Lack of confidence in the lower limb: Cognitive Functional Therapy (CFT) for a unilateral loading impairment in chronic non-specific low back pain. Case report

• A patient with non-specific chronic low back pain was treated with cognitive functional therapy.
• He had the belief that surgery was the only possible way to treat the cause of the problem.
• The patient presented with unilateral loading impairment of the left lower limb.
• Manual therapy and exercises were combined to encourage the patient to trust his lower limb again.
• The treatment resulted in complete absence of pain and disability.

This case report presents the effect of Cognitive Functional Therapy (CFT) in a patient with chronic non-specific low back pain associated with unilateral loading impairment of the left lower limb. The patient believed surgery was the only possible way to treat the cause of the problem. The management of this idea was to change such belief. Manual therapy and active exercises were combined in order to encourage the patient to trust his back and lower limb again. One month and a half after the first appointment, the treatment resulted in complete absence of pain and disability. The patient returned to work and he was able to climb stairs and load his left limb normally.