Modic Changes

What are Modic changes?

Modic changes are changes in the bone marrow of the spine that can be seen on magnetic resonance imaging, or MRI. They usually appear in the vertebral bones next to a damaged or degenerated intervertebral disc.

Modic changes are often found in people with chronic low back pain. Studies report that they are present in around 43% of people with chronic low back pain, compared with about 6% of people without symptoms.

There are three main types of Modic changes: type 1, type 2, and type 3. Type 1 is generally considered the most inflammatory and is often associated with pain.

What do we do at the Dudli Lab?

At Dudli’s lab, we aim to understand why Modic changes develop and which biological mechanisms drive pain and inflammation in the spine. In particular, we study the interaction between the intervertebral disc, the vertebral endplate, the bone marrow, and the immune system.

Our research focuses on how tissue damage, inflammation, bacteria, immune responses, and bone marrow changes may contribute to Modic changes. We investigate whether damaged discs and endplates release signals that activate inflammation in the adjacent bone marrow, and how these changes may promote pain-related processes.

Why does this matter?

Chronic low back pain is one of the leading causes of disability worldwide, yet many patients still lack a clear biological explanation for their pain. In patients with Modic changes, the affected vertebral bone marrow may be an important source of inflammation and pain.

Although Modic changes have long been viewed mainly as MRI findings, we believe they reflect an active disease process rather than a simple structural change.

Understanding these mechanisms could help identify biomarkers to better classify patients and support the development of more targeted treatments for chronic low back pain.

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