What is degenerative disc disease?
Despite the name, this is not really a "disease." It describes the changes that happen to the discs in your spine as you get older. Discs lose water, shrink, and develop small tears. The space between the bones becomes smaller, and the joints around the disc are forced to handle more load. Some people have a lot of these changes on their MRI with little pain, while others have only mild changes but significant pain.
Causes
- Normal aging
- Long-term wear and tear from work, sports, or repetitive activity
- Smoking, which speeds up disc wear
- Past injuries to the spine
- Genetics
Symptoms
- Aching low back pain, often worse with sitting
- Pain that flares up for days or weeks, then settles down
- Stiffness in the morning
- Pain when bending or twisting
- Sometimes pain or tingling into the buttocks or thighs
Nonsurgical management
Most patients are managed without surgery. The goal is to control pain and keep you active.
- Stay active and avoid long periods of bed rest
- Physical therapy focused on core strength and posture
- Weight management and quitting smoking
- Medications
- Spinal injections for flare-ups
- Heat, ice, and stretching
Surgical options
Surgery is considered only for selected patients with severe, disabling back pain that has not improved after months of nonsurgical care, especially when imaging clearly shows the painful disc level. The most common operation is a spinal fusion, which locks the painful disc level together so it stops moving. Some patients may be candidates for a disc replacement. The decision to operate for back pain alone is complex and should be made carefully with a spine surgeon.