Basivertebral Nerve Ablation Shows Early and Lasting Relief for Chronic Low Back Pain

Chronic low back pain is one of the most common and frustrating health problems worldwide. It affects millions of people, interferes with daily activities, limits mobility, and is a leading reason for doctor visits. While many people associate back pain with spinal discs or muscle strain, a significant portion of chronic low back pain actually originates from the vertebrae themselves, specifically from damage and inflammation in the vertebral endplates. This type of pain is known as vertebrogenic low back pain, and new research suggests there is an effective, long-lasting treatment option for it.

A recent Yale-led clinical study has found that basivertebral nerve ablation can provide rapid, sustained relief for patients suffering from chronic vertebrogenic low back pain. The findings were published in the medical journal Interventional Pain Medicine and offer encouraging news for patients who have not found relief through traditional treatments such as physical therapy, medications, or spinal injections.

Understanding Vertebrogenic Low Back Pain

Not all back pain is the same. Vertebrogenic pain originates from the vertebral endplates, which are the top and bottom surfaces of each vertebra. When these endplates become damaged or inflamed, they can generate a deep, aching pain that is typically felt in the midline of the lower back. This pain often worsens with activity, prolonged sitting, bending, or standing for long periods.

MRI scans can identify this condition by detecting characteristic changes in the vertebrae, commonly referred to as Modic changes. These changes signal inflammation or degeneration within the vertebral endplates and are considered a key diagnostic marker for vertebrogenic pain.

What Is Basivertebral Nerve Ablation?

Basivertebral nerve ablation is a minimally invasive surgical procedure designed to treat vertebrogenic low back pain at its source. The basivertebral nerve runs inside the vertebrae and carries pain signals from damaged endplates to the brain. By deactivating this nerve, the procedure prevents those pain signals from being transmitted.

During the procedure, surgeons use specialized instruments to access the affected vertebrae and apply controlled energy to ablate, or disable, the basivertebral nerve. The goal is not to affect spinal stability or movement, but purely to interrupt the pain pathway.

This approach is especially promising for patients who have lived with chronic pain for months or years without meaningful improvement from conservative treatments.

Details of the Yale-Led Study

The study followed 86 patients who underwent basivertebral nerve ablation. All participants had MRI-confirmed vertebral endplate changes and had experienced chronic low back pain for at least six months before treatment.

What makes this study stand out is its focus on the week-by-week timeline of pain relief and functional recovery, rather than only long-term outcomes. This allowed researchers to capture how quickly patients began to feel better and how those improvements evolved over time.

Rapid and Sustained Pain Relief

One of the most notable findings of the study was the speed of pain reduction. Relief did not take months to appear. Instead, many patients experienced meaningful improvements within weeks.

By the end of the first week, 34% of patients reported at least a 50% reduction in pain. By the third week, this figure increased to 76%, and by week six, a remarkable 91% of patients had achieved at least 50% pain relief.

Importantly, these improvements were not temporary. Pain reduction remained consistent and sustained through 24 weeks, demonstrating the durability of the procedure. For most patients, the third week marked a turning point where pain relief became clearly noticeable and meaningful.

Improvements in Daily Function and Quality of Life

Pain relief alone is not the only measure of success for people with chronic back pain. The ability to move, work, and perform everyday activities is just as important.

To assess functional improvement, researchers used the Oswestry Disability Index (ODI), a widely accepted tool that measures how much back pain interferes with daily life. Before treatment, the average ODI score among participants was 66.5, which indicates severe disability.

By 12 weeks after the procedure, the average score dropped to 32.3, reflecting a dramatic improvement in physical function. This level of improvement was maintained through 24 weeks, suggesting that patients were not only feeling less pain but were also regaining the ability to carry out normal daily activities with greater ease.

Predicting Long-Term Success Through Early Response

Another important insight from the study was the value of early pain relief as a predictor of long-term outcomes. Patients who experienced significant pain reduction within the first few weeks were far more likely to maintain those improvements over time.

Specifically, patients who achieved at least 50% pain relief by week three were much more likely to continue experiencing sustained relief at 12 weeks and beyond. This finding has practical implications for clinicians, as it allows them to better manage expectations, personalize follow-up care, and identify patients who are responding particularly well to treatment.

Reduced Need for Other Spine Treatments

The benefits of basivertebral nerve ablation extended beyond pain scores and disability measurements. The study also found a substantial reduction in the need for additional spine-related treatments.

Before undergoing the procedure, 86% of patients relied on spinal injections to manage their pain. After basivertebral nerve ablation, that number dropped sharply to 22%. This suggests that the procedure not only improves symptoms but may also reduce dependence on ongoing interventions and repeated treatments.

Why This Treatment Matters

Chronic vertebrogenic low back pain has historically been difficult to treat effectively. Many patients cycle through medications, physical therapy, and injections with limited or short-lived results. Basivertebral nerve ablation offers a targeted solution that addresses the underlying pain mechanism rather than simply managing symptoms.

The findings from this study strengthen the case for basivertebral nerve ablation as a durable and effective treatment option for appropriately selected patients. While additional research involving larger patient populations and longer follow-up periods will further refine its role, current evidence strongly supports its use in clinical practice.

A Growing Area of Back Pain Treatment

As understanding of spinal pain mechanisms continues to improve, treatments like basivertebral nerve ablation represent a shift toward precision-based pain management. Identifying the exact source of pain and treating it directly can lead to better outcomes, faster recovery, and improved quality of life.

For patients living with chronic vertebrogenic low back pain, this approach offers something many have been missing for years: real, lasting relief backed by solid clinical evidence.

Research paper:
https://doi.org/10.1016/j.inpm.2025.100652