Disk Degeneration

Degenerative disc disease is one of the most common causes of low back pain, and also one of the most misunderstood. Many patients diagnosed with low back pain caused by degenerative disc disease are left wondering exactly what this diagnosis means for them. Common questions that are often on patients’ minds include:

  • If I have low back pain from degenerative disc disease in my thirties, how much worse will it become with age?
  • Will the degenerative disc disease become a crippling condition? Will I end up in a wheelchair?
  • Should I restrict my activities?
  • Can I still play sports?
  • Will the degenerative disc disease spread to other parts of the spine?
  • Will the low back pain from degenerative disc disease cause any permanent damage?

Degenerative Disc Disease is a Misnomer

A large part of many patients’ confusion is that the term “degenerative disc disease” sounds like a progressive, very threatening condition. However, this condition is not strictly degenerative and is not really a disease:

  • Part of the confusion probably comes from the term "degenerative", which implies to most people that the symptoms will get worse with age. The term applies to the disc degenerating, but does not apply to the symptoms. While it is true that the disc degeneration is likely to progress over time, the low back pain from degenerative disc disease usually does not get worse and in fact usually gets better over time.
  • Another source of confusion is probably created by the term "disease", which is actually a misnomer. Degenerative disc disease is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc.

Disc degeneration is a natural part of aging and over time all people will exhibit changes in their discs consistent with a greater or lesser degree of degeneration. However, not all people will develop symptoms. In fact, degenerative disc disease is quite variable in its nature and severity.

What causes degenerative disc disease?

As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people.

These age-related changes include:

  • The loss of fluid in your discs. This reduces the ability of the discs to act as shock absorbers and makes them less flexible. Loss of fluid also makes the disc thinner and narrows the distance between the vertebrae.
  • Tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.
    These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting). People who are obese are also more likely to have symptoms of degenerative disc disease.

A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.

As the space between the vertebrae gets smaller, there is less padding between them, and the spine becomes less stable. The body reacts to this by constructing bony growths called bone spurs (osteophytes). Bone spurs can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.

What are the symptoms?

Degenerative disc disease may result in back or neck pain, but this varies from person to person. Many people have no pain, while others with the same amount of disc damage have severe pain that limits their activities. Where the pain occurs depends on the location of the affected disc. An affected disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttock, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.

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