Degenerative disc disease is the normal age-related change in the discs. They dry out, lose height, and form small cracks and bone spurs at the edges. It matters only where a specific level is causing specific symptoms.
A poor name. It is not really a disease, and calling it one has caused a great deal of needless fear.
In more detail
- The term describes the normal age-related changes in discs. They dry out, lose height, and form small cracks and bone spurs at the edges.
- It does not steadily get worse the way the word ‘degenerative’ makes most people think. And it is not a disease in the sense of something that will spread or take over.
- Many doctors now prefer ‘age-related disc change’ because the older term scares patients into sitting still, and that makes outcomes worse.
What it means for you
Being told you have degenerative disc disease at forty is about the same as being told you have gray hair. It matters only where a specific level is causing specific symptoms. It is treated on that basis.
Remember the general rule. Findings like this one are common in people with no pain at all. They become more common with age. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your exam. See understanding your MRI report.
Bring your scan and report in and we will go through it with you. Call us or request an appointment.
Related: an annular tear often appears on the same report, and discography is the test that asks which disc actually hurts.
How common is it, and what does it predict?
Despite the name, it is not a disease. It also does not steadily worsen the way patients assume. It describes age-related change in the discs: water loss, lost height, bulging, and sometimes tears in the outer ring. It is found in most adults past middle age. It is also found in a large share of people who have never had back pain. Being told you have it is closer to being told your spine is aging than to getting a diagnosis. When a disc truly is causing pain, the pain has a clear feel. It is deep and central, worse with sitting and lifting, and often hard to pin to one spot.
Common questions
Will it keep getting worse until I cannot walk?
No. This is the fear the name creates, and it is not what happens. Symptoms usually come and go, and often improve.
Should I stop exercising?
The opposite. Sitting still is the thing that reliably makes this worse.
That is the subject of Disc Desiccation — What It Means.
Will it get worse over time?
Degenerative change moves forward slowly with age in everyone. Pain does not track it reliably. Many people improve while the imaging stays the same.
That is the subject of Understanding Your MRI Report.
Is it hereditary?
Genes play a part in disc degeneration. But the finding is so common that having it says little about how any one person will do.
Is there anything that slows it?
Nothing reverses the structural change. But not smoking, keeping blood sugar in decent control and staying active all affect how well the tissue around it copes.
Glucose control is covered in Metabolic and Lifestyle Care.
Sources
- Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 2015. PubMed 25430861
- Fardon DF et al. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. The spine journal : official journal of the North American Spine Society, 2014. PubMed 24768732
- Bezuglov E et al. Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players. Spine, 2021. PubMed 33347092
- Dudli S et al. Pathobiology of Modic changes. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2016. PubMed 26914098
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