain like heart rate as a means of tracking and controlling pain. The third group received typical medical care for back pain.

The CFT groups received up to seven treatment sessions over the course of three months, plus a booster session at six months.

“There was no CFT intervention after this,” Hancock said.

After three years of follow-up, the CFT groups both scored better than the usual care group on measures of their pain levels and limitations on usual activities caused by pain.

“This is the exciting finding — that the effect lasted,” Hancock told Newsweek. “The intervention focuses on empowering patients to understand and manage their condition, so while we were pleased we were also not surprised.”

In all, “we found about 70% of people responded well,” Hancock added. “Interestingly, the effects were greatest for the worst affected patients.”

The addition of biofeedback did not appear to make any difference, however, as both CFT groups had about the same amount of sustained benefit.

Researchers said these results show that CFT should be adopted as a primary means of treating low back pain, given that other treatments like opioid painkillers and surgery offer only short-term benefits.

However, they added that more studies are needed to verify their findings and to figure out how to best implement CFT in management of both low back pain as well as other sources of pain.

"Almost certainly, these principles extend beyond back pain, and research is underway for other conditions,” Hancock said.

More information

The International Association for the Study of Pain has more on cognitive functional therapy.

SOURCES: The Lancet, news release, Aug. 5, 2025; The Lancet Rheumatology, Aug. 5, 2025; Newsweek, Aug. 6, 2025