Pain generated by the vertebral endplate — the bone-disc interface — rather than by the disc, the joints or a nerve.
In more detail
- The endplates are supplied by the basivertebral nerve. When the endplate is damaged and inflamed, that nerve carries the pain.
- It is associated on imaging with Modic Type 1 and Type 2 changes.
- It is a comparatively recently recognised category, which is why many long-standing back pain patients have never had it considered.
What it means for you
Typically it presents as deep, midline, aching low back pain, worse on sitting and on forward bending, in someone whose scans show endplate changes but no nerve compression. It is worth identifying because it is treated differently from disc or facet pain.
Remember the general rule. Findings like this one are common in people with no pain at all, and become steadily more common with age. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your examination. See understanding your MRI report.
Bring your scan and report in and we will go through it with you. Call (314) 310-5577 or request an appointment.
Common questions
Why has nobody mentioned this to me before?
It has only been well characterised relatively recently, and it requires someone to look specifically at the endplates and correlate them with the pain pattern.
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