Vertebrogenic Low Back Pain in Napa: Understanding Causes and Treatment Options

Nov 12

A Comprehensive Medical Guide to Vertebrogenic Low Back Pain and Basivertebral Nerve Ablation

By Dr. Jackie Weisbein, DO, Board Certified in Physical Medicine & Rehabilitation and Pain Medicine, Fellowship-trained in Interventional Pain Management

Quick Insights

Vertebrogenic low back pain originates from inflammation or damage in vertebral endplates, often appearing as Modic changes on MRI scans. This condition affects patients with chronic pain lasting six months or longer despite conservative treatment. Basivertebral nerve ablation, a minimally invasive outpatient procedure, targets the basivertebral nerve using radiofrequency energy to disrupt pain signals. Studies indicate this treatment may provide meaningful relief for properly selected candidates when physical therapy, medications, and injections have not been effective.

Key Takeaways

Vertebral endplate changes, seen as Modic changes on MRI, can cause chronic back pain.
Basivertebral nerve ablation is offered when conservative therapies haven’t relieved symptoms.
Proper diagnosis is crucial—chronic pain with “normal” scans may still be vertebrogenic in origin.
Napa Valley and surrounding areas now have access to advanced, minimally invasive options.

Why It Matters

Living with unrelenting back pain after “normal” scans can feel hopeless. Vertebrogenic low back pain is real—and current research indicates that targeted treatments like basivertebral nerve ablation may offer relief, restoring hope and daily function for those like Mark in the North Bay.

Introduction

As a double board-certified pain specialist serving Napa Valley, I see so many struggling with vertebrogenic low back pain —even after “normal” scans and dozens of treatments. This type of pain comes from inflammation or damage in the vertebral endplates, often missed on routine tests, but research highlights its importance in chronic back pain. I bring my experience as a top 100 implant physician, trainer of other doctors, and President of WIPM to deliver evidence-based options like basivertebral nerve ablation—an advanced, minimally invasive treatment. Studies suggest this approach, when carefully selected for the right patient, can relieve pain by targeting the basivertebral nerve, according to guidelines from the American Society of Pain and Neuroscience. If you feel like you’ve “tried it all” and you’re tired of living with pain that isn’t explained by typical scans, you’re not alone—and you may finally have a real answer.

Understanding Vertebrogenic Low Back Pain: Causes and Symptoms

When I talk with patients who are at their wits’ end—like Mark from Vallejo, who’s tried everything for his back pain—I often find that the real culprit is vertebrogenic low back pain. This type of pain comes from inflammation or damage in the vertebral endplates, which are the thin layers between the spinal bones and the discs. It’s not always obvious on standard scans, so many people are told “everything looks normal” even when the pain is real.

In my practice, I see this most in people who’ve had persistent pain for years, despite trying physical therapy, injections, or even surgery. Studies suggest that vertebral endplates can be a significant source of chronic low back pain, especially when other causes have been ruled out. If you’re feeling skeptical after so many failed treatments, you’re not alone—this is a common story in the North Bay.

As a double board-certified pain specialist, I can’t tell you how often I meet patients who have felt dismissed because their scan results don’t “match” their pain. When I dig deeper, I often find subtle changes in the vertebral endplates that connect directly to their symptoms. For many people, simply getting the right diagnosis brings tremendous relief—and opens the door to more targeted solutions that might have been overlooked before.

For more on the science behind vertebrogenic pain, the American Society of Pain and Neuroscience offers a helpful overview: best practice guidelines for vertebrogenic pain.

Understanding MRI Results: Modic Changes and Vertebral Endplate Damage

One of the most frustrating things for my patients—especially those like Lena who’ve seen multiple providers—is being told their MRI is “normal” when the pain is anything but. The truth is, standard scans often miss subtle changes in the vertebral endplates. That’s where Modic changes come in.

Modic changes are specific findings on MRI that show inflammation or damage in the endplates. They’re not always mentioned in radiology reports, but they can be a key clue for vertebrogenic low back pain. In my experience, identifying these changes has helped me finally give answers to people who felt invisible in the medical system.

If you’re reading research about Modic changes, it’s easy to get lost in the technical details. What matters in day-to-day practice is that these changes give us a “road map” to the source of pain. I’ve seen hundreds of cases where picking up on Modic changes after years of normal scans led to an accurate diagnosis—and finally, a path toward meaningful pain relief.

If you want to learn more about Modic changes and their role in back pain, check out this detailed explanation from ASRA.

Basivertebral Nerve Ablation: How Does It Work?

Basivertebral nerve ablation (BVNA) is a minimally invasive procedure designed to alleviate chronic low back pain originating from the vertebral endplates. This technique involves the precise application of radiofrequency energy to the basivertebral nerve, disrupting pain signals transmitted to the brain.

Patients can access minimally invasive procedures such as BVNA at the Napa Pain Institute, where radiofrequency energy is applied to the basivertebral nerve to help reduce pain.

