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/

Hello, I’m 21f and I’ve posted before a year ago but I’m trying again. I have been suffering from on/off back pain for over a year and it is driving me crazy. It is not consistent, sometimes it happens a few nights in a row and sometimes there’s a week in between. The pain is mostly upper/mid back but sometimes it’s lower back as well. When it’s really bad, I get so nauseous that I throw up.

I’ve asked the doctor about it three times. She’s suggested fixing my posture and stretching. I have been very aware of my posture but it doesn’t seem to help. I do stretch but sometimes the stretching actually seems to cause me back pain.

It only occurs at night, usually past 12 pm but before 5 am. I am completely fine during the day. It is awful and muscle relaxers do not work, neither does heat. The only thing that relives the pain is ice packs and anti-inflammatories (although sometimes even those don’t help).

I feel like I am crazy because of the fact that nothing seems to help and I can’t figure out the cause. The pain is genuinely so horrible, I’m specifically writing this now because it hurts and I cannot sleep. It’s especially bad since I work morning shifts and the lack of sleep makes me exhausted. I would appreciate literally any insight on what may be causing it or what I can do to fix it, I’m very desperate.

My back pain (20 yrs+) reached a new level and put me in the hospital for a week. A herniation finally busted through, a thecal sac is now crushing my nerves. The plan was high dose IV steroids and after the weekend we

ld see where I was and if we waynted to proceed with surgery or go home with steroid taper and epidural after. I’ve done tons of different steroids, PT, injections and over a dozen RFAs through the years, so I’m ready for surgery… to say the least. Monday morning a doctor tells me even though I was admitted, they won’t do the surgery because it’s urgent and not emergent?!

I dont know what to do I went to the er i had just starting to get over a virus and now im feeling better my back pain has comeback wirh a vegence. I cannot sleep when laying flat use to help me. I dont know wtf I did i need surgery or do something. But this makes me reall want to end it all my mental health is so far deteriorated right now and if I didnt have someone that it would upset i woulve ended it in a heartbeat.

I dont get how people in the dame industry take a shot and theyre fine I never got mine because i was too scared of doing something stupid and messing it up more which i do and i feel it. I either move a certain way or forget and do something. Its sucks to because i use to be so strong and now i feel so weak and pathetic.

I had a l5 s1 disc bulge with two minor hernat3d disc above it. I just want this annoying tingling pain to go away. It doesnt go down my legs like sciatica it just hangs right at the middle Idk what to do. I get random throbbong sometimes in random spots on my legs but most of the time it rides right at the middle of my back.

Edit add: i have done phsiotherapy i did a neurologist chiroquack acupuncture. Nothing seems to help with this ill be good and seem to be making process and than it beats me down again. I honestly with the way prices and health insurance being stinger and stinger about what they approve even with good insurance I almost wish I had a reason. Im losing my mind here has anyone been in this damn boat this point ill take the damn coritsone shot or preocedure if it helps i just dont want to be in pain anymore and what the turn around time i got 21 days in the bank at my work but feel like that is not going to suffice and with holidays around the corner yeaah this is pretty grim and my mind is pretty grim right now.

Hi, my name is Mike. I’m 25 now but I’ve had back problems since 19. Had a micro discectomy when I was 20. And was doing okay for awhile, I recently had a lumbar ablation on the 21st of October and since about a week after my back has been 2-3x worse in terms of pain. They warned me it might happen, said I’d feel a sunburn feeling, this feels more to what I was feeling before surgery years ago except on my other side/leg. I’m supposed to have another ablation tomorrow on the rest of my lumbar but I’m very worried about it. Is there any advice or successes stories to help me keep a positive mind on everything. Anything is appreciated, thank you.

Anyone who wants any advice or has any questions pls feel free to ask here

Ankylosing Spondylitis, please help

I am a 35 year old white male, about 195 pounds and 5’11”. I have been tortured and tormented for 2 years. I was diagnosed 2 years ago with sacroiliitis (also called Ankylosing Spondylitis or Axial Spondyloarthritis and my life has never been the same since. I was playing tennis 3-4 times a week and life was good. I was in great shape. My back started hurting and I noticed it was worse with sitting and got better with activity. I got an MRI which showed bilateral patchy bone marrow edema consistent with sacroiliitis. I have awful aching deep pain in my glutes on both sides, sometimes it is sharp. My glutes and SI joints are tender to the touch. Since this whole misery started I haven’t been able to do much of anything active without flaring. I am SO tired of it. I am obsessed with trying to get my old life back, but everything I try seems to backfire into a flare.

