Anne Keller, Eleanor Boyle, Thomas A. Skog, J. David Cassidy, Erik Bautz-Holter

March 2012, Volume 21, Issue 3, pp 418 - 424 Original Article Read Full Article 10.1007/s00586-011-1964-6

First Online: 12 August 2011


There is evidence for an association between Modic type 1 and pain in patients with low back pain (LBP), but little knowledge about its effect on clinical outcomes.


(1) To assess the prevalence of Modic changes, (2) to determine if Modic changes influence the clinical course of LBP, and (3) to identify prognostic factors for recovery.

Study design/setting

Prospective clinical cohort study, with a 1-year follow-up. The treatment consisted of brief intervention and instruction in stretching.

Patient’s sample

Two hundred and sixty-nine patients with chronic low back pain.

Outcome measures

Socio-demographic variables, education, profession, self-reported measures, degenerative changes on MRI.


Linear growth model and Cox regression analysis.


Five percent had a normal MRI, 14 and 50% had Modic 1 and Modic 2 changes. Modic changes were not significant covariates for the clinical course of pain, function or fear avoidance beliefs. Education was a strong prognostic factor for recovery.


Modic changes did not influence the clinical course of back pain and were not prognostic factors for recovery. Education was strongly associated with recovery.

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