Dr. Butwell Calmly Considers MRIs Modic Changes

September 10, 2019

“There are some Modic changes on your MRI report.” Dr. Butwell says “Don’t panic too much.” Our Georgetown back pain and neck pain patients are in good company regarding MRI reports reporting Modic changes. The research is evolving about just what Modic changes on MRI suggest for a patient..and what they do not. Dr. Butwell creates some perspective about these usual MRI findings.


“Modic changes” is a term used to explain the changes of the spine’s vertebral endplates which are linked to spinal degeneration. Modic type I changes are essentially regarded as bone marrow edema and inflammation signifying acute degenerative changes.  Modic type II changes signify fatty degeneration of the bone marrow. Modic III changes describe the replacement of bone with bony sclerosis with little bone marrow remaining. (1) Dr. Butwell likes the opportunity to take care of a painful back earlier in this cascade of change whenever possible. Dr. Butwell treats disc degeneration and spinal degenerative changes.


Modic changes are common findings on MRI. Modic changes on MRI appear in spinal degenerative diseases and are greatly associated with low back pain. (1) They are age-related degenerative findings that accompany disc degeneration. Greater Modic changes were linked to higher age, higher body mass index, and adjacent disc degeneration. (2) Lifestyle and occupational factors like cigarette smoking, regular exercise, and nonappearance of daily vehicle vibration seemed to have minor effects, if any, on the development of Modic changes in the lumbar spine. (3) Clearly, Dr. Butwell encourages proper lifestyle choices for overall good health!


What is unclear is the research about just what Modic changes imply for back pain patients. New research demonstrated that Modic changes were not found to be negatively affiliated with long-term pain, disability, or sick leave. The study stated that low back pain patients who had Modic changes had much less disability and sick-leave at long-term follow-up. (4) This is hopeful news to our Georgetown chiropractic back pain patients!

CONTACT Dr. Butwell

Listen to this PODCAST with Dr. Robert Rudy on The Back Doctors’ Podcast with Dr. Michael Johnson who described his treatment plan with the Cox® Technic System for their back pain relief to his patients so they get it.

Schedule your Georgetown chiropractic appointment now. Bring any MRIs with you. Together, Dr. Butwell and you will look at them for information and develop a treatment plan for Georgetown back pain relief that will prevent us both from panicking!

Dr. Butwell sees many back pain and neck pain patients who bring their MRIs with them to the office. Modic changes are often noted.