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Modic changes

DixiechickDDixiechick Posts: 27
edited 06/11/2012 - 8:58 AM in Chronic Pain
This is what I found researching Modic changes - I am in this position, and it scares me... I copied and pasted, I did not add anything to this documentation.

Diagnosing modic changes
Modic changes can only be seen on a magnetic resonance imaging, an MRI. Modic changes were first described and separated into 3 different types of changes by Dr. Michael Modic in 1988.
Normal bone consists of an internal scaffolding of bone, called trabeculae. In the hollows between the trabeculae is red bone marrow, which produces blood cells.
• In Modic type 1 the trabeculae are fractured in many places, the trabeculae are shorter and broader and the “scaffolding” pattern is unstructured and uneven. The marrow is substituted by serum, the same clear liquid that is inside a blister.
• In Modic type 2 changes the trabeculae are also fractured in many places, but are shorter and broader and the "scaffolding" pattern is unstructured and uneven. With Modic type 2 changes the marrow is substituted by visceral fat, the same kind of fat we have on our hips and bellies.
• Modic Changes type 3 are rare, and it is bone scar tissue.
[edit] Modic changes and pain
Many studies[which?] have examined the relationship between Modic changes in the vertebrae in the spine and pain in the lower back. There is a very strong correlation between having Modic changes, especially Modic changes type 1, and suffering from pain in the lower back.
Studies[which?] have shown that patients with Modic changes are rather different from other patients with normal back pain. For example 75 –80 % of patients suffering from Modic changes have constant pain, which means they do not ever have a pain-free moment day or night. There might be fluctuations in the intensity, but no break from the pain. 75% of the patients also suffers from pain during the night, and many wake up during the night because it is painful to turn in bed.
[edit] Treatment
It is difficult to treat patients with Modic changes. Treatment that normally cures or help patients with normal back pain does not have effect on Modic changes or pain from Modic changes.
The recommended treatment for long lasting pain in the lower back is exercises, normally aided by the instruction of a qualified physiotherapist. This is often followed by muscle strengthening and fitness training. This treatment does help the vast majority of normal back pain patients. But studies[which?] have shown that patients with Modic changes showed much higher pain score than patients with normal back pain, and most importantly that their pain increased with training.


  • Interesting...
    I just got my MRI results back and it mentioned something about Modic changes.

    I was reading on 1, 2, and 3 and struggled to really understand what it meant. The article I read also mentioned that people can move back and forth b/t 1 and 2, and then even b/t 2 & 3.

    I'm still not 100% sure I understand this but your article seems to add a little more clarity.

    I'm actually going to call my NS this week to have him look at the MRI and see what options I have b/c my situation hasn't changed much since last surgery BUT my pain is on the rise in my lower back.

    I guess I should dig on this a little more when I talk to my surgeon.
  • Ok, so I found the article you read.

    I need to start taking my oscal. Still believe that if I can help my bones, I can reduce my pain. Stomaching the calcium tablets might be worth it if it can help.

    I'm more intrigued now to read/find more on this.

    I went back and found the article I read and now it makes a little more sense. It did say that in the study 8% of diskectomy patients developed type I changes which was not a surprise b/c of being adjacent to a disk still undergoing DDD.

    I figured out, also, the article, indicated in the study that certain patients with Type I changes reverted after Fusion which again would make sense b/c they are no longer adjacent to the DDD. I think it was all in reference to end-plates.

    Very technical article. But still intriguing and something I will discuss with my surgeon.
  • Hi there,

    The study I read was

    The conclusion was the best part to read as it did a nice job summarizing what the study results found (or didn't find).

    Mods - I hope this is ok to post. I'm not looking to make any assessment of the article, just post it.
  • I'm glad you found that interesting. I looked up Modic changes and how it relates to pain. Your right, it is hard to look up and understand = tht is the most point blank info I could find. I found the "Never, ever get releif from pain part' a little depressing. and don't understand how it changes your bone marrow... I can visualize tht I guess. I am trying to understand this too. I wrote on an earlier post '34 yr old vetern' and listed wht my MRI said. I picked up my MRI on my own, I still having spoken to my Dr about it, so I'be been doing research to be prepaired on my own.
    What did your MRI state specifically about Mobic changes adn what type adn do youfeel that that is where your constant pain is coming from?
  • Interesting article. I have Modic type 2 changes at L3-L4-L5 (previously type 1, I think). You can see the change in appearance of the vertebrae and disc spaces (or absence of disc spaces, in my case!) clearly on the MRI. The colour and texture of the bone looks different.
  • Still need to talk to my NS. My gp ordered the new MRI and said it is relatively status quo and I didn't think to ask him about some of the verbiage.

