A groundbreaking therapy that encourages back pain patients to slowly take on movements they fear or that trigger pain, could relieve their suffering for at least three years, a study suggests.
Researchers in asked nearly 500 patients with chronic lower back pain that limited their daily movements to undergo cognitive functional therapy (CFT) for three months.
The therapy involved participants describing their pain to doctors to help understand its causes, followed by gradually attempting movements that caused discomfort in order to build confidence and equip them with strategies to better manage their pain.
Over the first three months, participants who tried the therapy reported significant improvements in movement and pain compared to those who relied on typical care, such as over-the-counter painkillers and surgeries.
After three years, those who received CFT were still reporting lower pain levels and fewer limits on movement than those who received typical care.
Dr Matt Hancock, a physiotherapist at Macquarie University who led the study, said: ‘CFT is the first treatment for chronic disabling low back pain with good evidence of large, long-term (over 12 months) effects on disability.
‘It offers a high-value, low-risk intervention with long-term benefits for patients with persistent, disabling low back pain.’
The researchers are now calling on doctors to begin recommending the therapy for all patients, calling it a cost-effective method of relieving back pain.
A study has found that cognitive functional therapy (CFT), which involves exposing patients to movements that trigger pain, could help to ease lower back pain (stock image)
An estimated 75 to 85 percent of Americans experience back pain at some point during their lifetimes, while 25million currently suffer from lower back pain.
Doctors normally treat the pain, which can be caused by sprains, arthritis and traumatic injuries, with over-the-counter painkillers, physical therapy and, in some cases, surgery.
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Patients have also been offered talk therapy since 2017, with doctors referring some patients for cognitive behavioral therapy (CBT).
With CBT, patients attempt to reconceptualize their pain in order to reduce it. Pain reductions from this tend to be short-lived, however.
In the new study, scientists recruited patients who had been suffering from moderate back pain who said it limited their day-to-day activities, such as causing them to move slowly or struggle to pick up heavy objects.
Participants were 47 years old on average, overweight and said they had been seeking care for the pain for four years.
They were asked to attend 20 clinics in Perth and Sydney, , to receive treatment between October 2018 and August 2020 and split into three groups.
The first received CFT, the second received CFT plus biofeedback, where sensors are used to map movements, and the third received typical care, or followed the care plan recommended by their doctor.
Participants in both CFT groups attended seven treatment sessions over three months and a booster session at six months. Each session lasted 60 minutes and was led by a physical therapist.
The above graph shows the percentage of adults aged 18 and over with any form of pain. Back pain is the most common form of pain in the US, the figures suggest
In the CFT sessions, participants were first encouraged to share the story of their pain to help them understand their discomfort and its underlying causes.
They were then guided through movements and activities that they previously said were painful, feared or avoided, to help them learn how to manage the pain.
At the end of the sessions, patients also received lifestyle guidance on healthy habits such as the need for regular physical activity, improved sleep, diet and regular socializing.
In the initial study, published in The Lancet Rheumatology, all participants had a moderate level of disability from back pain.
Three years later, however, in the groups that received CFT this had dropped to and remained at a mild level of disability, when back pain causes some limitations but does not impair overall function.
Those with mild impairment may be able to walk around with little difficulty but can still struggle to lift heavy objects.
There was no significant difference between the groups that received CFT only and those that received CFT and biofeedback.
In the group continuing typical care, however, people still experienced a moderate level of disability.
Participants who received CFT still reported significant improvements in pain three years later (stock image)
A moderate level of disability suggests participants can move only a short distance before requiring a break and can still perform basic daily activities like dressing or cooking but may take longer than usual.
The study was first revealed in 2023 but was republished again this month with updated data from three years after the study began, showing that the therapy could reduce pain for three years.
The scientists said CFT boosted participants' movement and reduced their pain because it reduced their fear of certain actions that had caused pain and made them less likely to avoid these behaviors.
They said the course was also carried out by trained therapists and had a booster session six months later, which ensured patients got better training.
In the latest paper, the researchers said: 'CFT produces clinically important effects for activity limitation at three-year follow-up.
'These long-term effects are novel and provide the opportunity to markedly reduce the effect of chronic back pain if the intervention can be widely implemented.'