Lower back pain can be a disabling condition, as it can interfere with an individual’s ability to perform daily activities and may affect their quality of life. According to the World Health Organization, lower back pain is one of the leading causes of disability worldwide.
I have been treating people with lower back pain in my medical practice for over 15 years. While I have had a good degree of success, there were always those patients that no matter what was tried their relief was minimal and temporary. In the last year I have been using a treatment called the Intracept procedure to treat lower back pain with a significant amount of success especially with those patients that previously had little to no success with treatment of their lower back pain. Now when I see patients and they have Modic (inflammatory) changes on their MRI, I can say that this end plate inflammation is causing the pain. My treatment pathways have now been altered, and are more successful.
Treating lower back pain can be difficult, as the cause of the pain can vary greatly from person to person and may not always be easily identifiable. In some cases, lower back pain may be caused by medical conditions such as degenerative disc disease, disc bulge or spinal stenosis, while in other cases it may be the result of muscle strain or other types of injury. In the past 3 years, vertebrogenic pain, or pain coming directly from the bones (vertebrae) of the lower back, has been identified as a significant contributor to overall lower back pain, and until recently this has not been directly addressed or treated.
Intracept is a new treatment option for lower back pain that was developed by Relievant Medsystems. It is a minimally invasive procedure that uses radiofrequency energy to target and deactivate the nerves that transmit pain signals from the lower back to the brain. This procedure is different from previous facet nerve radio frequencies or other nerve ablations as it targets the nerves in the bone that are actually causing the pain.
The procedure is performed in an outpatient setting and takes about half an hour per level to complete. It is intended for individuals with chronic lower back pain who do not have sciatica and who have not responded to other treatment options such as physical therapy, medication and injections.
There is clinical evidence to support the effectiveness of Intracept for the treatment of lower back pain. In a study published in the New England Journal of Medicine, patients who received the Intracept procedure reported significant improvements in pain, function and quality of life compared to a control group. It is important to note that the Intracept procedure is not appropriate for everyone, and it is important to discuss all treatment options with a healthcare provider to determine the best course of action for an individual’s specific needs.
Recovery from the Intracept procedure is generally quick and patients can typically return to their normal activities within a few days. Some patients may experience temporary discomfort or numbness in the treated area, but these side effects should resolve on their own within a few days to a few weeks. The effectiveness of the Intracept procedure can vary from person to person. In my practice I am careful to select those patients who would most benefit from this procedure, and have had better than 80% reduction in overall lower back pain. If you, or someone you know, would benefit from the Intracept procedure please feel free to reach out to my office to schedule a consultation, so that the full details of the pain generator and the procedure can be discussed.
The Intracept procedure is supported by multiple clinical studies, including two Level I randomized controlled trials and five-year data showing patient outcomes last long-term. Key findings include:
Statistically significant improvements in function and pain vs. sham and standard care.1,2
Improvements post-procedure are durable, lasting more than five years post-treatment.3
Significant decrease in the number of patients using opioids or injections long-term.3
Nearly 80% of patients indicated they would have the procedure again for the same condition.3
A quick note to add…
The Intracept study was halted at 12 months due to clinical superiority. To my knowledge, there are not many studies that have been stopped due to clinical superiority.
1. Fischgrund J et al., Intraosseous Basivertebral Nerve Ablation for the Treatment of Chronic Lower Back Pain: A Prospective Randomized Double-Blind Sham-Controlled Multicenter Study. European Spine Journal. Epub February 8, 2018. https://doi.org/10.1007/s00586-018-5496-1
2 Khalil J, Smuck M, Koreckij T, Keel J, Beall D, Goodman B, Kalapos K, Nguyen D, Garfin S. A Prospective, Randomized, Multi-Center Study of Intraosseous Basivertebral Nerve Ablation for the Treatment of Chronic Lower Back Pain Presented at the American Society of Spine Radiology Annual Symposium; February 22, 2019; Miami, FL.
3. Fischgrund JS, Rhyne A, Macadaeg K, Moore G, Kamrava E, Yeung C, et al. Long-term Outcomes Following Intraosseous Basivertebral Nerve Ablation for the Treatment of Chronic Lower Back Pain: 5-Year Treatment Arm Results From a Prospective Randomized Double-Blind Sham-Controlled Multi-Center Study. Eur Spine J. epub May 25, 2020.
Asher C. Goldstein, MD, completed his pain medicine fellowship in 2005, and has been practicing since then as a board-certified pain management physician. He has a private practice, Overlook PAIN + Recovery, which is located in Hackensack, New Jersey. Additionally, he serves as the Chairman of Pain Medicine at Holy Name Medical Center in Teaneck, New Jersey. Dr. Goldstein uses his years of experience and education in psychology, physical medicine and rehabilitation, and anesthesiology to form a treatment plan for patients that incorporates holistic and allopathic approaches. If you have questions or wish to schedule an appointment please, reach out at 201-645-4336 or [email protected].