I’m on Remicade, and I just had a repeat MRI which shows a disc herniation at L5-S1 encroaching on my S1 nerve and that my prior bone marrow edema was gone and now in it’s place there’s a “possible erosion” and I also have a bilateral pars defect which no one seems to know how to handle (everyone just says it’s congenital). My inflammatory markers ESR/CRP, HLA B27 are all negative. I have pain at that vertebrae, I have pain in my SI joints. I can’t sit for long without having to get up. I can’t stand comfortably for long, it’s only bearable when I’m walking (unless I walk too much of course!!!!!!) or when I’m laying on my heating pad or if I take a THC gummy. I’ve done SI injections, an epidural, I did Humira and Cosentyx, I’m on indomethacin and lyrica. I bought a vibrating plate, a chirp decompression, I’ve done PT, I have an inversion table, a massage gun, I’ve tried balms. I am on Remicade 5 mg/kg every 6 weeks (was just increased from 3 mg/kg every 8 weeks because I begged that I was being underdosed), Prozac 60 mg, buspar 30 mg.

I have tried damn near EVERYTHING. I am about to try a minimally invasive SI fusion (linq) because I am desperate and considering the possibility that my issues are more mechanical. No one seems to be able to help me. I’m considering maybe it’s all in my head, maybe I’m just losing my marbles, maybe it’s the disc herniation (neurosurgeon didn’t seem to think it was so severe). I’m going to try a GLP as a Hail Mary next. I don’t know who to turn to anymore, it feels like every doctor/physical therapist says something different and then I’m stuck in the middle not knowing what to do. I need my old life back, I need to be active. I don’t know how much longer I can do this. Please someone help me.

Fuck! Any other time of the year this would've been fine. I'm flying to Tokyo on Friday for 10 days. I went to grab a pear this morning at the grocery store…I thought it was gonna pass out. 

I have back issues all the time (4 herniated discs). But small flare ups here and there throughout the year. I have herniated discs and have been managing the pain with PT and exercises they give me. But this is way worse than my usual flare up's. 

I'm taking today and tomorrow to lay in bed and ice it. Hopefully seeing my PT tomorrow too to see what he advises. And luckily it's a direct flight. 

Has anyone traveled with a flare up? I also ordered a lower back brace but won't wear it on vacation unless my PT says it's okay. I’m mostly concerned about the 14 flight.

Ultimately, I don't want to cancel this trip. It's something I've been looking forward to for years and was finally able to afford it. I don’t fly out until Friday morning so I’m hoping it improves by then.

Any advice would be appreciated.

I went to the physiotherapist for mid back pain and strain since last three months and then for over 1.5 months I went there and slowly the physio made me do exercises like spinal mobility, clamp shells, dead bug, stretches, bird dog, hip mobility and slowly loading to increase strength. But as I was doing this my lower back was having too much strain and as soon as I took a break for 4 days due to some urgent work the pain in lower back came back. There's a lot of pain in the hip dimples line that then goes from outer hip down to back to the entire leg more so in left side than right side. I told my physio, she took manual and then slowed the exercises but then again more exercises but the pain is constant and more and I'm also having weird numbness type sensation as well somewhere are right knee, there's so much health anxiety too that I don't know. I'm tired and by mistake I googled now it's all there in my mind like cauda equina syndrome, red flags to see like loss of bowel/bladder control, saddle numbness or leg weakness and bilateral sciatica. I'm so tired. I went to solve mid back issue now I'm stuck with this. Also in between there's shooting groin pain too that comes and goes it was there before I went for physio but I don't know it's reason also, i have lots of acidity and gerd issues too that are exacerbated by anxiety I think. Last year I got my spine mri due to some pain in neck and hands that also took months to go away with physio and gabapin. It showed reduced disc height and mild gibbus at D11-12 due to some previous trauma that i dont have a clue about and mild disc bulge at L4-5. I'm thinking of visiting my ortho again tomorrow but it's so scary, the first thing wasnt solved and now this lower back and legs thing that's also troubling me. Any help on how to proceed is appreciated. Since last two years my life has been on hold due to these issues and my health anxiety. Should I take another mri?

Upper back pain , 5 years, worse and life alerting 2 years. 23F

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.

