By the Pain Management Team at Performance Pain and Sports Medicine
Suzanne Manzi, MD
Updated April 2026
Medically Reviewed By: Dr. Suzanne Manzi, MD
On This Page:
- What Is the Intracept Procedure?
- Understanding Vertebrogenic Pain
- Who Is a Candidate for the Intracept Procedure?
- How the Intracept Procedure Works
- Benefits of the Intracept Procedure
- Risks and Side Effects
- Intracept vs. Radiofrequency Ablation
- Recovery and What to Expect
- Why Choose Performance Pain in League City
- Frequently Asked Questions
Chronic low back pain is one of the most common reasons patients across Clear Lake and Bay Area Houston ask about advanced interventional options. For NASA contractors who spend long days in console seats, refinery shift workers, and active-adult boaters who want to keep spending weekends on Clear Lake, months or years of physical therapy, medications, and injections often produce only partial relief. When that happens, the underlying source may be vertebrogenic pain — a specific type of back pain that originates inside the vertebral bones themselves and does not respond to treatments aimed at the discs or facet joints.
The Intracept procedure, also called basivertebral nerve ablation, is an FDA-cleared, minimally invasive treatment that targets this nerve directly. At the League City office of Performance Pain and Sports Medicine, located on East Main Street just minutes from I-45, Dr. Suzanne Manzi performs comprehensive MRI-based candidacy evaluations and the Intracept procedure without requiring patients to drive into the Texas Medical Center. A 5-year pooled analysis of 249 patients showed durable improvements in both pain and function following basivertebral nerve ablation (Khalil et al., Interv Pain Med, 2024).
What Is the Intracept Procedure?
The Intracept procedure is a minimally invasive, outpatient treatment that uses radiofrequency energy to ablate (heat and disable) the basivertebral nerve inside the vertebral body. The basivertebral nerve (BVN) is a small nerve that runs through the center of each vertebra in the lower spine. When the endplates of vertebral bones become damaged or inflamed, the BVN transmits chronic pain signals to the brain.
Unlike traditional nerve ablation procedures that target nerves near the facet joints on the outside of the spine, the Intracept procedure targets the nerve inside the bone itself. This is an important distinction. The procedure is FDA-cleared, requires no permanent implant, and preserves the structural integrity of the spine.
A sham-controlled randomized trial of 225 patients demonstrated that basivertebral nerve ablation produced significantly greater improvements in disability scores compared to a placebo procedure (Fischgrund et al., Eur Spine J, 2018). This level of evidence, tested against a sham control, is considered the gold standard in clinical research.
Understanding Vertebrogenic Pain
Vertebrogenic pain is chronic low back pain caused by damage to the vertebral endplates — the thin layers of cartilage and bone that sit between each vertebra and the spinal discs. When these endplates become inflamed or degenerate, characteristic changes called Modic changes appear on MRI scans.
Modic changes are classified into types based on their MRI appearance and represent different stages of endplate damage (Wen et al., Skeletal Radiol, 2025). Type 1 changes indicate active inflammation, while Type 2 changes reflect fatty replacement of bone marrow at the endplate. Both types can stimulate the basivertebral nerve and produce chronic pain.
Vertebrogenic pain is different from disc-related pain or facet joint pain, though these conditions can overlap. Patients with vertebrogenic pain often describe a deep, aching low back pain that worsens with sitting or standing for long periods. Standard back pain treatment approaches such as physical therapy and epidural injections may not fully address this pain source because they do not reach the nerve inside the vertebral body.
Who Is a Candidate for the Intracept Procedure in League City?
The Intracept procedure is designed for a specific group of patients. Many of the Bay Area patients we evaluate at the League City office are NASA Johnson Space Center engineers and aerospace contractors at Boeing, Lockheed Martin, Jacobs, and Barrios; refinery shift workers at Bayport, Texas City, and the Houston Ship Channel; UTMB and Methodist Clear Lake clinicians; Clear Creek ISD educators; and active retirees whose decades of work have produced exactly the chronic axial low back pain pattern that vertebrogenic pain typically causes.
Candidates typically meet the following criteria:
- Chronic low back pain lasting 6 months or longer
- Failure to achieve adequate relief from at least 6 months of conservative treatment (physical therapy, medications, injections)
- MRI evidence of Modic Type 1 or Type 2 changes at one or more levels between L3 and S1
- Pain that is primarily axial (centered in the low back) rather than radiating down the legs
These criteria are based on the inclusion standards used in the SMART randomized controlled trial (Fischgrund et al., Eur Spine J, 2018).
