Advanced Options for Chronic Back Pain: Intracept, VIA Disc, and HFX: What They Are and Who May Benefit

For many people living with chronic back pain, conservative treatments like physical therapy, medications, and injections provide meaningful relief. But when pain persists despite these approaches—and surgery may not be appropriate or desired—advanced, minimally invasive options may be worth exploring.

Three newer treatments often discussed in spine and pain care are Intracept, VIA Disc, and HFX therapy. While they are very different from one another, each targets a specific source of pain and may be helpful for carefully selected patients.

Understanding how these therapies work—and who they are designed for—can help patients make more informed decisions alongside their care team.

Intracept® Procedure: Targeting Vertebrogenic Pain

What it is:
The Intracept procedure is a minimally invasive treatment designed to relieve vertebrogenic low back pain, which originates from damage or inflammation within the vertebral endplates of the spine. This type of pain is often associated with Modic changes seen on MRI.

How it works:
Intracept uses radiofrequency energy to deactivate the basivertebral nerve, which carries pain signals from the vertebral body. By interrupting these signals, pain can be reduced without altering the structure of the spine.

Who may be a candidate:

• Chronic low back pain lasting 6 months or longer
• Pain that has not improved with conservative treatments
• MRI evidence of Modic Type 1 or Type 2 changes
• No significant spinal instability or nerve compression requiring surgery

Potential benefits:

• Minimally invasive, outpatient procedure
• No implants or ongoing maintenance
• Targets a specific, identifiable pain source

VIA Disc®: Supporting Degenerated Discs

What it is:
VIA Disc is an injectable treatment designed to support degenerative disc disease by supplementing the disc’s internal environment. It is intended for patients whose pain is thought to be disc-related but who are not candidates for surgery.

How it works:
The procedure involves injecting a disc matrix product into the affected disc under imaging guidance. The goal is to support disc structure and function, potentially reducing pain associated with disc degeneration.

Who may be a candidate:

• Disc-related low back pain without severe nerve compression
• Mild to moderate disc degeneration
• Pain worsened by sitting, bending, or spinal loading
• No significant spinal instability or advanced disc collapse

Potential benefits:

• Minimally invasive
• Disc-focused approach rather than surgery
• May complement physical therapy and lifestyle strategies

HFX® Therapy: High-Frequency Spinal Cord Stimulation

What it is:
HFX therapy is a form of spinal cord stimulation (SCS) that uses high-frequency electrical signals to modulate pain pathways in the nervous system. Unlike traditional stimulators, HFX therapy does not produce tingling sensations.

How it works:
Thin leads are placed near the spinal cord to deliver high-frequency signals that interfere with pain transmission. Patients typically complete a temporary trial before moving forward with permanent implantation.

Who may be a candidate:

• Chronic back and/or leg pain
• Pain that persists after surgery or when surgery is not an option
• Neuropathic pain patterns
• Positive response during the trial period

Potential benefits:

• Adjustable and reversible therapy
• Addresses complex or widespread pain
• Trial period before permanent implantation

Choosing the Right Option: Why Diagnosis Matters

These treatments are not interchangeable. Each targets a different pain generator:

• Intracept targets vertebral endplate–related pain
• VIA Disc focuses on disc degeneration
• HFX modulates nervous system pain signaling

This is why thorough evaluation—including imaging, physical examination, and medical history—is essential. Matching the treatment to the true pain source is key to success.

When Advanced Options May Be Considered

Advanced therapies may be discussed when:

• Pain persists despite conservative care
• Surgery is not indicated or not desired
• Imaging identifies a clear pain generator
• Pain is limiting daily function and quality of life

These treatments are typically part of a multimodal care plan, not a standalone solution.

Final Thoughts

Intracept, VIA Disc, and HFX represent important advancements in non-surgical spine and pain care. While not appropriate for everyone, they may offer meaningful relief for carefully selected patients.

A personalized approach—guided by accurate diagnosis and shared decision-making—remains the foundation of effective pain management.

If chronic back pain is affecting your daily life, a consultation with a spine or pain specialist can help determine whether advanced treatment options may be appropriate.