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 Baytown
- Frequently Asked Questions
Chronic low back pain is one of the most common reasons workers across Baytown, Mont Belvieu, Channelview, Highlands, La Porte, Crosby, and the wider Houston Ship Channel community come into our office. For refinery operators on a 12-hour shift, turnaround crews bending and lifting through long days, longshoremen on the Ship Channel, and pipefitters and welders on big-plant projects, months or years of physical therapy, medications, and injections still leave many of them in daily pain. 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 Baytown office of Performance Pain and Sports Medicine, located on West Baker Road just off I-10 and Garth Road, Dr. Suzanne Manzi performs MRI-based candidacy evaluations and the Intracept procedure for East Harris County patients without requiring the long drive into the Texas Medical Center. The office offers bilingual English and Spanish care for our majority-Hispanic community. 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 Baytown?
The Intracept procedure is designed for a specific group of patients. Many of the East Harris County patients we evaluate at the Baytown office are ExxonMobil Baytown Complex operators and contractors, Chevron Phillips Cedar Bayou and Covestro chemical-plant workers, turnaround crews and welders, longshoremen and stevedores on the Houston Ship Channel, Goose Creek CISD educators, and Houston Methodist Baytown and Lee College health-program staff. Decades of bending, lifting, climbing, and standing on hard surfaces produce 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 Baytown-office 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 East Harris County 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 refinery and chemical-plant operators, turnaround crews, longshoremen and stevedores, welders and pipefitters, and family members we treat across Baytown and the Houston Ship Channel 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 ExxonMobil, Chevron Phillips, and Covestro workers facing decades more on hard surfaces, that kind of durability is what makes a real difference.
- 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 profoundly in safety-sensitive refinery, petrochemical, and offshore roles where DOT and process-safety policies make daily opioids a 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 blue-collar workers who want to avoid escalating to open spine surgery and the long disability that comes with it.
- 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 getting back to a full turnaround shift, a Ship Channel load-out, or a Friday night at Stallworth Stadium without the daily ache shutting them down.
- 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 off the job and out of the household.
Individual results depend on the accuracy of the diagnosis (Modic changes on MRI between L3 and S1) and on careful patient selection. The Baytown team will tell you honestly — in English or Spanish — 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 East Harris County 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 within a few days. Industrial workers — refinery operators, turnaround crews, welders, pipefitters, instrumentation technicians, longshoremen — should plan a phased return tied to their specific job demands and any DOT or process-safety policies. Heavy lifting, twisting, climbing, and overhead work are restricted during this period.
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 walking the Goose Creek Greenbelt, the Baytown Nature Center, or your own neighborhood is typically reasonable. Most household tasks resume 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. This timing matters when planning a return-to-work date for a turnaround crew or a Ship Channel rotation.
Seasonal considerations for Baytown. Long, humid summers affect hydration and tolerance for outdoor recovery. Hurricane season runs from June through November, and excessive ozone alerts can occur near the surrounding industrial complexes. The Baytown team will discuss hydration, indoor air-conditioned recovery, respiratory considerations on alert days, and a contingency plan for follow-up if a tropical system or air-quality alert disrupts a visit.
Specific post-procedure instructions are tailored to your activity level, occupation, and treatment plan during the pre-discharge conversation. Spanish-language aftercare materials are available on request.
Why Choose Performance Pain and Sports Medicine in Baytown
When patients across Baytown and East Harris County choose the Intracept procedure at the Baytown office, they benefit from a physician-led care team with deep training in interventional spine procedures and basivertebral nerve ablation, a team that knows the rhythms of refinery turnarounds and Ship Channel labor, and bilingual, family-centered care in a majority-Hispanic community.
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 Baytown 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 35 to 45-minute I-10 drive into the Texas Medical Center
- Bilingual English and Spanish care for our majority-Hispanic East Harris County community
- Workers’ compensation accepted for refinery, petrochemical, Ship Channel, and contractor cases — with detailed documentation that supports return-to-duty decisions in safety-sensitive process operator and DOT-regulated roles
- Convenient Baytown location on West Baker Road, accessible from Mont Belvieu, Channelview, Highlands, La Porte, Crosby, Anahuac, Beach City, Cove, Old River-Winfree, Wallisville, Dayton, and Liberty
For Baytown patients also exploring biologic alternatives or facet-mediated pain treatments, the practice offers PRP therapy and radiofrequency ablation in Baytown.
Our Baytown Location
Performance Pain and Sports Medicine — Baytown:
Address: 1650 W. Baker Rd., Ste A, Baytown, TX 77521
Major Cross Streets: West Baker Road at Garth Road, just off I-10
Nearby Landmarks: Houston Methodist Baytown Hospital, Lee College, ExxonMobil Baytown Complex, Baytown Nature Center
Parking: Free on-site parking
Phone: 346-217-1111 (Bilingual / Hablamos Español)
Conveniently located in the heart of East Harris County, the Baytown office serves patients from Mont Belvieu, Channelview, Highlands, La Porte, Crosby, Anahuac, Beach City, Cove, Old River-Winfree, Wallisville, Dayton, Liberty, and the wider Houston Ship Channel community, with quick access from I-10, Garth Road, SH-146, and the Fred Hartman Bridge.
Frequently Asked Questions
Is the Intracept procedure available in Baytown, TX?
Yes. The candidacy evaluation and the Intracept (basivertebral nerve ablation) procedure are coordinated through the Baytown office of Performance Pain and Sports Medicine, located at 1650 W. Baker Rd., Ste A. Dr. Suzanne Manzi, MD, leads the candidacy review and procedure for patients across East Harris County, the Houston Ship Channel community, and the wider Baytown area. The office offers bilingual English and Spanish care. 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 Baytown staff verifies benefits and coordinates prior authorization before the procedure is scheduled. Call 346-217-1111 for a benefits check. Hablamos español.
Do you accept workers' compensation for refinery, petrochemical, and Ship Channel back injuries?
Yes. The Baytown office regularly treats workers’ compensation patients from the ExxonMobil Baytown Complex, Chevron Phillips Cedar Bayou, Covestro, Cedar Crossing Industrial Park operators, Houston Ship Channel longshoremen and stevedores, turnaround and contractor crews, and Goose Creek CISD staff. We coordinate with case managers and adjusters and document MRI findings — including Modic changes between L3 and S1 — 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 Baytown summers are hot and humid, hurricane season runs June through November, and excessive ozone alerts can occur near the surrounding industrial complexes, your team will discuss hydration, indoor air-conditioned recovery, respiratory considerations on alert days, 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 Baytown 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 Baytown 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 Baytown office reviews your MRI and clinical history during the initial evaluation to determine whether Intracept may be appropriate. Spanish-language consultations available.
Schedule Your Intracept Consultation in Baytown
If chronic low back pain has not improved with physical therapy, medications, or injections, the Intracept procedure may be worth discussing. The Baytown pain management team at Performance Pain and Sports Medicine offers MRI-based candidacy evaluations and same-day outpatient treatment. Bilingual English and Spanish care available. Request an appointment to find out whether basivertebral nerve ablation could help your specific pain pattern.
Performance Pain and Sports Medicine — Baytown
1650 W. Baker Rd., Ste A, Baytown, TX 77521
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
