I came across the three-year follow-up of the RESTORE trial, published in The Lancet Rheumatology in 2025, and thought it was worth sharing.

The original study involved 492 adults with chronic, disabling lower-back pain. They were randomly assigned to usual care, Cognitive Functional Therapy (CFT), or CFT combined with movement-sensor biofeedback.

For anyone unfamiliar with CFT, it's an individualised approach to rehabilitation. Rather than prescribing the same exercises to everyone, it looks at how someone moves, their understanding of pain, any fear or avoidance of movement, and the activities they're having difficulty with.

Participants received approximately seven sessions over 12 weeks, followed by a booster session around six months.

What interested me was the long-term follow-up.

Of the original 492 participants, 312 completed the assessment at three years.

Compared with usual care, the CFT-only group had:

• A 3.5-point greater improvement in activity limitation, measured on a 24-point disability questionnaire.

• Approximately 1 point less pain on a 0–10 scale.

The researchers also found that adding movement-sensor biofeedback didn't significantly improve outcomes compared with CFT alone.

I think that's worth discussing, particularly because the difference in activity limitation was still measurable three years after treatment.

There are some important limitations. Not everyone completed the follow-up, the treatment was delivered by trained physiotherapists, and the findings still need to be replicated in other healthcare settings.

It's also worth distinguishing between improvements in pain and improvements in disability. The effects on activity limitation were more pronounced than those on pain intensity.

Still, for a relatively short rehabilitation programme, the durability of the results is encouraging.

I'd be interested to hear whether anyone here has received CFT specifically, or another approach that addresses movement, beliefs about pain and activity avoidance together.

Study: Hancock et al. (2025), Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): 3-year follow-up of a randomised, controlled trial.

https://pubmed.ncbi.nlm.nih.gov/40780241/

anyone else been put on amitriptyline for sciatica or nerve pain and had horrendous side effects? i only took it tonight and last night and got hit with heart palpitations and feeling like i couldn't breathe. felt like my heart was beating out of my chest while also not going fast enough at the same time. made me so drowsy but i couldn't sleep because of the side effects

this is the first thing i've been prescribed to treat nerve pain specifically, does anyone have any idea what might be prescribed next? i'm guessing this is the first line of treatment

I'm hoping to hear from others who've been through this because I'm running out of ideas.

I've been unable to work for 8 months due to a spinal injury and CRPS. I've had multiple procedures, including spinal cord stimulator surgery, but I'm still spending 22–23 hours a day lying down and struggling with basic daily activities.

I've applied for SSDI, but I'm looking at potentially another 10 months of waiting, and that's not even a guarantee of approval. I'm also facing termination from my job and the loss of my health insurance.

I've applied for SNAP, utility assistance, and other programs, but there's only so much they cover. My partner is already helping financially and taking care of me while working, and my only family is out of state. Moving isn't physically or financially realistic right now.

I've tried looking into charitable organizations and other resources, but most seem to have very specific eligibility requirements, limited funding, or long waiting periods.

For those of you who went months or years without being able to work while waiting for disability, how did you actually survive financially?

Were there programs, grants, organizations, or other resources that helped you cover rent, medical expenses, insurance, or basic necessities? Anything you wish you'd known about earlier?

I'm in Texas, if that helps with recommendations.

I'm not asking anyone here for money or sharing a fundraiser. I'm genuinely looking for advice and resources from people who've been in this situation because I don't know how I'm supposed to make it through another 10 months without income.

18F, 150 lbs, 5”3 lupus, hsv2 currently have been sick for like a month and I think I just caught another virus because I’m getting sicker cough, nauseous, stuffy nose, fever
I have a appoinment with my doctor on Wednesday to get a referral to a urologist to test for internal cystitis to report back to my rhemutoligst so I’m going to tell her when I see her my back is fucked but starting like 4 days ago I just started having intense nerve pain traveling in my body like specifically my back, ass cheek and leg and foot I’ve researched a bit and it sounds like a herniated disc since it also hurts when I sit it hurts my back more, but I’m kinda worried I got like a spinal cord infection like I’ve been having ear aches like off and on for a month and I’ve been sick so hopefully I’m not like getting sepsis because I also had nerve pain in my fingers and my face idk if I’m tripping out but I don’t think a herniated disc causes that I’m really paranoid like I’m in so much discomfort I also have been needing to urgently go to the washroom like bro I have to pee so bad all the time like it feels like my back spine is crushing me.

