International Research Journal of Public and Environmental Health

Original Research Article

The effects of cognitive functional therapy in chronic pain management: A systematic review

Evgenia Trevlaki1, Emmanouil Trevlakis2, Paris Iakovidis2, Panagiotis Notopoulos3, Ourania Papadopoulou1 and Alexandra Hristara-Papadopoulou*2

1MSc, Academic scholar, Physical therapy department, International Hellenic University, Greece.
2PhD, Assistant professor, Physical therapy department, International Hellenic University, Greece.
3PhD, Professor, Physical therapy department, International Hellenic University, Greece.
4PhD, Professor, Economics and Management department, International Hellenic University, Greece.

*Corresponding Author Email: hristara2(at)

Evgenia Trevlaki

Emmanouil Trevlakis

Paris Iakovidis

Panagiotis Notopoulos

Ourania Papadopoulou

Alexandra Hristara-Papadopoulou

Article Number: irjpeh.23.010  |   Pages: 88-97  |   Vol. 10 (3), November 2023   |   DOI:

 Received: August 7, 2023  Accepted: October 3, 2023  Published: October 31, 2023


Cognitive Functional Therapy (CFT) is a multi-disciplinary approach that combines cognitive and behavioral techniques with physical rehabilitation and activity modification to help individuals manage chronic pain (CP) and improve their function. This systematic review aimed to evaluate the effectiveness of CFT for treating CP. The systematic review has been registered in the PROSPERO CRD42022335858, and the results will be reported according to the PRISMA guidelines. A comprehensive search was conducted in multiple electronic databases: Google Scholar, PubMed, PEDro, SpringerLink and Cochrane Library. A total of 1816376 studies were initially identified. After screening titles and abstracts, 73 studies met the inclusion criteria and were reviewed in full. 11 studies conducted by various authors, published in different journals between 2018 and 2022, were included, (n=10) concerning CLBP and (n=1) chronic neck pain. Most studies (n=3) compared the results with usual care, (n=2) the MT combined with exercises, (n=2) core exercises and education, one (n=1) the LST and (n=2) had no comparison group. The results of the studies are generally consistent, with most trials reporting significant improvements in disability, self-efficacy, fear of movement and quality of life after treatment. These promising results are due to changes in the beliefs and attending of independence of patients with CP. Only the pain intensity showed mixed results after the treatment. Further studies with larger sample sizes, longer follow-up periods, and rigorous control groups would help to strengthen the evidence for the effectiveness of CFT.

Keywords: Chronic pain, cognitive functional therapy, pain, function

How to Cite this Article

Trevlaki E, Trevlakis E, Iakovidis P, Notopoulos P, Papadopoulou O Hristara-Papadopoulou A(2023).The effects of cognitive functional therapy in chronic pain management: A systematic review.  Int. Res. J. Pub. Environ. Health 10(3):88-97.DOI:

© 2023 The authors.
This is an Open Access article that is distributed under the terms of the Creative Commons Attribution License ( and the Budapest Open Access Initiative (, which allow unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

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