Patients who may not be candidates include those with:
- Spinal instability or significant spinal deformity
- Active spinal infection
- Radiculopathy (nerve root compression) as the primary pain source
- Pregnancy
A thorough League City evaluation, including MRI review and clinical assessment, is necessary to determine whether vertebrogenic pain is the primary driver of your symptoms.
How the Intracept Procedure Works
The Intracept procedure follows a three-step pathway from diagnosis to treatment.
Step 1: Diagnostic Evaluation. The treating physician reviews your MRI to confirm the presence of Modic changes at the affected spinal levels. A clinical assessment determines whether your pain pattern is consistent with vertebrogenic pain. This step ensures the procedure targets the correct pain source.
Step 2: The Procedure. The Intracept procedure is performed as an outpatient surgery, typically lasting about one hour. The patient receives light sedation. Using fluoroscopic (live X-ray) guidance, the physician places a small probe through the outer bone of the vertebra and into the vertebral body. Radiofrequency energy is then delivered to the basivertebral nerve, creating a targeted lesion that disrupts the pain signal. The probe is removed, and no implant is left behind.
A randomized trial comparing basivertebral nerve ablation to continued standard care was halted early by an independent safety committee because the treatment group showed such significant improvement, with a 25.3-point reduction in disability scores compared to 4.4 points for standard care (Khalil et al., Spine J, 2019).
Step 3: Recovery. Patients are discharged the same day. Specific activity modifications during the initial recovery period are discussed before discharge.
Benefits of the Intracept Procedure
For Bay Area Houston patients with chronic vertebrogenic low back pain, the Intracept procedure has produced some of the most durable outcomes documented in interventional pain medicine. The published evidence supports several practical advantages for the NASA contractors, refinery and petrochemical workers, healthcare professionals, educators, and active-adult boaters we treat across Clear Lake and the wider Bay Area community:
- Durable, multi-year pain relief. Pooled data from three clinical trials (249 patients, followed for 5 years) showed a mean pain reduction of 4.32 points on a 0-10 scale, sustained through year five. Approximately 32% of patients reported being completely pain-free at the 5-year mark (Khalil et al., Interv Pain Med, 2024). For NASA engineers facing decades more in console seats and refinery operators on 12-hour shifts, that durability matters.
- Substantial reduction in opioid reliance. Among trial participants who were using opioids before the procedure, 65% had discontinued opioid use by the 5-year follow-up. That outcome matters in safety-sensitive aerospace, refinery, petrochemical, and offshore roles where DOT and process-safety policies make daily opioids a real career risk.
- Minimally invasive with no permanent implant. The Intracept procedure preserves the structural integrity of the spine. There is no hardware, no fusion, and no device left behind — an important consideration for Bay Area patients who want to avoid escalating to open spine surgery.
- Functional improvement, not just pain relief. Five-year follow-up from the SMART trial showed that 66% of treated patients achieved at least a 50% reduction in pain, with a 75% composite responder rate combining both pain and disability scores (Fischgrund et al., Eur Spine J, 2020). Patients describe being able to load up at South Shore Harbour again, sit through a full mission console shift, and walk the Hometown Heroes Park trail without the daily ache.
- Less downstream care over time. Across the 5-year follow-up window, spinal injection use among treated patients decreased by 58%, and only 6% went on to have lumbar fusion surgery. Fewer procedures means fewer days away from work, the boat, and the family.
Individual results depend on the accuracy of the diagnosis (Modic changes on MRI between L3 and S1) and on careful patient selection. The League City team will tell you honestly whether your specific imaging and pain pattern make Intracept a reasonable next step.
Risks and Side Effects
The Intracept procedure has demonstrated a strong safety profile across published clinical trials. Across three prospective studies involving over 300 treated patients followed for up to 5 years, zero serious device-related adverse events were reported (Khalil et al., Interv Pain Med, 2024).
Possible side effects may include:
- Temporary soreness or discomfort at the procedure site
- Minor bruising near the insertion point
- Rare risk of infection, as with any procedure involving needle insertion
As with any medical procedure, individual results vary. The treating physician discusses all potential risks and benefits during the pre-procedure consultation.