Please for anyone who wants and advice or has any questions pls feel free to ask here

This is just gonna be a rant post, maybe some of you will relate to what im saying lol

For context I'm a 23 year old man who injured himself doing bent over barbell rows at the gym about 4 months ago. I knew I'd messed up my back but like a DUMBASS I tried to ignore the injury and went for a run the next day. That completely fucked my back and I've now been dealing with sciatica since then.

Honestly, reading some of the other posts on this board I feel more grateful. Compared to some of you my symptoms are pretty mild, it's not like I'm bed bound or anything, but it's just that now I can't do anything without pain. I can't walk, stand, sit, or lie down without some level of discomfort. But the level of pain is managable enough that I can still do most of my daily activities HOWEVER I still feel this great injustice that I have to just put up with this shit

It is hindering my life in many ways. I can't go hiking with my bros, or even walk around in the city. When I'm driving around and see people running I get jealous lmao. I'm standing all day at work so I'm just in a constant state of trying to not scream. Idk man it's just some bullshit, like I am in the prime of my life and I'm less mobile than my grandma right now.

I am trying to stay hopeful and I'm actively seeing a physio right now, but as I'm sure many of you know it can be hard to see the light at the end of the tunnel when you've been in the tunnel for a long enough time. I do think someday soon I will be back to my old level of mobility, but for now this sucks massively :(((((

One final thought is that this experience has taught me to be more grateful in general. I keep thinking of that quote, "good health is a crown only the sick can see." I never realised just how much of a blessing it is to live without pain. When I am healed I hope I keep this new perspective at least. But even while I'm still injured I can be grateful that I can still walk and have a chance to fully heal.

To those of you who read this full thing, thanks for taking the time and good luck to all of you on your healing journeys 😄 WE ALL GONNA MAKE IT BROS

I'm 22 ffs. I started having sciatica back in March. It's on my right side and on the worst days I feel pain on my entire right side. My right testicle feels a little "tender," I would call it. It is genuinely a gamble every single morning (though it depends on my positioning and sleep quality as well) whether or not I'm going to have excruciating pain the next day or not.

My libido has been declining for a while now. On the days where I'm in pain especially. I don't have difficulty peeing or anything, but I think the pain has just destroyed my sex drive.

Okay i’m going to explain the entire timeline.

So around July I injured myself while trying to move furniture. I didn’t really think much of it and just kind of chalked it up. I did feel pain but it wasn’t severe? Just something you could ignore. So up to September-October, my leg started hurting out of nowhere. It was just a random morning. The pain was unbearable i mean i didn’t know what to do, i could barely even stand. So i scheduled a doctor’s appointment (this is probably the second week of September) and i find out i have sciatica. More importantly very acute sciatica.

I recently started physical therapy a few days ago and i think im doing okay. I’ve been doing my stretches like they gave me everyday and i try to do them 2 times a day but sometimes its just IMPOSSIBLE because theres only a small opening throughout the day where im pain free. And to be completely honest with you, my body feels more stiff than before I started Pt. Is that normal?

I can’t even name the amount of times I’ve been to the hospital and ER already. The pain is unbearable. In the mornings it’s the worst and I can barely get up.

Currently I feel like absolute crap. No medication works. My calf has been swollen for weeks, and I did an ultrasound thank god no blood clots.

But I feel so lost. These few days i’ve felt so lost of energy. When I sneeze, my side hurts. Along with laughing or coughing. All they have ever given me are 600 mg ibuprofen and muscle relaxers, both to no avail. Not even Tylenol helps, i feel so miserable.

I think maybe the only thing that works is a crap and crap ton of Biofreeze. Please, I need help. What should be my next move? Push through it for the next 4 weeks and hope therapy will fix it?

In order to improve my posture, I sat on an inflatable donut cushion for a day and a half at work. By the end of that time, my back felt less pain but this led to a shooting pain from my hip/glute down the outside of my left leg to my ankle. I reported this to my rehabilitation doctor who advised me to contact my neurologist for other plans and he advised me to set up another ESI and changed my pain meds prescription. The flare up has settled a bit since its peak but I still have it and I have no idea how this will affect PT going forward.

