Modic changes are MRI findings that indicate structural and inflammatory changes in the vertebral endplates and adjacent bone marrow. They are strongly linked to chronic low back pain, particularly in cases of degenerative disc disease.

- Type 1 Modic changes suggest active inflammation, often due to microinstability at the disc and endplate. These changes are associated with persistent, intense pain, as they involve swelling, increased blood flow, and bone marrow inflammation.

- Type 2 Modic changes indicate fatty degeneration, representing a more chronic process that may or may not cause significant pain.

- Type 3 Modic changes reflect sclerosis and scarring, often signaling a stabilized, less inflammatory state with a weaker correlation to pain.

Since Modic-related pain is often discogenic, meaning it originates from the disc itself, treatment options target the underlying pathology. Basivertebral nerve (BVN) ablation is an emerging therapy that disrupts nerve signaling from the vertebral body, potentially reducing pain in patients with Modic changes.

Other options include disc regenerative treatments, disc replacement, or traditional spinal fusion, depending on the severity of degeneration and patient-specific factors. Understanding Modic changes can help guide more effective treatment strategies for chronic back pain.