Modic change has been documented by SPECT analysis [Isotope scanning using single positron emission computerized tomography], combined with high-resolution CT imaging. This method has shown high metabolic activity in 96.1% of endplates with Modic change type I and 56% with Modic change type 2. Modic changes have been observed in dogs. Treatment Exercise and surgery alone are ineffective treatments for patients with Modic changes The most commonly recommended treatment for long-lasting pain in the lower back are exercises and fitness training usually under the supervision of a qualified clinician. This treatment does help the vast majority of back pain patients but does not have a pain-relieving effect on Modic changes or pain from Modic changes. Modic changes are also an independent predictive marker for poor clinical outcomes, meaning that conventional treatments such as strength training, manipulations, physiotherapy, acupuncture, and surgery do not reduce the pain of individuals with Modic changes. Treatment with antibiotics In the case that body tissue is infected with bacteria, this will, in most cases, lead to the patient being given treatment with antibiotics, which in most cases will cure the infection. A research group led by Gilligan has presented a description of how they hypothesize 4 stages, from infection of the discus to developing Modic changes in the vertebrae. The first study to investigate the efficacy of long-term antibiotic treatment for patients with Modic changes was published in 2013. This clinically randomized controlled trial showed this treatment to be a highly efficacious treatment for this subgroup of patients with chronic low back pain and Modic changes. Since then, in total, 10 studies have been conducted evaluating the effect of antibiotic treatment in patients with chronic low back pain and Modic changes. Two clinically controlled studies with long-term follow-up and one clinically controlled study with short-term follow-up have been performed. In addition, seven cohort studies have been completed, of which there are follow-up results in the six of the studies. Differences in the efficacy of antibiotics in treating Modic changes with antibiotics warrants further investigation of optimal treatment protocol with antibiotics and diagnosis. Treatment is generally not offered to individuals with modic changes in the healthcare system due to the lengthy process between new scientific knowledge and its acceptance and optimal application in the healthcare system. Bibliography https://ama.com.au/ausmed/back-pain-breakthrough-crippled-doubt http://dx.doi.org/10.1136/bmj.l5654 References Spinal cord disorders