    Huggy -the study did indicate that people can move b/t 1 and 2

    Anyhow, I am curious on pain and assumed it is arthritic in nature or muscular.
    On the flip side, I was told that my nerve took a really hard hit wnphen the disc ruptured and even with my surgeries, was told the nerve migh be permanently damaged which is some of my pain comes from.
  • Did some more googling and found this study. Similar information.

    Interestingly enough, I'm starting to explore changing my diet. If Type 1 are inflammatory in nature, I suspect my diet can help if I eat an 'anti-inflammatory diet'....like Garlic, herbal teas, etc.

    Not sure...just interesting.

  • This is a hard Term to look up then understand, but I think that it speaks volumes to present to DRs or possibly Social Securtiy. Thank you for all the additional articles you guys have found for me and all the others reading.
  • I have Modic type one and two changes in my neck and lumbar. A year ago I had a lumbar laminectomy with fusion and hardware. Although I am standing straight, the pain is wearing on me. When the NS saw me after surgery, he said my bones were mushy.
    After doing research on Modic changes, my bones are mushy b/c the Modic change type 1 can be bacteria in the marrow and secrets a blister like clear fluid. The endplates of the bone are broken or cracked , thus creating pressure on the nerve endings. With most LBP, exercise is the best therapy but with Modic changes they are finding that rest is best.
    The Doctors don't seem to know much about this and it is becoming very frustrating.
    I still have severe pain down both legs which wakes me at night. Before rain, I am in tears and this is with pain killers. I cannot plan anything as I do not know how I will feel the day of. My upper thighs feel like I was kicked by a horse and my legs become wonky if standing too long.
    Although I understand what is going on with the Modic changes, there does not seem to be any kind of cure for it. There have been studies that people with this underwent 100 days of antibiotics but have found no real evidence that it works.

    Good luck to all and if I learn anything new, I will post it.
  • When all of this spine stuff really started for me I threw myself into physical therapy. I describe my first PT as "over zealous". I tried so hard but my pain just increased. Not one to give-up lightly, after 9 months I found a new therapist. I took my old exercise & stretch list with me & after looking at my MRI my new PT put a line through a large number of my exercises & told me never to do them again because of all the 'Modic Changes'! He developed a routine of stretches & exercise that doesn't increase my pain levels. It's my understanding that it's still important to keep your body moving (I have arthritis & a very messed-up spine) but to avoid really moving & stretching your spine in certain ways.

    I eat an antiinflamatory diet too.
    Osteoarthritis & DDD.
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 08/27/2014 - 2:56 PM
    Out of interest... Do others with Modic changes have cysts too?
    Osteoarthritis & DDD.
  • After surgery, I found that I could not stretch. I then learned some stretches online. My PT insists that I need to do lots of walking, exercise even though it increases my pain levels. I am getting so frustrated since no one here understands the MC. It is very difficult to find answers.
    I just requested an MRI 11 months post op and my Doc says I don't need one. I also was told by a Chiropractor that I should see a Physiatrist. Now my GP has given me meds for Parkinson's for my leg pain. I just don't know how to get through to him.
  • Hi English Girl,
    What kind of cysts do you mean?
    Not sure if they are cysts or just fatty deposits close to the surgical site.
  • Oh Chance please never, ever let a chiropractor do adjustments on you!! I've voiced this opinion lots so I won't go into it again. Just please, please it worries me when people say chiropractor & surgery or spine damage.

    I've found that a lot of specialists don't seem to consider Modic changes at all when discussing my options. Others make a very big deal out of it. Ugh!! It does get frustrating. I was so pleased when a PT finally told me why I was hurting so much when I did regular disc treatment type physical therapy. I kept thinking it was my fault for not being strong enough to work through the pain. You know? The whole 'no pain = no gain' stuff!
    Osteoarthritis & DDD.
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 08/27/2014 - 4:20 PM
    I've got a few. I've been told its fluid leaking out of the messed-up bone & getting caught in the 'skin' stuff that covers the bone. They're like little balloons of fluid. I've also been told my pain would reduce when I sit if they are a major pain generator. I've also been told that that's not true by other specialists! Ugh! I hurt sooooo very much when I sit that I can't tell if one pains going (cyst pain) as the other pain is coming on strong. Ugh!

