Cognitive Functional Therapy

Cognitive functional therapy

What is it?

Cognitive Functional Therapy is an evidenced based approach to the management of persistent low back pain. The approach has been pioneered by Professor Pete O’Sullivan from Curtin University in Australia, and is unlike any other therapy currently being used for persistent low back pain in that it is a scientifically based programme yet a truly holistic form of management.

Cognitive Functional therapy is a patient centred approach that considers ALL the factors that can cause pain to persist. Physiotherapists trained in this technique have the skills to enable patients to identify factors in their life that are contributing to vicious cycles of pain and disability.

Where models of healthcare have previously failed in the management of persistent low back pain is the primary focus is often on the STRUCTURE of the spine, what the x-ray or MRI findings show. But lots of research has shown that scan findings are not highly predictive of pain, yet multidimensional factors such as health attitudes and beliefs, stress levels, sleep habits, lifestyle issues and levels of physical activity can work together negatively to create a downward spiral of persistent pain and declining functional ability.

Unlike Cognitive behavioural therapy, Cognitive functional therapy considers attitudes and beliefs as well as physical factors such as functional movement quality. The two affect each other. For example, if someone is particularly afraid to bend forwards because they think it is harmful or it’s going to hurt, that fear is likely to change the movement strategy. We see people moving with excessively braced postures, which puts a lot of pressure on the back, and causes it to hurt. A self-fulfilling prophecy develops. By working with someone to improve how they move, to enable movements to become easier and less painful, naturally the fear around moving starts to dissolve.

Stress can have a huge impact on a person’s back pain. Not just by increasing background muscle tension, but by causing the body’s pain alarm system to become more sensitive. Back pain is stressful, and stress aggravates back pain. Another cycle. Cognitive Functional Therapy can help people become more aware of the tension they hold in their body, and can be used to teach people how to reduce the tension through relaxation and mindfulness techniques.

Back pain and sleep are often interlinked, one affecting the other one negatively. Cognitive Functional therapy considers factors such as poor sleep hygiene, and a goal commonly is to restore or improve a person’s sleep but looking at sleep habits, sleep positions, relaxation etc.

Whilst this approach has been pioneered for the use in the management of persistent low back pain, we use elements of the technique in the management of all persistent musculo-skeletal pain disorders… neck, shoulder, knee pain and even recurrent sporting injuries.

Cognitive functional therapy

More about CFT

To learn more about Cognitive functional therapy please have a watch this video:

  • Testimonials

    "The physiotherapy service I’ve received at Physio Art from Ruth has been absolutely life changing. I’ve never been stronger, more mobile or more aware of my own body. The exercises in the app have been easy to follow and remember, and more importantly I’ve been able to step down from more invasive treatment for my back and get back to work."


  • Testimonials

    "Sophie has helped me rehab a long standing shoulder issue resulting from overuse of playing tennis and other racket sports. She was quick to identify the condition, gave an accurate timeline of recovery and helped my put in place various exercises over the next few months to get to a state where I can exercise and play sports free of the pain again. I'd highly recommend Sophie and Physio Art."


  • Testimonials

    "There is nowhere else I would go than Physio Art. My 11-year old son had an emergency appointment with Adhip for a very painful lower leg and he was absolutely brilliant. His knowledge and advice was excellent and the results began to show during the appointment. Every physio we have seen there has been highly professional, incredibly helpful and so kind. "


  • Testimonials

    "I have complete trust in Sarah whom I have seen on a number of occasions for different problems. She always listens intently and delves deep into my experience so I feel completely confident in the course of treatment she recommends. I love that she is so good at explaining what is affecting the problem and often there is more at play than just the mechanics of the body. Any consultation with Sarah is fascinating as well as healing!"


  • Testimonials

    "I have been a Physio Art client for many years, accessing physios for both injury and long term back problems as well as Pilates classes. Sarah and her team have my full trust and I don’t hesitate to recommend them to anyone. Their knowledge and care is second to none and they always go that extra mile to ensure that the treatment and advice you receive is personalised to your needs."

  • Testimonials

    "Physioart has built itself to be a clinic with a special vibe about it, a relaxed but professional space that allows the clients to feel listened to, whilst also knowing their receiving the optimum evidence based care. The physios working here really know their stuff, and are genuinely kind and brilliant people. "

  • Testimonials

    "I have used the services of Physio Art to treat three different conditions with a successful outcome on each occasion. Grateful thanks to both Sarah and Sophie. I have no hesitation in recommending Physio Art."

  • Testimonials

    "A vibrant and energetic clinic with top class comprehensive treatment. The professionalism was second to none and I couldn’t recommend this clinic highly enough. Sarah Duncton, the founder is so passionate and dedicated to her patient’s every need."


  • Testimonials

    "Sophie is an absolute life saver. Visited her with very bad pain in my shoulder & neck due to extremely tight muscles. An hour later I left feeling looser and my pain significantly reduced."


  • Testimonials

    "All the physios at PhysioArt are amazing and really know what they’re talking about. They treat their clients with empathy and understanding and make sure they are working towards the clients individual goals. Would definitely recommend."


    Book an Appointment

    If you would like to book an appointment or have any questions then please get in touch using one of the methods below.

    Send Us A Message

    Contact Info



    Our Location

    165 Knightlow Road, Harborne, B17 8PY

    Our Email

    Working Hours

    Mon-Thurs-Fri: 8AM-8PM
    Tue-Wed: 8AM-5PM
    Sat: 9AM-1PM

    Follow Us