Overview
Vertebrogenic pain is a type of chronic low back pain that comes from the vertebral endplates, the top and bottom surfaces of the vertebrae next to the discs. The basivertebral nerve carries pain signals from these endplates.
It is identified using your symptoms together with specific MRI findings called Modic changes. For selected patients who have not improved with at least six months of conservative care, basivertebral nerve ablation (Intracept) may be an option.
Watch: Vertebrogenic Pain explained
Video: “What Is Vertebrogenic Pain? A Patient’s Guide to a Root Cause of Chronic Low Back Pain” from Chronic Pain Relief by Boston Scientific on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Common symptoms
- Chronic low back pain in the middle of the back
- Pain worse with sitting and bending forward
- Pain with physical activity
- Pain lasting six months or longer
Causes and risk factors
- Endplate damage and inflammation
- Disc degeneration
- Repetitive loading
How it is diagnosed
Diagnosis relies on your history, exam and an MRI that shows Type 1 or Type 2 Modic changes at the painful levels.
Treatment options
Care is stepped: most people start with self-care and physical therapy, and move to the next step only if pain continues. Some problems, such as nerve weakness, may skip ahead. Your exam, imaging and goals decide which options fit you.
Self-care and lifestyle
Stay active within comfort and build core strength.
Physical therapy and medications
Physical therapy and medicines are usually tried first.
Injections and nerve blocks
Injections are sometimes used to help sort out other pain sources.
Minimally invasive procedures
Intracept may be an option when MRI shows specific endplate changes (Modic type 1 or 2) and pain has lasted at least six months.
Surgical evaluation
Surgical evaluation is considered for other structural problems.
Learn how we approach care: our care philosophy · nonsurgical options · second opinions.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, severe pain after a significant fall or accident, or pain with fever or unexplained weight loss.
Frequently asked questions
How is vertebrogenic pain different from disc pain?
It comes from the vertebral endplates rather than the disc itself, and it has specific MRI markers.
Do I need a new MRI?
Your physician will review your existing MRI. A new or updated study may be needed to look for Modic changes.
What is Intracept?
A minimally invasive procedure that uses radiofrequency energy to ablate the basivertebral nerve inside the vertebra.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.