The Effect of Cognitive Functional Therapy in Chronic Neck Pain: A Systematic Review


George Ploutarchou
Health Science, European University, Cyprus
Christos Karagiannis
Health Science, European University of Cyprus, Cyprus
Christos Savva
Health Science, European University of Cyprus, Cyprus
Vasilleios Korakakis
Orthopaedic and Sports Medicine Hospital, Aspetar, Qatar
Berki Stir Alexandrou
Department of Health Science, European University, Nicosia, Cyprus


Chronic Neck Pain (CNP) is a multifactorial condition and its manifestations are strongly related with psychosocial and biomechanical components. Cognitive Functional Therapy (CFT) is a multidimensional approach based on the Bio-Psycho-Social model mainly investigated in Chronic Low Back Pain (CLBP). Research in CNP is sparse.

 To systematically search and evaluate the effectiveness of CFT in adults with CNP.

 Five electronic databases were searched by using the PICO model, and the reporting of this systematic review adhered to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Two authors independently screened, evaluated study and risk of bias by using the PEDro scale, and rated the certainty of evidence using the Best Evidence Synthesis approach.

Results: Three studies met the inclusion criteria, two randomized clinical trials and one case control study. Limited evidence suggests that CFT is more effective than exercise alone or a wait-and-see policy in pain catastrophizing, fear-avoidance beliefs, anxiety, depression, stress, and pain and kinesiophobia at the very short term follow up.

 Available data suggests that CFT has the potential to be a useful treatment approach in management of CNP.

 CFT presented favorable results when compared to exercise or wait-and-see at the short term; however, given the limited number of available studies, further research is needed in larger groups of CNP patients in a range of neck pain subgroups and condition severity.

November 30, 2022