Vertebrogenic low back pain: causes, symptoms, and treatments
Learn about vertebrogenic low back pain, its symptoms, and how targeted exercises and at-home treatments can help you manage discomfort.
Table of Contents
Vertebrogenic low back pain may sound complex, but it simply refers to pain that originates from the bones (vertebrae) in your lower spine. Despite its clinical-sounding name, vertebrogenic low back pain is a common and treatable condition.
“Movement is one of the most important ways to manage vertebrogenic pain,” says Mark Schroeckenstein, PT, DPT, a physical therapist at Hinge Health. “It’s about paying attention to which activities make you feel better or worse, and using that information to guide your recovery.”
The most effective strategy for managing this kind of low back pain isn’t total rest or waiting until you feel better to engage in activity. Rather, gentle, regular movement, including physical therapy exercises, helps with the recovery process.
Read on to learn what causes vertebrogenic low back pain and what you can do to feel better, especially with exercises recommended by Hinge Health physical therapists.
Reviewed by our clinical and medical experts
Richard Keyme, MD
Christynne Helfrich, PT, DPT
Mark Schroeckenstein, PT, DPT
What is vertebrogenic low back pain?
Vertebrogenic low back pain primarily occurs from changes in the vertebral endplates — the protective layers connecting your spinal bones (vertebrae) to the discs in your spine. Your spine is made up of bones called vertebrae, which are stacked on top of each other. Between each vertebra is a soft, cushiony disc that acts as a shock absorber and allows your back to bend, twist, and move smoothly. The vertebral endplates are thin layers of tissue that sit between each vertebra and disc, helping them work together.
Sometimes, changes in the endplates can cause the nerves in this area to become more sensitive.
“Pain develops when the ends of these vertebrae interact with the discs and activate certain nerves nearby,” explains Dr. Schroeckenstein. This can contribute to vertebrogenic low back pain during certain movements or activities.
It’s estimated that vertebrogenic pain accounts for about 15% of all cases of chronic lower back pain, according to research in the International Journal of Spine Surgery. “It can technically happen anywhere along your back, but we most often see it in the lower back,” adds Dr. Schroeckenstein.
Who gets vertebrogenic pain?
Anyone can develop changes in their vertebral endplates that lead to vertebrogenic pain. However, certain factors may increase your risk, including:
Age-related changes in the spine
A history of back injuries
Having a physically demanding job with frequent lifting
Being very tall, overweight, or obese
Having a genetic predisposition to back conditions
Note: Having one or more of these risk factors doesn’t mean you’re bound to develop vertebrogenic pain — many people with the same risk factors never experience it. These factors simply increase your chances compared to others.
Causes of vertebrogenic low back pain
Vertebrogenic low back pain commonly develops as part of the natural aging process. Over time, everyday activities, repetitive movements, or even long periods of sitting can contribute to subtle changes in the structures of the spine — especially the vertebrae, discs, and surrounding joints. These small shifts may add up, making pain more likely for some people, especially when additional risk factors are involved.
Several issues can play a role in vertebrogenic low back pain, including:
Disc issues. Over time, the discs between your vertebrae can naturally change or shift, which may affect the areas around them — including the vertebral endplates and nearby nerves — and contribute to back discomfort.
Sedentary lifestyle. Spending long periods sitting, especially without breaks to move or change position, can make your back feel stiff and uncomfortable.
Arthritis (spondylosis). As you age, the protective cartilage that cushions your spinal joints can thin. This may cause changes that irritate nearby nerves and contribute to vertebrogenic pain.
Facet joint arthritis. These small joints connect the vertebrae and help your spine move smoothly. When arthritis affects the facet joints, inflammation and stiffness can impact how the vertebrae interact with the discs and nearby tissues, sometimes sending pain signals through sensitive nerves.
Symptoms of vertebrogenic low back pain
Vertebrogenic low back pain typically causes discomfort right in the center of your lower back, along your spine, says Dr. Schroeckenstein. Many people describe it as a deep, persistent ache that tends to get worse when you:
Sit for extended periods
Engage in physical activity
Bend or twist
Exercises for vertebrogenic back pain
Want expert care? Check if you're covered for our free program →- Cat cow
- Open book
- Bird dog
- Dead bug
- Side plank
These exercises and stretches, recommended by Hinge Health physical therapists, are designed to strengthen and loosen tight lower back muscles and increase spinal flexibility and mobility. By regularly incorporating them into your routine, you can help support your spine and reduce the risk of future back pain.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Treatments for vertebrogenic low back pain
Vertebrogenic low back pain is most often managed with time and at-home treatments designed to get you moving, relieve discomfort, and support your spine so you can return to your normal routines. “Movement is one of the best ways to manage vertebrogenic pain — even if it feels a little uncomfortable at first,” says Dr. Schroeckenstein. Depending on your needs, the following may be recommended:a mix of targeted exercises, self-care strategies, pain relief techniques, and, in rare cases, minimally invasive procedures if symptoms persist
Targeted exercises and physical therapy. Stretches can help restore mobility and reduce stiffness throughout your spine, and back-strengthening exercises help take pressure off your spinal joints. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Note: It’s normal to feel more discomfort in the beginning with these activities, before you start to feel better.
