Related Experiment Video
Updated: May 24, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Disabling chronic low back pain with Modic type 1 MRI signal: acute reduction in pain with intradiscal corticotherapy
J Beaudreuil1, P Dieude, S Poiraudeau
1Service de rhumatologie, hôpital Lariboisière, AP-HP, université Paris-7, Paris, France. johann.beaudreuil@lrb.aphp.fr
Objectives:
The objective of the current study was to compare short- and long-term effect on chronic low back pain of intradiscal injection of methylprednisolone with or without presence of Modic type 1 MRI changes.
Patients And Methods:
Medical charts of patients receiving intradiscal injection of methylprednisolone from January 1, 1995 to December 31, 1998 were retrospectively reviewed. Clinical parameters were recorded at baseline, 24h after injection and at follow-up (12-14 months). Patients were studied in three groups: Modic I-a, if patients had Modic type 1 changes with no previous surgery or nucleolysis (n=30); Modic I-b, if patients had Modic type 1 changes at the level of previous surgery or nucleolysis (n=37); Control, if patients had no Modic type 1 changes (n=30).
Results:
Twenty-four hours after methylprednisolone injection, higher proportion of patients with self-assessed improvement was observed in Modic I-a (90%) and Modic I-b (71%) than in Control (30%). Low back pain decreased in both Modic groups. Low back pain did not vary from baseline in controls. No effect was detected in three groups, neither for radiating pain 24h after injection, nor for any outcome parameters at the latest follow-up.
Conclusions:
We suggest that patients with disabling chronic low back pain and Modic type 1 MRI changes have specific acute response to intradiscal injection of methylprednisolone. Clinical studies are however necessary to further investigate the effectiveness and safety of such injections.
Insights
Intradiscal methylprednisolone injections show a significant acute benefit for chronic low back pain patients with Modic type 1 MRI changes. Long-term effects were not observed in any group.
Area of Science:
- Orthopedics
- Radiology
- Pain Management
Background:
- Chronic low back pain is a prevalent condition.
- Modic type 1 changes on MRI indicate active bone marrow edema, often associated with pain.
- The efficacy of intradiscal methylprednisolone injections for chronic low back pain, particularly in the presence of Modic changes, requires further elucidation.
Purpose of the Study:
- To compare the short- and long-term effects of intradiscal methylprednisolone injections on chronic low back pain.
- To investigate the influence of Modic type 1 MRI changes on treatment response.
Main Methods:
- Retrospective review of medical charts for patients receiving intradiscal methylprednisolone.
- Categorization into three groups: Modic I-a (Modic type 1, no prior surgery), Modic I-b (Modic type 1, prior surgery/nucleolysis), and Control (no Modic type 1).
- Clinical parameters assessed at baseline, 24 hours, and 12-14 months post-injection.
Main Results:
- A higher proportion of patients with Modic type 1 changes (Modic I-a: 90%, Modic I-b: 71%) reported improvement 24 hours post-injection compared to controls (30%).
- Low back pain decreased in both Modic groups but not in the control group at 24 hours.
- No significant long-term effects were detected for any group at the latest follow-up.
Conclusions:
- Patients with chronic low back pain and Modic type 1 MRI changes exhibit a specific acute response to intradiscal methylprednisolone.
- Further clinical studies are warranted to confirm the effectiveness and safety of these injections.