The precision of this procedure often results in less trauma and a faster return to normal routines compared to traditional surgical options. BVNA is performed as an outpatient procedure, allowing patients to go home the same day. The procedure is conducted under local anesthesia with light sedation and typically takes about an hour. Most patients are up and walking within a few hours.

For those concerned about safety, strict protocols are followed, and coordination with local hospitals like Queen of the Valley Medical Center is often undertaken. The goal is to help patients regain function safely and confidently. Many individuals have regained the ability to walk, garden, or travel again after undergoing BVNA. This procedure opens up a new chapter for many, allowing them to return to activities they love.

For a step-by-step look at the procedure, the ASRA blog provides a clear breakdown: how basivertebral nerve ablation is performed.

Who Is a Candidate? (Patient selection and evaluation)

Not everyone with back pain is a candidate for basivertebral nerve ablation. In my practice, I look for people who have:

Chronic low back pain lasting six months or more
Pain that hasn’t improved with physical therapy, medications, or injections
MRI evidence of Modic changes in the vertebral endplates

I’ve found that careful patient selection is key—especially for those who, like George in Sonoma, worry about safety or being “too old” for new procedures. Guidelines recommend this treatment for people who haven’t found relief with conservative care and have the right MRI findings.

As someone who trains other doctors around the country in advanced pain treatments, I can assure you that the most important step is a detailed evaluation tailored to your unique history and scan findings. Even if you’ve been told in the past that “nothing more can be done,” I encourage you to seek out a specialist familiar with this technique. In Napa, I’ve helped people in their 30s all the way up to their 80s—each with a different story, but all wanting real answers and safe, thoughtful care.

If you’re unsure whether you qualify, I always encourage a thorough evaluation. For more on candidacy, see the official guidelines.

What to Expect: Procedure, Safety, and Recovery

For a deeper dive into safety and recovery, the ASRA review is a great resource: post-procedure care tips.

Benefits and Outcomes (with mechanism-level research summary)

Many individuals have regained the ability to walk, garden, or travel again after undergoing BVNA. This procedure opens up a new chapter for many, allowing them to return to activities they love.

The latest evidence shows promise for this approach. For a comprehensive systematic review of clinical outcomes, see this 2022 meta-analysis from Pain Medicine. I make sure every patient knows that outcomes depend on careful patient selection, high-quality imaging, and a strong commitment to the right rehab after the procedure. For many people in the North Bay, this procedure opens up a new chapter—returning to activities they love and feeling hopeful after so many setbacks.

If you want to see how others have benefited from this approach, you can read verified patient testimonials about real experiences and outcomes.

For a summary of current evidence and limitations, I recommend reading the American Society of Pain and Neuroscience guidelines.

Understanding Your Options

At Napa Pain Institute, every advanced pain procedure, including BVNA, is personally overseen by experienced specialists. As a local provider, the institute is proud to bring therapies to Napa Valley that aren't widely available elsewhere, drawing on years of expertise in interventional pain management. The practice offers a boutique, highly personalized approach, combining the latest interventional treatments with holistic support like exercise, wellness, and ergonomic coaching. Close collaboration with local resources ensures comprehensive care, including coordination with primary care teams or local hospitals such as Queen of the Valley Medical Center.

If you’re ready to explore your options, you can learn more about local pain management resources at the Queen of the Valley Medical Center.

Voices from Our Community

As someone who’s dedicated my career to restoring function and hope for people in Napa Valley and the North Bay, I’m always grateful when community members share their experiences. My approach—whether it’s spinal cord stimulation, Intracept, SI-BONE fusion, or ReActiv8—centers on advanced, evidence-based care delivered with a personal touch. As a double board-certified, fellowship-trained physician and President of Women Innovators in Pain Management, I believe that every person deserves thoughtful, individualized treatment. One Google review shared a glimpse of this philosophy in action:

Google Review Spotlight

Dave: Dr Weisbein is very caring and an excellent physician 😀. She performed dorsal root ganglion surgery and helped to markedly reduce my pain View Review

Hearing these stories from our local community inspires me to keep raising the bar for pain care in Napa and beyond.
Read the full review on Google

Conclusion

In summary, vertebrogenic low back pain is a real and often overlooked cause of persistent back pain—even when your scans look “normal.” For those in Napa Valley and the North Bay, basivertebral nerve ablation is now available locally, offering hope when other treatments have failed. Careful diagnosis and patient selection are key, and studies suggest that targeting the basivertebral nerve can provide meaningful relief for the right candidates.

If you’re tired of feeling dismissed or skeptical after so many failed attempts, know that you’re not alone—and you don’t have to keep living in pain. As a double board-certified physician in Physical Medicine & Rehabilitation and Pain Medicine, fellowship-trained in Interventional Pain Management, and President of Women Innovators in Pain Management, I’m here to help you find answers and regain control. Schedule your consultation today.

This article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

back pain

Jackie Weisbein