Changing beliefs for changing movement and pain: Classification-based cognitive functional therapy (CB–CFT) for chronic non-specific low back pain

This case report presents the effect of classification-based cognitive functional therapy in a patient with chronic disabling low back pain. The patient was assessed using a multidimensional biopsychosocial classification system and was classified as having flexion pattern of movement impairment disorder. Management of this patient was to change her belief that bending over and sitting would cause damage to her disc, combined with active exercises for graded exposure to lumbar flexion to restore normal movement. Three months after the first appointment, the treatment resulted in reduced pain, the mitigation of fear avoidance beliefs and the remediation of functional disability. The patient returned to work and was walking for one hour a day on a treadmill. The cognitive intervention to change the patient's negative beliefs related to the biomedical model was important to make the graded exercises and the lifestyle changes possible.