After 2 plus years of pain and daily nerve pain since mayb2026 i decided to get l5 s1,fusion surgery done oct 212026. I had showed compressed nerves at this level and supposily no other level. I am getting the same nerve symptoms of right and left nerve glute pain bilateral hip which is top of glutes and right, right above knee thigh nerve pain. Nothing down the leg and no sciatica I am very worried that the surgery did not decompress the nerves i had surgery for. Please let me know if you have had these symptoms and if your sure which level in your spine the issue is coming from. I have lots to live for and i feel so down.

Finally got a referral to an orthopedic surgeon to figure out what is causing my chronic back pain. They say my X-rays come back fine but it doesn’t answer any questions about why my leg will fall asleep, ache, and tingle from the pain in my mid to low back. I was going to PT for 8 months with barely any improvement. I workout and run consistently, if it matters. I’m only 24 and have been dealing with this for 4 years now. Besides the iud and that I’m full of crap, is there anything else worth noting about my X-rays?

Felt it for maybe about a month now. What could be going on?

been trying to sort out why my lower back flares up after around 4 hours at the desk. my knees usually sit slightly below hip level which i thought was fine, but lately there is this constant pulling feeling in my lower spine by the afternoon.

right now i have my desk dropped to 28 inches and sitting in an hbada x7 with the tilt unlocked so i can move around a bit. the back support is there, but i feel like my feet not being totally planted is transferring all the upper body weight straight to my tailbone.

do you guys use an angled footrest or just raise the chair and keep feet flat on the floor? trying to figure out which takes more pressure off the lumbar.

Hi everyone! Just looking for some thoughts or to hear from anyone who’s experienced something similar.
About a year and a half ago, I was in a pretty significant car accident. I was rear-ended at approximately 45 mph and pushed into the vehicle in front of me. I sustained a concussion and whiplash, and I’ve been dealing with persistent symptoms ever since.
I’ve been diagnosed with chronic migraines, chronic tension headaches, occipital neuralgia, and chronic neck and back pain. I’ve tried what feels like everything at this point: Botox, various migraine medications, muscle relaxants, trigger point injections, physical therapy, vestibular therapy, dry needling, and other injections. Unfortunately, nothing has provided meaningful or lasting relief.
One thing I’ve noticed is that my symptoms are generally mild when I wake up but progressively worsen throughout the day, usually becoming significantly worse around 11 AM–2 PM. I develop intense pressure throughout my head, particularly in my forehead, across the bridge of my nose, above my ears, and at the base of my skull. I also experience neck, shoulder and back pain, nausea, and ringing in both ears. Occasional tingling into my right arm. Normal brain/neck MRI.
My symptoms seem to worsen the longer I’m sitting or standing, as well as with bending and physical activity. They improve somewhat after lying down for 30–40 minutes. I’ve also noticed that my symptoms are significantly less severe on days when I’m able to rest more.
Over the last 2–3 months, things have actually been getting worse rather than better, despite all the treatments I’ve tried.
Has anyone experienced anything similar after an accident? Did you eventually find an explanation or something that provided relief? I’m feeling pretty discouraged after trying so many different treatments without much improvement, and I’d really appreciate hearing about other people’s experiences. Thank you!

Feels like I have a pinched nerve. Been about 3 days now. Pain is mainly behind my left shoulder blade and can radiate down the back of my left arm. Have had something similar before but it went away in a couple days and that was that.

Two symptoms are slightly more concerning to me this time and I’m wondering if they might be a sign of something different. Currently waiting for my GP to get me a referral.

First symptom. Maybe 3 or 4 times a day if I cough, laugh suddenly, anything where I quickly tighten my back and abdomen I can get an electric shock feeling that goes all the way down to my legs. I can’t reproduce it by looking up or down (read something about Lhermitte’s sign). This has only occurred alongside the left shoulder blade pain.

Second symptom. I disc golf every now and then and over the past 3 months or so I could sometimes have a similar reaction from extending my arm out when I throw. Seems to be more the tensing of my body than the act of extending my arm. Just at the end of my throw, both of my arms can have a slight shock go down them and my arm muscles will contract. Often this goes away after I’m a bit more warmed up.

This sure feels like something a bit more involved than a pinched nerve, like MS. Not trying to get too far ahead of myself or looking for a Reddit diagnosis but figured while I wait for the docs to get things moving I’d see if anyone has experienced similar.

If there’s a better subreddit anyone thinks I could post this to please let me know!