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Home > Could Your Chronic Low Back Pain be Vertebrogenic Pain?

Could Your Chronic Low Back Pain be Vertebrogenic Pain?

Dr. McFarland

Mark W. McFarland, DO

As a spine specialist who frequently treats patients for low back pain, I thought it would be helpful to share some findings from 2023 research that were recently published on this issue.  They are:

“According to a 2023 study published in The Lancet Rheumatology, 619 million people worldwide, or nearly 10% of the global population, had experienced low back pain (LBP) in 2020. This number is projected to increase to 843 million by 2050, largely due to population growth and aging. LBP is the leading cause of disability worldwide and most people experience it at least once in their lives. Prevalence increases with age, peaking at 50–55 years old, but older people are particularly at risk, with the peak impacted age being 85 years.”

Unfortunately, an easy answer for low back pain is hard to find for some patients.  Typically, most patients are treated conservatively for at least two-three months for their low back pain with some or all of the following:

  • Physical Therapy
  • Activity Modification
  • Anti-inflammatory medication
  • Muscle relaxant medication
  • Hot/cold therapy
  • At-home exercise regimen
  • Bracing or back support

When these treatments don’t provide relief, an MR scan will be ordered to give me a full view of what is happening with the patient’s spine that I will not have been able to see on x-ray.  The MR scan will often reveal degenerative changes to the spine, the vertebrae (spinal bones) and the spinal discs that act as cushions between the vertebrae in the spinal column. Most of us who are over the age of 40 will show at least some degenerative changes on our MR scan – from wear and tear and everyday living. However, it’s only if these changes cause pain and dysfunction that we do anything about them.

The MR scan may show damage to the vertebral endplates, the tissue that covers the top and the bottom of each vertebral bone segment and separates it from the spinal disc. Our daily activities can stress the endplates and damage them, leading to inflammation and vertebrogenic pain.

The reason for the vertebrogenic pain is the basivertebral nerve (BVN), found within the spinal bone or vertebrae, which carries the pain signals from the inflamed endplates to the spinal cord and then to the brain.  See the picture below, which illustrates the endplates, the BVN (within the bone) and the locations within the spinal column.

We currently have no way to repair/replace the vertebral endplates to remedy the pain.  We do have a way of treating the inflamed nerve so that it stops sending painful signals to the brain – through a process called radio frequency ablation (RFA).

The procedure I perform is called Intracept® and is done in an outpatient setting, is minimally invasive, requires no implants, and has shown to be effective at reducing pain and dysfunction for chronic low back pain patients.  If you’re interested in learning more, call 757-596-1900 for a consultation with me to discuss qualification for this treatment.

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