    Can you tell I feel like venting my frustrations tonight? I discovered today that I have a LOT more bone spurs than I thought I had & I had an SI joint shot they may or may not of worked but it took him over an hour to get the variety of different shaped needles into the joint!! Ugh! ;-)
    Osteoarthritis & DDD.
  • Meds for Parkinson's? Which ones that?
    Osteoarthritis & DDD.
  • The past four days have been hell for me.
    I actually asked my old GP if those lumps were the synovial fluid from the disks...he said no way!
    I had spondylolithesis and for four years, just on pain meds. I thought surgery would help the pain but I don't find it has changed. After my NS did the laminectomy with fusion and hardware, my GP sent me for a bone density and discovered I have osteoperosis.

    In my opinion, these cysts we have are the fluid from the disks. After all, it has to go somewhere.
    Vent all you want! I know your pain and frustration. They make you feel like it is your fault or all in your head. Meanwhile, they just want you to stay on the drugs....which help a bit but never take the pain away completely.

    Those needles are painful...I hope they work for you!
  • EnglishGirl said:
    Meds for Parkinson's? Which ones that?
  • JulistigJJulistig Posts: 1
    edited 02/14/2015 - 11:03 PM
    I've got modic type 2 after MRI. My doc didn't tell me so much so I've been reading up on the web. I get that there is no help for this condition, but I want to know what I can and can't (shouldn't) do. Running? Cycling? Weight lifting? Skiing? Swimming? Lumbar exercises?
    Does MC get worse if I do these activities?? I know it will hurt the day after but it is worth it mentally to stay active. So anyone with a doc that can answer these questions? Also anyone that has gotten exercises for lessening the pain?


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  • EnglishGirl said:
    Out of interest... Do others with Modic changes have cysts too?
    I have DD, bulging disc type 2 modic end plate changes, tissue atrophy as well as Tarlov cyst in my L4, L5, S1 region. I have no idea of why and the specialist I went to see seemed unfamiliar with all of these conditions. I have not received any help for it, but I can say the pain is enormous. I also have a cervical spine injury, I am not sure if I have any cyst or modic changes there.
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 04/10/2015 - 7:35 AM
    If you're seeing a spine 'specialist' who doesn't know about Modic changes or cysts find a new one!! Cysts are almost always a symptom of instability in the joints. You should be having 'moving X-rays' or other diagnostic tests to see if the joints 'slip' over eachother with movement etc. That's what I've been told anyway. I'm amazed that a specialist doesn't know about these conditions!!
    This site has some great information. Search at the top of the page & inform yourself. I'd take notes along to your next appointment...I always do.

    Does your pain decrease when you sit down for a while? I've been told that's a big sign that cysts are causing your pain. I have a lot of other damage & very large cysts. My pain changes when I sit. I'm assuming that some cyst pain is aleved but replaced by other pain when I sit. Does your MRI say that nerves are compressed by your cyst? It's a hard one to know because the position you're in for the MRI can reduce/move the cyst. Ugh!!!!
    Osteoarthritis & DDD.
  • Lizib23LLizib23 Posts: 1
    edited 07/26/2015 - 7:30 AM
    Hi. I'm new to this site but ive been reading up on modic changes and have found very little information. I have found out I have modic changes grade 3 which from what I can make out,is scar tissue inside the bone. I know that this means this will restrict my movements and I have to be taught how to live with this,but so far the fact I even have these changes hasn't even been acknowledged. Is there anyone else out there with modic 3 changes? :-)

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  • I am so glad that I found this place. I have had a buldging disc for 3 years. My neurologitst gave me a prescription for physical therapy and ordered MRIs. The Lumbar MRI, shows Modic Change #1 in L4-5 and Modic Change #2 in L3-4. Plus other changes.
    I had never heard of Modic Changes before, The scary part is that I also have premalignant bone marrow cancer or MGUS. I have searched and have not found any connection between the two conditions except that both are more promeninet when you get older. After reading everything about physcial therapy and it not helping and then told to go back I really don't want to. I read the previous posts and feel more assured now that I need to see a spine specialist.. I have looked at original research on Modic changes but there does not seem to be much. Also I only found a few websites of spine specialists where they even mention modic changes. Are there any more sources that I can check. I will be calling for an appointment with a spine specialist on Monday but I want to make sure that they think that Modic changes are of significance,
  • Hi. thanks for posting info on something my MRI found. I do have modic 1, L1-L2, L2-L3, L3-L4 and L4-L5. Also on areas mentioned above, discs bulging, disc material pressing on above exiting nerve roots. Been told something about degenerative nerves. Also, I have a SYNOVIAL CYST posterior...with all that, think I'm looking at surgery. I see my NeuroSurgeon tomorrow 6/9/16. Have u heard of Synovial Cyst? have a good day!  McK
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