Non-specific low back pain remains one of the leading global causes of disability, substantially diminishing productivity and quality of life among working-age adults. A subset of individuals develop chronic non-specific low back pain, characterised by persistent functional limitations.1 This group accounts for a disproportionate share of health-care resource use compared with people experiencing acute or subacute episodes.2 When symptoms persist for longer than 12 weeks, neurophysiological adaptations can alter pain processing pathways, leading to a shift in the pain profile from predominantly nociceptive or neuropathic to nociplastic.

Treatment sessions of CFT produced sustained effects at 3 years for people with chronic disabling low back pain. These long-term effects are novel and provide the opportunity to markedly reduce the effect of chronic back pain if the intervention can be widely implemented. Implementation requires scaling up of clinician training to increase accessibility and replication studies in diverse health-care systems.