Intracept vs. Radiofrequency Ablation
Patients researching pain management options often ask how the Intracept procedure compares to traditional radiofrequency ablation (RFA). While both use radiofrequency energy to treat nerves, they target different structures and address different types of back pain.
| Feature | Intracept (BVN Ablation) | Traditional RFA (Medial Branch) |
|---|---|---|
| Target nerve | Basivertebral nerve (inside the vertebral body) | Medial branch nerves (near facet joints) |
| Pain source treated | Vertebrogenic pain (endplate/Modic changes) | Facet joint pain |
| Diagnostic confirmation | MRI showing Modic changes | Positive medial branch block response |
| Durability of relief | 5-year data shows sustained improvement | Typically requires repeat procedures every 6-18 months |
| Procedure location | Inside the vertebral bone | Outside the spine, near facet joints |
Proper diagnosis determines which procedure is appropriate. Traditional RFA treats facet-mediated pain, while the Intracept procedure treats vertebrogenic pain originating inside the vertebral body.
Recovery and What to Expect
The Intracept procedure is performed as a same-day outpatient case. Most Bay Area patients leave the surgery center within a few hours of the procedure and head home with a friend or family member at the wheel. Compared to lumbar fusion or other open spine operations, recovery is dramatically simpler.
First 1 to 2 weeks. Mild soreness at the small probe-insertion site is normal and usually self-limiting. Most patients are back to light daily activities — including a return to office or light-duty roles at NASA, UTMB, Methodist Clear Lake, or Clear Creek ISD — within a few days. Heavy lifting, twisting, and high-impact exercise are restricted during this period. Refinery operators, turnaround crews, and offshore workers should plan a longer phased return based on their specific job demands.
Weeks 2 to 4. Activity levels gradually return to normal. Many patients begin to notice a meaningful drop in their background low back pain during this window. Light gym work, walking the South Shore Harbour boardwalk, and most household tasks are typically reasonable by the end of week four.
Months 1 to 3. Maximum benefit can take up to 90 days to fully develop. Clinical trial data shows improvements continue to build during this window and are then sustained through 5 years of follow-up.
Seasonal considerations for the Bay Area. Long, humid summers affect hydration and tolerance for outdoor recovery, and hurricane season runs from June through November. The League City team will discuss indoor air-conditioned recovery and a contingency plan for follow-up scheduling if a tropical system disrupts a visit. Mild winters mean year-round outdoor walking is realistic.
Specific post-procedure instructions are tailored to your activity level, occupation, and treatment plan during the pre-discharge conversation.
Why Choose Performance Pain and Sports Medicine in League City
When patients across the Clear Lake and Bay Area Houston community choose the Intracept procedure at the League City office, they benefit from a physician-led care team with deep training in interventional spine procedures and basivertebral nerve ablation for vertebrogenic pain.
Dr. Suzanne Manzi, MD — Quadruple Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine — is fellowship-trained at Michigan State University in Interventional Spine and Pain Management and serves on teaching faculty at UT Health Houston McGovern Medical School. Her residency at Baylor College of Medicine and her work as a founding member of the Society of Women Innovators in Pain Management align directly with the diagnostic precision required for Intracept patient selection.
What sets the League City office apart for Intracept candidates:
- Physician-led MRI review with attention to Modic Type 1 and Type 2 changes between L3 and S1
- Honest, evidence-based candidacy conversations — we will tell you if Intracept is unlikely to help your specific pain pattern
- TMC-caliber care without the I-45 drive into the Texas Medical Center
- Same-day outpatient procedure performed at an affiliated Bay Area surgery center
- Workers’ compensation accepted for NASA contractor, refinery, petrochemical, maritime, and healthcare cases
- Convenient League City location on East Main Street, accessible from Friendswood, Webster, Dickinson, Kemah, Seabrook, Nassau Bay, Texas City, La Porte, Pearland, Pasadena, Alvin, and Santa Fe
For League City patients also exploring biologic alternatives or facet-mediated pain treatments, the practice offers PRP therapy and radiofrequency ablation in League City.
Our League City Location
Performance Pain and Sports Medicine — League City:
Address: 1216 East Main Street, Suite A, League City, TX 77573
Major Cross Streets: East Main Street (FM 518) at I-45
Nearby Landmarks: South Shore Harbour, UTMB Health League City Campus, Big League Dreams, Kemah Boardwalk
Parking: Free on-site parking
Phone: 346-217-1111
Conveniently located in the heart of Bay Area Houston, the League City office serves patients from Friendswood, Webster, Dickinson, Kemah, Seabrook, Nassau Bay, El Lago, Texas City, La Porte, Pearland, Pasadena, Alvin, Santa Fe, and the wider Clear Lake / Galveston Bay communities, with quick access from I-45, FM 518, FM 646, and NASA Road 1.
Frequently Asked Questions
Is the Intracept procedure available in League City, TX?
