Tom Nolan’s research reviews—11 May 2023

Cognitive functional therapy for low back painPainfully few effective treatment options are available for chronic low back pain. Although the National Institute for Health and Care Excellence (NICE) has 30 recommendations on non-invasive treatments, most of these are about what not to offer, and it makes only lukewarm recommendations for group exercise, manual therapy, psychological therapies, and non-steroidal anti-inflammatory drugs. Perhaps cognitive functional therapy (CFT) will offer a safe and effective non-invasive treatment? CFT is a physiotherapist led intervention, similar to cognitive behavioural therapy, but with an emphasis on stopping protective muscle guarding, movement avoidance, and other pain provoked movements that often contribute to low back pain. A randomised controlled trial assigned 492 patients with chronic disabling low back pain to receive CFT with biofeedback (wearing a back sensor to help you learn how to move better), CFT with sham-biofeedback, or usual care. A clinically meaningful improvement was seen in…
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