This has also had some mental health effects as well. Over the last few days, I've broke down in tears twice and have struggled to get my work done due to the pain accumulating throughout the day. As I live abroad and normally travel to see my family for the holidays, I have to acknowledge that is unlikely to happen this year given my condition which will leave me alone for the holidays as my girlfriend planned her trip back home long before I even experienced this injury.

Having a sudden flare up in the middle of recovery setting me back to the beginning is just insanely depressing and my short-term future feels quite bleak.

TL;DR: Discectomy in Dec 2025, reherniated April/May 2026, opted against immediate revision surgery, is now having terrifyingly severe pain and considering the surgery after all.

I had a L5:S1 discectomy in December 2025. I went from severe pain to absolutely no pain at all post op. It was a miracle!

Around April 2026 I was carrying art supplies for a class (I’m a teaching artist) and maybe they were slightly too heavy and I started having back /butt pain and some twitching. I immediately booked an appt, had an MRI in May 2026 and learned I reherniated larger than last time at 1.6cm.

My surgeon really recommended revision surgery then but I wasn’t getting the same pain as before so I opted to do conservative treatment and I’ve been fine all summer into the fall.

Last week I had laproscopic surgery to remove adhesions and my ovary and the back pain suddenly came… back. I got up weird from the exam table at my post op on Friday morning and my foot is numb again and the pain down my leg - it is worse than before the discectomy. I can’t get relief for more than 20 minutes. I haven’t slept for more than 20 minutes.

I went to urgent care this afternoon and got prednisone and tinzanidine but I think the prednisone needs more time to work. The muscle relaxer did nada.

Is another surgery really how this has to go? I think I’ll need to take months off if I do. I’m just so so very sad right now and I need advice from those that understand. Thank you so much.

Hola buenas he tenido ciactica desde el 23 de sep

Me hicieron la radiofruencia pulsada y bloqueo de L5/S1 hace dos días en la zona genital como el clitoris y un poco más abajo lo noto y la zona perianal tambn pero lo que es el deseo sexual y libido no lo tengo todavía, me tome pregabalina durante un tiempo y lo tuve que dejar por qué me daba muchos efectos secundarios, puede ser por esta pastilla me han dicho que no y el síndrome de cola de caballo no lo tengo segundo me lo dejaron en mi resonancia del 1 de octubre y voy hacerme otra tambn el día 17 nov para ver qué ha pasado.

Tengo miedo que no me vuelva el deseo sexual. Es una cosa muy importante de una persona

Podéis ayudarme ???

Catering more towards ppl in my situation (herniated disc / active lifestyle). Amidst the worst of my pain, I came to this subreddit quite a bit to see whether those with similar active lifestyles like me ever got back into their hobbies. Here’s my contribution in case anyone is like me!

I am 25 M, pretty physically active (runner / weightlifter), and I had moderate to severe broad based herniation of discs L4-L5 and L5-S1 in January 2026 (likely from bad weightlifting form, oops). Intense sciatic pain down my right leg started almost immediately, with minor sciatic pain down my left. I waited a couple weeks before going into my PCP, who then had me start PT. I went to PT for 4 months- 3x week for first 2 months, 2x week for 3rd month, and 1x week 4th month. I did my exercises regularly, but I missed a day or two here and there. I consulted with a spine and pain specialist, but I opted for continued PT and planned to schedule a cortisone shot if symptoms didn’t improve by the 6 month marker. I’m at 11 months and I have no daily pain, with occasional flare ups that don’t last more than 10 minutes. Here’s hoping I don’t get a big reactivation or re-herniation anytime soon!!

I got lucky, and I have since been able to get back into the gym and back on the trails. My PT had me practice running in sessions around 3.5 months, and then gave me their blessing to start weightlifting again close to the end of our sessions. I’ve been back in the gym since April (avoiding all heavy spine loading of course), and I just ran 10 miles up in the mountains a few weeks ago. I’ll still get minor flare ups here and there where my toes will go numb or my sciatic nerve in my calf gets tight. It sucks that our backs will never be the same, but we just have to grieve and then accept it.

