Background: Low-back pain is a major health and economical problem that affects populations around the world. Chronic low-back pain, in particular, is a major cause of medical expenses, work absenteeism, and disability. Objective: To explore the effect of adding cognitive-behavioral therapy to physical therapy interventions in patients with chronic non-specific back pain. Patients and methods: 20 male and female patients between 25 and 40 years old diagnosed as chronic non-specific back pain with central sensitization and fear avoidance behaviors symptoms participated in this study. Patients were randomly assigned into two groups. The first group was treated by cognitive behavioral therapy (graded exposure and graded activity) in addition to physiotherapy the second group was treated by physical therapy interventions which was given only 3 times/week for 4 consecutive weeks. Results: Descriptive statistics was used to identify each variable's mean and standard deviation. A paired t-test was used to compare characteristics of patients between both groups. Pre-treatment results showed no significant difference in both measured variables of Oswestry, and pain in both groups (P > 0.05). On the other hand, post-treatment results showed a significant decrease in the Oswestry, and pain only in group A (the study group). Conclusion: Adding graded exposure and graded activity as an operant cognitive behavioural therapy approach to physical therapy program is more beneficial than physical therapy program alone. More data and follow up needed for this study.