Cognitive Functional Therapy and the cervical spine

Cognitive functional therapy for neck pain is presented mainly through the lens of two patient patterns, with particular emphasis on the tense, guarded, fear-avoidant “Type 1” patient. Learners can expect an explanation of how these patients often restrict rotation or extension, brace excessively, hold their breath, and worsen pain through protective muscle tension rather than structural damage alone. The main concepts include person-centered, multidimensional assessment and identifying each patient’s key drivers, such as beliefs, fear, stress, sleep, social factors, movement habits, and general health. A central principle is helping patients experience pain-free or easier movement by changing how they move: relaxing the jaw, breath, trunk, and neck, reducing bracing, and testing feared movements safely. The summary also challenges common advice about “correct posture,” constant scapular retraction, and rigid sitting, showing how these strategies may aggravate symptoms in some people. Case examples illustrate how reassurance, guided movement, and practical demonstrations can quickly improve confidence and function. Overall, the approach combines physical guidance with cognitive and emotional reframing to restore control, reduce fear, and support self-management.