Vertebral subchondral bone, also known as bony or osseous endplate, is an important anatomical part of the spine, including cartilage endplate and intervertebral disk. Vertebral subchondral bone plays a critical role in spinal function and maintenance of intervertebral disk health. Recent data suggest that some vertebral subchondral bone changes, detected by MRI and described as Modic changes, may be specifically associated with degenerative disk disease and chronic low back pain, and that these changes may be related to local inflammation. Thus, Modic changes may be a useful imaging biomarker to identify particular sub-groups of patients with chronic low back pain for whom a link between pathoanatomy, namely vertebral subchondral bone alterations, and pain can be established. Such identification may give rise to develop more specific therapies targeting, for example, inflammatory changes involving vertebral subchondral bone in Modic change-associated non-specific chronic low back pain.