Dr. Suga attended Cognitive Functional Therapy course in London
“a pain neuro science and psychological informed approach”
Dr. Suga has attended the 3 days course in June 2024. He has applied pain neuro science
based holistic pain approach combining with fascia manual therapy. He wanted to make his
chronic pain management skill and knowledge more solid. The lecturer for the course was Peter
O’Sullivan who is a professor in Curtin university in Australia and Dr. Suga has followed his
researches since he attended his symposium in a world physical therapy conference in
Singapore in 2015. Here is the detailed summery for the Cognitive Functional Therapy, which is
a holistic pain neuro science and phycology based approach. If you have an unknow chronic
pain which is applicable other than low back pain as well, we highly recommend you to see Dr.
Suga!
Introduction and Background Cognitive Functional Therapy (CFT), a novel approach designed
to address disabling low back pain (LBP) by integrating physical, psychological, and lifestyle
interventions. This approach challenges the traditional biomedical model, which often fails to
effectively manage chronic LBP, and instead adopts a biopsychosocial model that considers the
complex interplay of physical, cognitive, and environmental factors influencing pain.
Principles and Components of CFT

- Making Sense of Pain: This involves educating patients about the nature of their pain,
helping them understand that chronic LBP is not solely due to structural damage but also
influenced by psychological and social factors. - Exposure with Control: This component focuses on gradually exposing patients to
feared movements and activities, allowing them to regain control and reduce fear-
avoidance behaviors. - Lifestyle Change: Encouraging modifications in daily activities and promoting healthier
lifestyle choices to support long-term pain management and overall well-being.
Clinical Reasoning Framework CFT employs a multidimensional clinical reasoning framework
that assesses various factors contributing to a patient’s pain experience. This includes evaluating
physical impairments, psychological distress, and social challenges. Therapists use this
comprehensive assessment to develop individualized treatment plans tailored to each patient’s
unique needs and circumstances.
Implementation of CFT The implementation of CFT involves several stages: - Assessment and Goal Setting: Initial assessment focuses on understanding the patient’s
pain experience, beliefs, and functional limitations. Collaborative goal setting is essential
to align treatment with the patient’s values and aspirations. - Targeted Interventions: Based on the assessment, therapists employ targeted
interventions such as movement retraining, cognitive restructuring, and lifestyle
modifications. These interventions aim to address specific pain drivers identified during
the assessment. - Integration into Daily Life: Therapists work with patients to integrate new movement
patterns and coping strategies into their daily routines, ensuring that the changes are
sustainable and meaningful.
Evidence of Efficacy Several studies have demonstrated the effectiveness of CFT in managing
chronic LBP. Compared to traditional physical therapy and manual therapy, CFT has shown
superior long-term outcomes in reducing pain intensity, disability, and psychological distress. For
example, one randomized controlled trial highlighted in the article reported that patients who
underwent CFT experienced significant improvements in pain and function compared to those
receiving standard care.
Conclusion Cognitive Functional Therapy represents a significant advancement in the
management of disabling low back pain. By addressing the multifaceted nature of chronic pain,
CFT offers a holistic and individualized approach that has the potential to improve outcomes for
patients with chronic LBP. As more therapists are trained in this method and additional research
supports its efficacy, CFT could become a standard of care for managing chronic pain conditions.
If you are suffering from chronic pain, go to see him!
Reference
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037069/