Vertebrogenic pain is a recently recognized source of chronic low back pain that originates from the vertebral endplates—the interfaces between the spinal discs and vertebral bodies. When these endplates become damaged or inflamed, they can stimulate basivertebral nerves, leading to persistent deep, aching back pain.
Unlike discogenic pain (from the disc itself) or radicular pain (from compressed nerves), vertebrogenic pain is often centralized in the low back, with no leg symptoms, and is aggravated by sitting, bending, or physical activity.
Common Causes of Vertebrogenic Pain
Endplate damage due to mechanical stress, disc degeneration, or trauma
Modic changes seen on MRI—signal changes in the vertebral body adjacent to the disc (particularly Modic Type 1 and Type 2)
Chronic disc degeneration leading to inflammation and vertebral body stress
Overuse, repetitive lifting, or axial loading injuries
These changes result in inflammation of the basivertebral nerve, which is responsible for transmitting pain from the vertebral body.
Symptoms of Vertebrogenic Pain
Chronic low back pain localized in the midline (not radiating down the legs)
Pain that worsens with:
Sitting or standing for long periods
Forward bending or lifting
Physical activity
Morning stiffness or aching
Pain that improves with rest or lying down
Often unresponsive to traditional treatments such as medications, injections, or physical therapy
How Vertebrogenic Pain Is Diagnosed
Diagnosis involves a combination of:
Clinical history and physical exam
MRI imaging showing Modic changes (Type 1 or 2) at one or more lumbar vertebral levels
Exclusion of other pain generators such as facet joint arthritis, herniated discs, or sacroiliac joint dysfunction
Conservative Treatment Options
Before interventional therapies are considered, patients typically undergo:
NSAIDs or pain-relieving medications
Physical therapy focusing on core strengthening and posture
Activity modification
Bracing or ergonomic adjustments
Cognitive-behavioral therapy for chronic pain management
However, vertebrogenic pain often does not respond well to conservative care, which leads to consideration of advanced options.
Interventional Treatment: The Intracept® Procedure
What Is Intracept?
The Intracept® Procedure is a minimally invasive, FDA-cleared outpatient treatment that targets the basivertebral nerve, which transmits pain from damaged vertebral endplates.
How It Works
A small probe is inserted into the affected vertebral body under fluoroscopic guidance
Radiofrequency ablation (RFA) is used to disable the basivertebral nerve
The procedure takes approximately 60–90 minutes and requires no implant or hardware
Benefits of Intracept®
Clinically proven to provide long-term pain relief
Minimally invasive with short recovery time
Significant improvements in pain, function, and quality of life
Ideal for patients who have failed conservative treatments and want to avoid spine surgery
When to Seek Help
You may be a candidate for vertebrogenic pain evaluation if you:
Have chronic low back pain lasting more than 6 months
Show Modic changes on MRI imaging
Have not responded to physical therapy, injections, or medications
Experience centralized low back pain without significant leg symptoms
Find Real Relief from Vertebrogenic Back Pain
At Parkview Spine & Pain, we specialize in identifying the true source of your back pain. Using advanced imaging and cutting-edge procedures like Intracept®, we target pain at its origin—without major surgery or long recovery times.
👉 Schedule a consultation today to learn if you're a candidate for Intracept® and take the first step toward long-lasting relief.