Degenerative Disc Disease

What it is

Despite the name, degenerative disc disease is not really a disease — it is the normal aging of the spinal discs, the cushions between the vertebrae. Over time discs lose water and height and become less springy. This is a universal part of getting older, and on its own it is often painless; an X-ray showing “disc degeneration” is a description of wear, not a diagnosis of doom.

What it feels like

When it does cause symptoms, it is usually back or neck pain that comes and goes, often worse with certain positions or after a long day, and sometimes a sense of stiffness. As discs settle, they can also contribute to other conditions — a pinched nerve, a slip, or narrowing — which is often where more specific symptoms come from.

How we evaluate it

Your history and exam come first; imaging confirms wear but rarely changes the plan by itself, because degeneration is so common even in people without pain. I am careful not to over-read a scan, since the goal is to treat your symptoms, not the picture.

How we treat it

The mainstay is non-surgical and effective for most people: staying active, physical therapy and core conditioning, good body mechanics, and medication or heat for flares. Surgery has a limited and selective role for degeneration itself, and I am cautious about it — because a fused level shifts load onto its neighbors and can speed their wear, I reserve it for specific, well-defined problems rather than general wear-and-tear pain.

The science — for the curious

Here is the reassuring reality: disc degeneration is nearly universal by middle age, yet most people with worn discs on imaging have little or no pain. That disconnect is exactly why I treat the patient rather than the MRI, and why I am conservative about surgery for degeneration alone — the natural history is usually favorable, and the least-invasive path that keeps you moving is almost always the right first step.

Learn more

OrthoInfo — Low Back Pain: orthoinfo.aaos.org

OrthoInfo — Cervical Spondylosis (Arthritis of the Neck): orthoinfo.aaos.org

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.