Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?

Eur Spine J. 2012 Mar;21(3):418-24. doi: 10.1007/s00586-011-1964-6. Epub 2011 Aug 12.


Background: There is evidence for an association between Modic type 1 and pain in patients with low back pain (LBP), but little knowledge about its effect on clinical outcomes.

Purpose: (1) To assess the prevalence of Modic changes, (2) to determine if Modic changes influence the clinical course of LBP, and (3) to identify prognostic factors for recovery.

Study design/setting: Prospective clinical cohort study, with a 1-year follow-up. The treatment consisted of brief intervention and instruction in stretching. PATIENT'S SAMPLE: Two hundred and sixty-nine patients with chronic low back pain.

Outcome measures: Socio-demographic variables, education, profession, self-reported measures, degenerative changes on MRI.

Methods: Linear growth model and Cox regression analysis.

Results: Five percent had a normal MRI, 14 and 50% had Modic 1 and Modic 2 changes. Modic changes were not significant covariates for the clinical course of pain, function or fear avoidance beliefs. Education was a strong prognostic factor for recovery.

Conclusions: Modic changes did not influence the clinical course of back pain and were not prognostic factors for recovery. Education was strongly associated with recovery.

MeSH terms

  • Adult
  • Cohort Studies
  • Exercise Therapy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / diagnosis*
  • Intervertebral Disc Degeneration / epidemiology*
  • Intervertebral Disc Degeneration / rehabilitation
  • Low Back Pain / diagnosis*
  • Low Back Pain / epidemiology*
  • Low Back Pain / rehabilitation
  • Lumbar Vertebrae / innervation
  • Lumbar Vertebrae / pathology*
  • Lumbar Vertebrae / physiopathology
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / standards
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Recovery of Function / physiology
  • Young Adult