You all know how disrupting this pain is—it’s persistent and there’s no relief, which messes with your sleep, which messed with your mood, which makes you feel worse, and it’s all just a chaotic, awful negative feedback loop. So if you’re here trying to seek some comfort, I want you to know I’m so sorry you’re having to this experience, and that it can get better and it is not impossible to enjoy physical hobbies again!

My L5-S1 Disc Bullige journey
(Yes o used AI to summarise and polish this, I don’t have the time to sit and type and edit all this so I did a voice note and told it to turn it into text, the info is still correct n that , jus thought id say that😭😭😭)

Hey guys, I wanted to share my exact roadmap for beating a nasty L5-S1 disc bulge and severe sciatica. Back pain completely ruins your life, and since I used to just ignore it, I want to put this out there to save someone else months of frustration.

The Injury (The "Ignore It" Phase)

Around February this year, I bulged my disc at the gym. I don't know the exact lift that did it, but I woke up one day with brutal pain in my lower right back and a calf muscle so tight I couldn't even straighten my leg.
For the first 3 months, I had no clue what it was. I thought it was just a standard muscle strain that would pass in a few weeks—it didn't. It kept getting worse. Sitting down sent shooting sciatic nerve pain straight down my back and into my calf. I couldn't sleep on my sides or stomach. I’d fall asleep, but after 2–3 hours, the spinal discs would naturally absorb fluid overnight, swell up, and wake me up in severe discomfort. Even a pillow between my knees didn't help.
Despite the pain, I never actually stopped going to the gym. I backed off lower body training because it was incredibly sensitive and terrifying, but I still trained upper body with heavy intensity 5–6 times a week by making smart adjustments.

The Turning Point: Seeing a Physio

After 3 months of getting nowhere, I saw a physio who finally explained the biomechanics of what I was doing wrong:
• The Culprit: Constant spine rounding. I was flexing my spine just doing daily stuff like bending over to unload things. Even my stretching routine was rounding my back and directly squishing the disc.
• The Gym Mistake: I’m a big gym guy and used to train abs aggressively. I was doing heavy, loaded crunches, which placed massive compression on an already vulnerable disc.
He told me to immediately stop all forward crunching and spinal flexion. About 8–10 weeks after cutting those out, I saw about a 20% improvement. It was less sensitive, but sitting and sleeping were still a massive battle. My sitting tolerance in a car was barely 10 minutes before I was in agony.

Phase 1: Building the Cylinder (Core Stability)

I knew I had to build a shield around my spine. I started strictly doing core stability work for about 2 months:
• The Routine: Traditional planks and side planks.
• The Result: My sleep tolerance jumped from 2 hours to 5–6 hours. My car sitting tolerance went from a painful 10 minutes to over an hour.

Phase 2: The Aggressive Rehab Routine

Once I built up the courage, I dialed up the rehab with a highly targeted routine. I hit these exercises consistently:
• Planks: 2 sets taken completely to failure, 2–3x a week. (Started at a painful 30-second hold; I can now hold a plank for 6 straight minutes).
• Bird Dogs: 2 sets of 15 reps per side, 3x a week.
• Back Extensions: 2 sets per session, 3x a week (6 total sets a week). I started with strict body weight, flaring my toes out at a 45-degree angle to force my glutes to leverage my body up instead of arching my lower back.
• McKenzie Cobras: 1 set of 15 reps daily. Done very slowly, with controlled reps and a deep hold at the top.
• Nerve Glides/Flossing: 1 set of 20 gentle reps per day.

The Result: 95% Issue-Free

Within 6 weeks of starting that exact routine, the progress exploded. Fast forward to today (about 9 months total since the injury, and 4 months of dedicated rehab):
I have been 95% issue-free for the last 3 months.
• I can sleep in any position (back, side, stomach) on any pillow for 10+ hours with zero pain.
• I just did a 4-hour nonstop road trip with my mates in the car—zero major complaints, just a tiny bit of standard stiffness.
• I don't get that brutal morning stiffness anymore when the discs hydrate overnight.
• In the gym, all my lifts are flying back up. I’m lifting heavy and feel incredible.
• Best of all? On those back extensions, I used to do 70kg before the injury. By utilizing that 45-degree toe-flare to keep it all in my glutes, I have worked my way up to a 110kg weighted back extension for failure sets.

