Modic Type I Changes in Patients with Degenerative Disc Disease and Slipped Disc (Herniated or Protruding spinal discs)
Over the years we have seen many patients who presented with Modic Type I changes in their spine. Most had questions as to what it is and what it meant when it comes to recovery. Questions regarding the Modic changes are the reasons why we are writing about Modic Type I changes. Our goal is to provide our patients with the best non-surgical spine and joint care. And as such, we believe that providing our patients with access to information about their illness or conditions can improve their recovery. Modic changes is a common condition seen in a slipped disc (herniated or protruded spinal disc) patients. We hope the information provided here is helpful.
What are Modic Types and Changes?
Changes in the vertebral subchondral bone marrow can be picked up by magnetic resonance imaging (MRI). The Modic Type I are the changes seen in the end-plate (thin cartilaginous structures that attach the spinal disc to spinal bone) and the bone marrow signals. These changes have a strong relationship with degenerative disc disease and low back pain.
Symptomatic back (back Pain) sufferers and those with radicular pain or sciatica like sensations may have Modic changes in the spine. Younger general population with no history of a lower back condition has a much lower percentage of presenting with Modic changes. Modic Type I changes are more likely associated with the symptomatic back or neck.
Before we get started, it might be helpful to relate that there are three different types of Modic changes. Type I, II and III. The type I Modic changes is a representation of an acute inflammatory process, often seen in patients with degenerative disc disease. Contrary to the common belief, a degenerated disc is an unhealthy disc that predisposes one to more sinister forms of spinal disc disorder. Degenerative disc disease can be painful as with degenerations; the spinal disc may tear or worse slip (bulge, herniate, protrude or prolapse), leading to pain.
What are the MRI Findings in Modic Changes?
Modic Type I changes are shown as decreased signal intensity on T1 weighted MRI images. Also, it will have an increased intensity on T2 weighted MRI images. Type I Modic changes are the result of inflammatory processes in the subchondral (bone attachment points to end-plate and spinal discs). Modic type changes cause fissures in the vertebral endplates. The vertebral end-plate is a thin cartilaginous structure that attaches the spinal disc to the subchondral bone (vertebrae or spinal bone). Tears of the vertebral end-plate have been thoroughly studied and confirmed through histological examination, of Modic changes.
Modic Type I changes are inflammatory disorders that can progress quite rapidly. They deform the intervertebral disc and adjacent vertebral bodies. These changes are found in the anterior third of the superior endplates of the middle lumbar spine in people with no lower back pain. However, these changes can be found in both the superior and inferior endplates and are distributed more evenly and to a larger extent in people with the symptomatic lower back condition.
What is the common site for a Modic Spine Changes?
The Modic Type I changes are more commonly noted in the lower segments of the lumbar spine in people with lower back pain and those with sciatica. The presence of Modic changes leads to poor outcome in patients with low back pain as there is persistence acute inflammatory process.
It is proposed that degenerative disc disease without the presence of Modic Type I changes will progress much slower. As Type I Modic changes progress into Type II Modic changes, there is a decrease in the intensity of low back pain and other radicular symptoms.
What is the best treatment option for those that have Modic Spine Changes?
In our centers, we pay particular attention to the Modic changes. Modic type I, Modic Type II, Modic Type III will impact the kind of care you receive as well as the frequency and length of treatments. Unlike others, our research-based system of care can increase your chances of recovery without surgery.
Our research-based clinical teams of chiropractors and physiotherapists have the skills, knowledge, and technology to treat even the most challenging spine disorder. Patients that have a Modic Type I, II or III changes will certainly require a diagnosis based treatment that targets the entire joint complex (muscles, ligaments, spinal discs, spinal endplate and spinal bones). In other words, for a patient to recover, the care they receive must be comprehensive. When it comes to any Modic changes, the importance of a holistic care is paramount.
The best and most comprehensive (holistic) means of treating patients with Modic changes is through NSD Therapy® protocols. NSD Therapy® is a multifaceted method of integrative treatments offered by our clinical teams of physiotherapists and chiropractors in Malaysia. The most critical component of NSD Therapy® is treatments rendered through the RxDecom®. The RxDecom is the most advanced form of spinal decompression therapy. Goals of treatments through the RxDecom® and NSD Therapy® methods is to increase blood flow to the damaged and malfunctional spinal discs, vertebral end-plates, and soft tissues surrounding spinal joints. Visit one of our centers to discover the benefits of a targeted, comprehensive treatment backed with advanced technology.
- Järvinen J, Karppinen J, Niinimäki J, et al. Association between changes in lumbar Modic changes and low back symptoms over a two-year period. BMC Musculoskeletal Disorders. 2015;16:98. doi:10.1186/s12891-015-0540-3.
- Nguyen C, Jousse M, Poiraudeau S, Feydy A, Rannou F. Intervertebral disc and vertebral endplate subchondral changes associated with Modic changes of the lumbar spine. A cross-sectional study. BMC Musculoskeletal Disorders. 2017;18:34. doi:10.1186/s12891-017-1407-6.
The above citations are our research sources for Modic Type I changes.