Stay active. Regular movement is essential for maintaining a healthy spine. “Your spinal joints are designed to absorb pressure and shock, so lack of movement can actually make them more painful,” explains Dr. Schroeckenstein. If your pain is especially intense or new, avoid activities that aggravate your symptoms. However, gentle, lower-impact exercises like walking or stretching are usually more comfortable and can help maintain flexibility and strength.
Ice or heat. Using an ice pack can help ease pain and inflammation, especially after pain flare-ups. Heat can relax tight muscles and improve blood flow. Experiment with both to see which feels best for you.
Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active when you have vertebrogenic low back pain. Other options include topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.
TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain associated with conditions like vertebrogenic low back pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.
Complementary treatments. Research suggests that alternative treatments, such as massage, acupuncture, or chiropractic care, can be effective for vertebrogenic back pain. Talk to your provider if you’re interested in trying any of these.
Nerve ablation. For persistent pain that doesn’t respond to other treatments, a procedure called basivertebral nerve ablation may be recommended. This minimally invasive procedure inactivates the basivertebral nerve, which is responsible for transmitting pain signals from the vertebrae bones. “In the right situations, it can be a very effective option for persistent pain,” says Dr. Schroeckenstein.
How to prevent vertebrogenic low back pain
While vertebrogenic low back pain is often a natural part of aging, these simple habits can lower your risk and make symptoms easier to manage. Try these prevention strategies:
Take frequent movement breaks. “Your spinal joints, like the rest of your body, crave movement,” says Dr. Schroeckenstein. If you find yourself sitting or standing for long periods, make it a habit to take short breaks to walk around or do a few simple mobility exercises.
Make lifting work for you. There’s no single “right” way to lift, and lifting heavy objects isn’t bad for your back. The trick is to make sure you're not lifting more than what your body is ready for. It also helps to move with control and focus on engaging your glutes (butt muscles) and quadriceps (front of thigh muscles), versus your back muscles. When you’re feeling sensitive, focus on comfort and the load: keep items close if that helps, use both hands, bend at your hips or knees as feels natural, or split heavy tasks into smaller trips. Gradually build up as you feel better.
Avoid smoking. Smoking and nicotine can accelerate the aging of your spine by reducing blood flow to the spinal structures. This may increase your risk of pain or injury.
Choose supportive chairs. When sitting, opt for chairs and sitting positions that support your spine. At both work and home, adjust your chair height so your feet rest flat on the floor. If your chair has armrests, use them to keep your arms supported with elbows close to your body and shoulders relaxed.
PT tip: Check your habits
Throughout your day, make it a habit to check in with how you’re feeling physically. “Notice if your posture supports your back, especially when sitting, and pay attention to how you move when lifting objects to help protect your lower back,” advises Dr. Schroeckenstein. Small adjustments, like changing your sitting position or pausing to stretch, can make a meaningful difference in how your back feels. If you’re sitting often, set an alarm for every 15 to 20 minutes as a reminder to take brief standing breaks.
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Lorio, M., Olivier Clerk-Lamalice, Rivera, M., & Kai-Uwe Lewandrowski. (2022). ISASS Policy Statement 2022: Literature Review of Intraosseous Basivertebral Nerve Ablation. The International Journal of Spine Surgery, 16(6), 1084–1094. doi:10.14444/8362
Chou, R. (2025, September 12). Subacute and chronic low back pain: Management. UpToDate. Retrieved from https://www.uptodate.com/contents/subacute-and-chronic-low-back-pain-management?topicRef=7780&source=related_link#H2883739741
Chou, R., & Cohen, S. P. (2025, August 29). Subacute and chronic low back pain: Nonsurgical interventional treatment. UpToDate. Retrieved from https://www.uptodate.com/contents/subacute-and-chronic-low-back-pain-nonsurgical-interventional-treatment?search=basivertebral%20nerve%20ablation&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2492130340
Xu, H.-R., Zhang, Y.-H., Thanh Luan Ngo, Yang, Q.-H., Du, S.-H., & Wang, X.-Q. (2023). Association between smoking and incident back pain: A prospective cohort study with 438 510 participants. Journal of Global Health, 13. doi:10.7189/jogh.13.04152