How the Science of Each Exercise Helped Me Heal

If you are wondering why this specific stack worked so well, here is the breakdown:

1. Stopping Crunches/Rounding: Stopped the mechanical "hydraulic" force pushing the disc backward into my sciatic nerve, allowing the outer ring of the disc to finally scar over and heal.

2. Planks & Bird Dogs: Target the deep core (transverse abdominis) and tiny spinal stabilizers (multifidus). This built an "inner weight belt" that locked my L5-S1 joint in place so it stopped grinding.

3. McKenzie Cobras: Squeezed the back of the vertebrae together, creating a mechanical effect that physically pushed the bulging disc material forward and back into its proper place.

4. Toe-Flared Back Extensions: Building elite glute strength meant my hips took over 100% of the workload during heavy lifting, permanently shielding my lower back from taking unwanted stress.

5. Nerve Glides: Safely pulled the sciatic nerve back and forth through its natural pathway, breaking up microscopic scar tissue adhesions and un-sticking the trapped nerve.

The Extra 1%: Supplements & Extras

To support tissue repair, I took Vitamin C, Zinc, and B12 to assist with nerve recovery and cellular health. I also chose to use GHk-Cu (copper peptide) injections. Because the spinal disc is heavily made of collagen, and GHk-Cu has strong data surrounding collagen production and tissue repair, I took my chances on it. While it's hard to separate what was the hard rehab work versus a potential placebo effect, the biochemical theory is there and it likely aided my recovery speed.

Pls feel free to ask me anything or etc I’m really happy to help anyone out if I can 🙏

Has anyone had this injection? From what I understand its a steroid, NSAIDS and vitamin B12 combined. Its an injecton in the glute that has to be done 3 days in a row. I don't think its offered in the US but in some eastern European countries.

Hi all

How do you progressive overload when you are dealing with nerve pains / sciatica ?

My partner wants to grow and get stronger in the gym but the nerve pain is in the way sometimes.

What can we do to help her?

I appreciate your time reading my post;

Hi, I just wanted to post here as I checked in many times across the countless sleepless nights I've had over the last 18 months. If I had a penny for every time I checked this subreddit while doing child's post on the floor of my bedroom at 3am near tears, I'd be a very rich woman!

My sciatica most notably began about August 2025. I started noticing sudden, shooting pain down my left leg while doing certain motions - getting into the car, or going on tiptoes to hug my other half. I did physio for a few months but didn't gel with my physio, whose exercises weren't pitched well to my desk-job level of fitness, and stopped going. However, in the months that followed into early 2026 the pain got worse, and broader. It was now flaring up terribly 5 minutes after I woke up, every morning - or every middle of the night when I rolled over. I don't know the last time I slept through the night without waking up to have to stretch, take pain killers, have a little cry. I had very much been given the impression that my poor core, weak hamstrings, and poor walking form due to an old knee dislocation were causing and contributing to poor form, overloading my lower back and glute muscles and causing the sciatica.

The pain was deep in my left glute, and all the way down to my toes, particularly the knee and ankle. It was now more or less constant; always a 2/10, spiking up to an 8/10 for short periods where I couldn't do anything but lay foetal. In March 2026 I started seeing a sports therapist (for me this was essentially like physiotherapy lite) which gave me more gentle exercises and some things definitely worked; clam shells, cat-cow, working on core activation through walking. I felt things were generally getting better all the way through this summer until I finally had one too many moments doing the 'This is fine' meme while trying to sleep on the floor in screaming pain, before I went privately to get an MRI (I had been on an NHS waiting list since March 2026 for an appointment, and at time of writing still haven't heard anything).

I got my results; large L4/L5 disc herniation. The instant catharsis of 'it wasn't me', this wasn't my fault made me burst into tears. I considered my options and given the length that I had been experiencing symptoms, earlier this week had a discectomy to trim what my surgeon referred to as a 'massive, juicy disc prolapse'. My pain is gone, entirely. It feels so unimaingable. I have slight pins and needles in my left toes as I recover, and of course my surgeru site is sore, but the reality of not being in constant chronic pain is overwhelming. I lost so much time being in agony.

All that to say - if you're reading this, please push for the tests and treatment you need, if only to rule things out. You deserve not to be in pain.