Basivertebral Nerve Ablation Provides Early, Sustained Chronic Lower Back Pain Relief

Chronic lower back pain significantly affects quality of life for millions of people worldwide. Back pain makes it difficult to perform everyday tasks and is among the leading reasons why patients see their doctor.

Some back pain comes from the bones themselves, known as the vertebrae, not just the discs in the spine. Damage and inflammation to the top and bottom sides of the vertebrae create vertebrogenic pain. This chronic condition causes a deep, aching midline back pain that worsens with activity, prolonged sitting, or bending.

Basivertebral nerve ablation can stop this pain by turning off the nerves inside those back bones, preventing them from carrying pain signals to the brain.

A Dec. 2025 Yale study published in Interventional Pain Medicine showed this treatment provided fast, long-lasting results for patients with this chronic lower back pain.

Basivertebral nerve ablation is performed by surgeons who target the basivertebral nerve, which transmits pain signals from the damaged vertebral endplates to the brain. By deactivating this nerve, basivertebral nerve ablation can substantially reduce back pain. This treatment offers new hope to patients who have not found relief through physical therapy, medications, or spinal injections.

A recent study, led by Charles Odonkor, MD, principal investigator and assistant professor of orthopaedics & rehabilitation, examined the week-by-week pain relief and functional improvements in 86 patients following basivertebral nerve ablation. Each participant had MRI-confirmed changes in their vertebral endplates and experienced chronic back pain for at least six months.

“We designed this study to capture the exact timeline of pain reduction and functional recovery,” Odonkor says. “Our goal was to provide practical insights for both patients and clinicians on what to expect following basivertebral nerve ablation.”

The study found that pain relief from basivertebral nerve ablation can be both fast-acting and substantial. By the end of the first week, 34% of patients reported at least a 50% reduction in pain.

This figure rose to 76% by the third week and 91% by week six. These improvements were consistent and sustained through 24 weeks, demonstrating the procedure's long-term effectiveness. Most patients typically experienced significant relief around the third week.

“The rapid onset of pain relief was one of the most striking findings of our study,” Odonkor adds. “Many patients see meaningful improvements within the first few weeks, which is encouraging for those who have been suffering from chronic pain for an extended period of time.”

In addition to pain relief, basivertebral nerve ablation also resulted in improvements in functional ability.

The Oswestry Disability Index measures a person’s functional disability due to lower back pain. Before treatment, the average score of 66.5, a severe disability, significantly decreased to a score of 32.3 at 12 weeks. This level of improvement was maintained through 24 weeks, suggesting that basivertebral nerve ablation helps patients regain much of their lost ability to perform physical activities of daily life.

“Functional improvement is just as important as pain relief,” Odonkor says. “Our patients not only felt less pain but could also perform daily activities with greater ease. This comprehensive recovery underscores the potential of this treatment.”

The study categorized the patients into groups depending on how quickly they responded to treatment. Nearly 62% of patients experienced at least 50% relief by week six.

A key finding was the predictive value of early pain relief. Patients who experienced significant pain reduction within the first few weeks were much more likely to sustain their improvements over time.

Specifically, those who reported at least 50% pain relief by week three were more likely to maintain that relief at 12 weeks and beyond. According to Odonkor, this insight can help clinicians identify people who will respond early to treatment, set realistic expectations, and tailor follow-up care accordingly.

“Identifying patients who will respond early to treatment allows clinicians to optimize patient care,” he says. “If we know a patient is likely to achieve sustained relief based on their early response, we can adjust ongoing management more effectively.”

Patients also needed less spine-related treatments after the ablation. Before basivertebral nerve ablation, 86% of patients relied on various spinal injections for pain management. This figure dropped to 22% after the procedure.

“Our study provides compelling evidence that basivertebral nerve ablation offers a durable solution for patients with chronic lower back pain,” Odonkor says. “This treatment can significantly enhance their quality of life, providing relief that is both rapid and sustained.”

According to Odonkor, the findings show basivertebral nerve ablation is a strong treatment for vertebrogenic chronic lower back pain. As research continues, studies on larger populations and over extended periods will be crucial in expanding these findings. For now, basivertebral nerve ablation stands out as a highly effective option for those suffering from chronic vertebrogenic lower back pain.

In addition to Odonkor, the co-authors include: Oghenewoma Oghenesume; Sera Yoo, MD; Sergio Mosquera Limas, DO; Jacky Yeung, MD; Patrick Doherty, MD; Sumeet Kadian; Jared Rosenberg, MD; Sudhir Kadian, MD; and Peter Whang, MD.