Yes. The candidacy evaluation and the Intracept (basivertebral nerve ablation) procedure are coordinated through the League City office of Performance Pain and Sports Medicine, located at 1216 East Main Street, Suite A. Dr. Suzanne Manzi, MD, leads the candidacy review and procedure for patients across the Clear Lake and Bay Area Houston community. Most insurance plans, Medicare, and workers’ compensation cases cover medically necessary Intracept. Call 346-217-1111 or request an appointment online.
How much does the Intracept procedure cost in Texas?
Cost varies depending on insurance coverage, the number of spinal levels treated, and the facility. Many commercial insurance plans and Medicare provide coverage for basivertebral nerve ablation. The League City office staff verifies benefits and coordinates prior authorization before the procedure is scheduled. Call 346-217-1111 for a benefits check.
Do you accept workers' compensation for NASA contractor, refinery, and Ship Channel back injuries?
Yes. The League City office regularly treats workers’ compensation patients from NASA Johnson Space Center contractors (Boeing, Lockheed Martin, Jacobs, Barrios, and others), Houston Ship Channel and Bayport refinery and chemical-plant operators, longshoremen and maritime workers on Galveston Bay, UTMB and Methodist Clear Lake healthcare staff, and Clear Creek ISD educators. We coordinate with case managers and adjusters and document MRI findings that support appropriate work status decisions. Call 346-217-1111 to discuss your specific case.
Is the Intracept procedure permanent?
The Intracept procedure creates a permanent lesion on the basivertebral nerve. Published 5-year follow-up data shows that pain relief and functional improvement are sustained over time, with no evidence of diminishing results. Current evidence suggests a single procedure may provide lasting benefit for most appropriately selected patients.
What is the recovery time for the Intracept procedure?
Most patients resume light activities within a few days and return to normal routines within 2-4 weeks. Full benefit may take up to 3 months to develop. Recovery is significantly shorter than lumbar fusion or other open spine surgeries. Because Bay Area summers are hot and humid and hurricane season runs June through November, your team will discuss hydration, indoor air-conditioned recovery, and a contingency plan for follow-up if a tropical system disrupts a visit.
Is the Intracept procedure the same as nerve ablation?
The Intracept procedure is a type of nerve ablation, but it differs from traditional radiofrequency ablation. Traditional RFA targets medial branch nerves near the facet joints, while the Intracept procedure targets the basivertebral nerve inside the vertebral body. They treat different pain sources and are not interchangeable.
Does Medicare cover the Intracept procedure?
Medicare has established coverage for basivertebral nerve ablation. Coverage may vary by region and specific Medicare plan. The League City staff assists with verifying Medicare benefits and obtaining any required prior authorization before the procedure is scheduled.
Who is not a candidate for the Intracept procedure?
Patients who may not be candidates include those with spinal instability, active spinal infection, pregnancy, or pain primarily caused by nerve root compression (radiculopathy). An MRI must show Modic Type 1 or Type 2 changes for a patient to be considered. Candidacy is determined through a complete evaluation at the League City office.
How do I know if I have vertebrogenic pain?
Vertebrogenic pain is diagnosed through clinical evaluation and MRI imaging. The key diagnostic marker is the presence of Modic changes on MRI at the affected spinal levels. Patients with vertebrogenic pain typically have chronic, axial (non-radiating) low back pain that has not responded to conservative treatment. The League City office reviews your MRI and clinical history during the initial evaluation to determine whether Intracept may be appropriate.
Schedule Your Intracept Consultation in League City
If chronic low back pain has not improved with physical therapy, medications, or injections, the Intracept procedure may be worth discussing. The League City pain management team at Performance Pain and Sports Medicine offers MRI-based candidacy evaluations and same-day outpatient treatment. Request an appointment to find out whether basivertebral nerve ablation could help your specific pain pattern.
Performance Pain and Sports Medicine — League City
1216 East Main Street, Suite A, League City, TX 77573
Phone: 346-217-1111
MEDICAL DISCLAIMER
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. The information presented reflects an interventional pain management perspective and is intended to support, not substitute, your relationship with a qualified healthcare provider. Individual results vary based on diagnosis, pain duration, overall health, and response to treatment. Some procedures may not be covered by insurance. Treatment outcomes depend on proper patient selection and accurate diagnosis. Always consult a board-certified physician before pursuing any pain management treatment.
Medically reviewed by Suzanne Manzi, MD
Quadruple Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine. Teaching Faculty, UT Health Houston McGovern Medical School
Last reviewed: April 2026
