Cognitive Behavioral Therapy and Mindfulness in Chronic Low Back Pain

Chronic low back pain (CLBP) is the foremost contributor to years lived with disability worldwide. Accumulating evidence indicates that persistent pain cannot be explained solely by structural pathology, but instead reflects complex interactions between neurobiological, psychological, and social determinants. Cognitive behavioral therapy (CBT) has therefore assumed a central role as a non-pharmacological intervention within contemporary pain management frameworks. This chapter synthesizes established knowledge on a theoretical basis, mechanisms of action, and clinical utility of CBT in CLBP. Classical CBT models and third-wave approaches, including mindfulness-based interventions, are discussed with emphasis on their influence on pain-related distress, functional disability, coping behavior, and self-efficacy. Modes of delivery, patient selection, and integration within multidisciplinary care pathways are examined. Current evidence supports CBT as an effective adjunct to physical rehabilitation and medical management. However, further research is required to define optimal component combinations and long-term treatment sequencing.