Patient Education

Chronic back pain can be frustrating and exhausting—especially when you have already tried treatments like physical therapy, medications, injections, or chiropractic care but still have persistent pain.

One of the most common reasons back pain continues is that different types of spine pain require different treatments. If the true source of the pain is not identified, treatments may only provide temporary relief.

At Chester County Spine Care, our focus is identifying the specific cause of chronic back pain and selecting treatments that target the underlying problem.

Below are three of the most common causes of persistent spine pain.

A common but often overlooked cause of chronic low back pain is vertebrogenic pain, which originates from inflammation of the vertebral endplates inside the spine.

This type of pain is transmitted through the basivertebral nerve and may cause:

• Deep aching pain in the lower back
• Pain that worsens with sitting or bending
• Pain lasting longer than 6 months
• Limited improvement with injections or therapy

For patients with vertebrogenic pain, the Intracept® procedure can target the basivertebral nerve responsible for transmitting pain signals.

By treating the source of the pain, many patients experience significant and lasting improvement in chronic low back pain.

Another common cause of persistent back and leg pain is lumbar spinal stenosis, a condition in which the spinal canal narrows and compresses the spinal nerves.

Symptoms often include:

• Pain or heaviness in the legs when walking
• Difficulty standing for long periods
• Numbness or tingling in the legs
• Relief when sitting or leaning forward

Many patients notice they can walk farther when leaning on a shopping cart.

For appropriate patients, the MILD® (Minimally Invasive Lumbar Decompression) procedure can remove small amounts of thickened ligament tissue that are compressing the spinal nerves. This can help relieve symptoms and improve walking ability.

Pain is not only generated in the spine—it is also processed in the brain. In some patients, chronic pain can persist because the nervous system continues to amplify pain signals even after the original injury has improved.

This is sometimes referred to as central pain processing.

In selected patients, Transcranial Magnetic Stimulation (TMS) may help modulate the brain circuits involved in chronic pain perception.

TMS is a non-invasive therapy that uses magnetic pulses to stimulate specific areas of the brain involved in pain processing.

Chronic back pain is rarely the same for every patient.

Effective treatment begins with accurately identifying the source of pain, whether it is:

• Vertebrogenic pain
• Spinal stenosis
• Nerve compression
• Chronic pain processing changes

At Chester County Spine Care, we focus on careful evaluation and evidence-based treatments designed to address the root cause of the pain rather than simply masking symptoms.

If you have been living with chronic back pain for months or years, newer treatments may be available that specifically target the underlying cause.

A consultation at Chester County Spine Care includes a thorough evaluation and review of imaging studies to determine the most appropriate treatment options.

• Intracept® Procedure – for vertebrogenic chronic low back pain
• MILD® Procedure – for lumbar spinal stenosis
• Transcranial Magnetic Stimulation (TMS) – for chronic pain modulation

“Many patients come to us after years of persistent pain and being told that nothing more can be done.”