commonwealth pain and spine logo

Why Intracept® Might Be the Right Treatment for Your Lower Back Pain

Aug 03, 2022
misc image
Lower back pain is a common and costly problem. Commonwealth Pain & Spine is proud to offer Intracept®, a new, effective treatment option that is proven to significantly reduce vertebrogenic pain.

Lower back pain is a common and costly problem that will affect 8 in 10 people in their lifetime. Globally, around 577 million people have lower back pain—including lost wages and productivity, the annual cost of lower back pain in the U.S. exceeds $100 billion and nearly 150 million lost workdays.  

Many cases of lower back pain can be treated with over-the-counter medication, stretching, and exercise. However, pain that originates from the nerves within the vertebrae—known as vertebrogenic pain—typically doesn’t respond to traditional treatment, leaving patients to struggle with chronic spine pain from daily activities such as bending to tie their shoes. 

Now, our patients have a new, effective treatment option that is proven to significantly reduce vertebrogenic pain. Intracept, an outpatient nerve ablation procedure, can precisely target and deaden damaged and inflamed nerves in the lower back, relieving vertebrogenic pain by 50-75% or more in the weeks after treatment—and providing sustained relief for five years after a single treatment. 

TV personality Carson Daly recently detailed his experience with low back pain, which prevented him from actively parenting his children. After years of unsuccessful treatments, Daly underwent this minimally invasive outpatient procedure to help relieve his vertebrogenic pain and has seen excellent results. 

At Commonwealth Pain & Spine, our doctors Shawn Milburn, MD and Brandon Gish, MD offer Intracept. They are some of the few physicians in Kentucky credentialed to perform the procedure. If you have had lower back pain for more than six months and conservative treatments have been ineffective, you may qualify for Intracept.  

Who is a candidate for treatment? 

Vertebrogenic pain is caused by damaged vertebral endplates — the top and bottom edges of the vertebrae in the front of the spinal column. The endplates degenerate over time due to the wear and tear of daily activities, which can cause inflammation that triggers pain from the nerves inside the vertebrae.  

Not all back pain is vertebrogenic—lower back pain also can be caused by arthritis, sports injuries, or bone or tissue injuries that do not affect the nerves. Intracept is designed specifically to treat vertebrogenic pain. 

To confirm whether your pain is vertebrogenic, the doctor will perform a physical exam and use an MRI to look for what are known as “modic changes” in your spine. 

If you have already had an MRI, the results may not necessarily note modic changes even if they are present. These can include:

  • Changes to the endplate such as inflammation, edema (swelling caused by fluid), disruptions, and fissuring
  • Changes to the fibrovascular bone marrow
  • Replacement of fatty bone marrow

Most patients with vertebrogenic pain experience symptoms during simple daily activities such as sitting for long periods of time, picking things up from the ground, or bending over to tie their shoes.  

Not every patient with vertebrogenic pain is a candidate for the Intracept procedure. Candidates for Intracept must meet three criteria:

  • Chronic lower back pain for at least six months.
  • Insufficient results from conservative measures like chiropractic care, yoga, medication, injections, and physical therapy.
  • Modic changes in the vertebral endplates are visible on an MRI.

A review of prior MRI results can indicate whether your symptoms are the results of modic changes, so talk with your doctor or contact us to learn more. Most patients are referred by orthopedic spine specialists, and we work closely with these experts and others to plan effective, personalized spine care. 

How the procedure works 

The Intracept procedure targets the basivertebral nerve for heat ablation (burning). With the patient sedated under anesthesia, your doctor will access the affected vertebrae with a small needle guided by real-time X-rays.  

Next, a channel is created through the vertebrae bone to access the trunk of the basivertebral nerve inside. Through this channel a special probe is placed directly next to the nerve, ablating it with heat from radiofrequency energy. This deadens the nerve, rendering it unable to communicate pain signals to the brain, all without hindering mobility or weakening the spine. 

The Intracept procedure takes about an hour. After sedation has worn off, patients return home that same day. While there are no restrictions on activities after the procedure, most people experience some soreness around the site for 24-48 hours and resume their normal activities after a few days. 

One study indicated that 12 months after the procedure, more than 70% of patients reported at least 50% less pain. Of the patients studied, 84% rated their condition as “improved” and 60% said it was “vastly improved”. Patients reported their quality of life was better, and they spent less time in the hospital receiving treatment for back pain.  

The same study revealed that 70% of patients who were managing pain with opioids at the time of the procedure were able to stop using the medication after Intracept treatment.  

Even five years after the procedure, studies show patients have seen significant, ongoing improvement in their pain. In fact, two thirds of patients reported their pain was reduced by half after five years, almost half of patients experienced a 75% reduction, and 34% reported no pain at all. 

How to get started

The spinal column is a complex structure, and back pain can be complicated. That’s why it’s important to have a team of experts working on the same page to provide care.

If you are interested in learning more about Intracept and seeing if you are a patient, click here to fill out an interest form and someone from our team will reach out to you.