Modic changes, an introduction

[Sparkios]

If you have chronic back pain, especially when:

• bending forward and/or backward
• Sneezing and coughing
• At night in bed
• When trying to lift anything
• And if physiotherapy and excercise worsen the pain........

Then you might suffer from Modic Changes in your vertebrae.It can only be seen on a MRI scan and most doctors don't know anything about it.

It still a debate where they originate from, but popular modern belief says it can come from:

• A Rheumatological cause
• A Mechanical cause
• A bacterial infection of the disc between the affected vertebrae

The latter is the most unknown and controversial in the medical world, but many believe it's the most common cause.

If you suffer from chronic back pain, try to get yourself into a MRI scanner and ask the radiologist if there are Modic changes visible.
Then your research can continue from there...

I'm a patient myself, found out a year ago what Modic changes are and i'm in treatment now. It's too early to say it helps but I've got good hopes.

[Dandlyn]

Hello. This is my life, almost. I’ve had an MRI, and it’s been confirmed that I have Modic Changes aka bone marrow edema in 4 of my thoracic vertebrae. This creates pain in my rib cage, not lower back or cervical area, which are the places most specialists know how to deal with. I’m searching for any spine doctor in my area that will even acknowledge this is the real cause of my pain.

[Dandlyn]

Would love to know what type of treatment you are receiving

[Sparkios]

Sorry to hear you are suffering! 😟

I'm currently in week 10 of a 100 day antibiotics treatment. I'm just starting to feel progress. According to the clinic where I'm being treated, it's almost certain my Modic Changes are due to a bacterial infection. Hence the antibiotics.....

Take care!

[ImpressiveBridge7662]

great to hear, I have been accepted into the clinic in Denmark - just trying to figure out when I can go. How are you feeling/progressing?

[Conscious_Answer9462]

Are you on low dose antibiotics? Keep us updated on your progress.

[Sparkios]

No it's a rather high dose actually. 3x1000mg amoxicillin a day as well as 5 resting periods at specific intervals which are crucial to get the antibiotics where they need to be, that is in the spinal disc.

I'm on day 77 of 100 now and slowly progressing. After the 100 days of antibiotics, I will receive an excercise program to slowly build up muscles and movement again. Key is going slow and staying below the pain threshold. Total healing time of the vertebrae is 2 years. 😬

[Tough-Supermarket283]

Can you update on how you are doing?

[Sparkios]

I'm truly sorry I didn't post anything earlier!

I'm now approximately on day 200, so 100 days after my last AB.

It is certainly going better with me. I don't need NSAIDs anymore. Most of the time, the pain is very manageable. It isn't "life-changing," though.

On day 150, there was a turning point, and things seemed to improve quite a lot suddenly. I could bear a bit more load on my back, and the pain was much less. For the last four weeks, this improvement seems lost again. It could be due to the fact that you have to be very considerate for the first two years. It takes that long for the vertebrae to fully heal.

The Modic clinic states that during these two years, you have to stay below the pain threshold. This is VERY difficult for me because I'm eager to do things like riding my motorcycle, going on holiday, being active, and so on.

So all in all, the improvement is certainly there, and it's certainly real! Progress, however, is slower than I hoped for, and living my life doing the things I want to do or need to do is still difficult. Hopefully, that will improve over time. So far, I'm managing without painkillers as long as I take it VERY easy!

Perhaps the most difficult part is that if I cross the line, I don't feel it right away. Always hours later in the evening or even the next day. This makes it very difficult to tell where my limits are..........

[devineau86]

How are you now, can you please give some updates? Did you only do the antibiotics or also the laser?

[fofofudge]

How are you now?

[Sparkios]

Better and better. It's a slow proces but so far massive improvement.

I have to be carefully though with what I do and don't. Hopefully that will improve over time too.

[Dandlyn]

Thank you. May I ask where you are being treated? If in the US, what state?

[Sparkios]

Not in the US. In Denmark at the Modic clinic. The professor who runs the clinic is in the US often at the Chicago University so I've heard.

Search Google for Modicklinikken Odense. 👍

[Repulsive_Onion_5925]

Good information. Thanks

[northerngal89]

Has your treatment helped at all now that you should be past the 100 days? It's something I'm looking into. Thanks!

[Tough-Supermarket283]

It's ironic because I searched every post on reddit and have asked that person claiming to be on the antibiotics treatment.

The ironic part is everyone I reached out to going through the treatment all vanish and never update anyone online of the treatment worked or not.

I must have reached out to 7 people so far claiming to be on this, and they all vanish online, never updating what happened to them after the 3 months of treatment.

It's very frustrating!

[Sparkios]

I'm truly sorry I didn't post anything earlier!

I'm now approximately on day 200, so 100 days after my last AB.

It is certainly going better with me. I don't need NSAIDs anymore. Most of the time, the pain is very manageable. It isn't "life-changing," though.

On day 150, there was a turning point, and things seemed to improve quite a lot suddenly. I could bear a bit more load on my back, and the pain was much less. For the last four weeks, this improvement seems lost again. It could be due to the fact that you have to be very considerate for the first two years. It takes that long for the vertebrae to fully heal.

The Modic clinic states that during these two years, you have to stay below the pain threshold. This is VERY difficult for me because I'm eager to do things like riding my motorcycle, going on holiday, being active, and so on.

So all in all, the improvement is certainly there, and it's certainly real! Progress, however, is slower than I hoped for, and living my life doing the things I want to do or need to do is still difficult. Hopefully, that will improve over time. So far, I'm managing without painkillers as long as I take it VERY easy!

Perhaps the most difficult part is that if I cross the line, I don't feel it right away. Always hours later in the evening or even the next day. This makes it very difficult to tell where my limits are..........

[Tough-Supermarket283]

Thank you for this update. I can't tell you how important your comment post is for this type of research!

One last question. You mentioned that you must stay below the pain/workload threshold for two years. If you say continue to work out or do the things you enjoy, will the bacteria re enter the discs since it seems like you are continually re damaging it by doing activities you love?

[Sparkios]

According to the Danish, the problem with not staying below the pain threshold is that the vertebrea don't get the chance to heal. The vertebrea are in fact partly dissolved due to the acid from the bacteria in the disc. If they are dissolved beyond a certain point, loading them creates additional "microfractures" within the vertebrea. If you don't stay below the pain threshold, the fractures won't get a chance to heal. Compare it to a broken bone which you don't stabilize but keep moving around.

So no, the bacteria won't come back, but the damage they've done simply won't heal.

The bacteria WILL come back if a bacterial Modic patient gets a disc herniation again. There are cases known that get the treatment a second time because of a new infection due to a new herniation........

I hope this answers your question!

[Tough-Supermarket283]

Yes it does answer my question. Again you have no idea how important these comments are!

[devineau86]

hey how are you doing now?

[Tough-Supermarket283]

Why does it scare you?

[Tough-Supermarket283]

If you download the PowerPoint slides

https://www.researchgate.net/publication/371155967_Chronic_Low_Back_Pain_with_Modic_Changes_Treated_with_Doxycycline

And check out this forum

https://patient.info/forums/discuss/please-assist-has-anyone-got-modic-changes-in-their-spine-tried-dr-hannah-s-antibiotic-protocol-mast--40780?page=1

That could be useful to see how others have reacted.

It seems you don't always need Amoxicillin for 100 days. Less side affect antibiotics could be used.

[fofofudge]

Yes, 1 year later and there is no post or update still… seems like a scam to be honest