What Is Degenerative Disk Disease?

Medically Reviewed by Jabeen Begum, MD on October 25, 2023
Written by Teresa Dumain, Matt McMillen
10 min read

Degenerative disk disease is when normal changes that take place in the disks of your spine cause pain. Despite its name, this condition isn't actually a disease. Degenerative disk is a condition caused over time by injuries, sports, daily activities, or if a spinal disk dries out and shrinks.

What are spinal disks?

Spinal disks are like shock absorbers between the vertebrae, or bones, of your spine. They help your back stay flexible so you can bend and twist. As you get older, they can show signs of wear and tear. They begin to break down and may not work as well.

Nearly everyone's disks break down over time, but not everyone feels pain. If worn-out spinal disks are the reason you're hurting, you have degenerative disk disease.

 

Disk degeneration typically develops in the parts of your spine that move the most: your lower back or your neck.

Lumbar degenerative disk disease

Your lower back, or lumbar spine, has five vertebrae, which are the largest bones in your back. Doctors refer to them as L1 to L5. Spinal disks separate each of these vertebrae. About 90% of disk problems caused by degenerative disk disease happen in the lowest portions of your lumbar spine.

Cervical degenerative disk disease

This happens in your neck, or cervical spine. Seven vertebrae make up your cervical spine. They are each separated by a spinal disk. Your cervical spine supports all sorts of movements, such as turning your head from side to side and looking up and down. Disk degeneration in this area can make those movements painful and difficult, though many people have no symptoms.

Your spinal disks are made up of a soft inner core and a tough outer wall. The disks change in ways that may cause degenerative disk disease, such as by:

Drying out. When you're born, the disks in your spine are mostly made up of water. As you age, they lose water and get thinner. Flatter disks can't absorb shocks as well. The water loss also means less cushion or padding between your vertebrae. This can lead to other problems in your spine that may cause pain.

Cracking. Stress and strain on your back can cause tiny tears in the outer wall of your disks, which contain nerves. Any tears near the nerves can become painful. And if the wall breaks down, the disk's soft core may push through the cracks. The disk may bulge, or it may slip out of place, which is called a slipped or herniated disk. It can affect nearby nerves. Such tears can be caused by:

  • Daily activities. Wear and tear on your back from the things you do every day, like lifting a heavy laundry basket, picking up a crying child, and working in the garden, can contribute to disk degeneration over time.

  • Injuries. Even minor injuries to your back -- from a fall, for example, or lifting something heavy incorrectly -- make disk degeneration more likely. You may not feel pain at the time of the injury, but their impacts add up over time.

A number of things boost your risk of disk degeneration. Some of them can be avoided, while others can’t be.

Aging. This is the big one. As you get older, your disks begin to degenerate. Some experts estimate that about 9 out of 10 people will show signs of disk degeneration by age 60. But that’s considered normal, and it does not always cause pain or other symptoms. If you do have symptoms, you likely have degenerative disk disease.

Obesity. Several studies have linked being overweight to spinal damage, including degenerative disk disease. Excess weight puts stress on all parts of your spine. If you have obesity and carry the bulk of your weight in your middle, your risk of degenerative disk disease may be particularly high.

Heavy lifting and manual labor. Some research suggests that jobs in which you have to do a lot of heavy lifting may modestly bump up your risk of disk degeneration.

Family history. Did one or both of your parents have degenerative disk disease? If so, you may be at higher risk because it can run in families. Scientists have identified many genes that may increase your risk.

Smoking. Need another reason to quit? Several studies have reported that smoking ups your odds of degenerative disk disease. But that’s not all. If you already have degenerative disk disease, smoking may make it worse. You may feel more pain. If you need surgery, smoking may make you more likely to have complications.

You'll probably feel a sharp or constant pain in your back and neck. Your exact symptoms will depend on where the weak disk is and other changes it has caused.

Common signs include pain that:

  • Feels worse when you sit and better when you move and walk
  • Feels worse when you bend, lift, or twist
  • Gets better when you change positions or lie down

In some cases, degenerative disk disease can lead to numbness and tingling in your arms and legs. It can also cause your leg muscles to become weak. This means the damaged disks may be affecting the nerves near your spine.

The pain, which can be severe, may not be constant. This is because the bone around the injured disk has become unstable. This instability can cause pain that lingers as briefly as a few days or sticks around as long as a few months.

The pain that you feel may range from mild to disabling. The pain starts in the area of your spine where the disk degeneration happens. Lumbar disk degeneration leads to pain in your lower back, while cervical disk degeneration causes pain in the neck. But that pain and discomfort is not always limited to those areas. A degenerated disk can pinch, or compress, the nerves in your spine. If that happens, pain can travel to other parts of your body. A pinched nerve in your lower back can cause pain in your buttocks and thighs, while a pinched nerve in your neck may cause pain in your arms and hands.

Your doctor will talk to you about your medical history and your symptoms. They may ask you:

  • When the pain started
  • Which part of your spine hurts
  • If it has spread to other parts of your body
  • If you've had past spine injuries
  • If you have a family history of similar problems

They'll look at your spine for signs of the condition, like pain in your lower back or neck. They may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

The goal is to ease pain and stop more damage. Your doctor will suggest the best plan for you, based on your symptoms and how serious your condition is. Treatment may include:

  • Medication. Over-the-counter pain relievers like aspirin and ibuprofen can help fight inflammation. They can ease your pain and lessen swelling. Your doctor may prescribe a stronger drug for pain if you need it.

    Degenerative disk disease may also lead to muscle spasms. Your doctor may suggest medicine to help relieve them.

  • Physical therapy. Specific movements make the muscles in your neck and back stronger and more flexible. This supports the spine.

    In most cases, physical therapy and pain medication are enough for long-term relief.

  • Steroid shots. These have strong medications to ease pain, swelling, and inflammation. Your doctor may suggest you get a shot in the epidural space in your back, a fluid-filled area around the spinal cord, or get one in your nerve or muscle.
  • Radiofrequency neurotomy. In this procedure, your doctor will use radio waves to heat and destroy nerve tissues in your spine. This prevents the nerve from sending pain signals to your brain. You may feel immediate pain relief, though it could take up to 3 weeks for the benefits to fully kick in. That pain relief typically lasts 6 months to a year, though it can continue for several years. Unfortunately, some people do not benefit as much as others from this procedure.

Dealing with degenerative disk disease pain

Medical treatments are not the only way to manage your pain. Here are some other things that you should try:

  • Slim down. Excess weight strains your back and raises your odds of nerve damage and pain. Losing weight can help prevent or ease your discomfort.

  • Get a massage. Some research suggests that massages can offer temporary lower back pain relief. Massage may be included in your physical therapy plan.

  • Try TENS.Transcutaneous electrical nerve stimulation, or TENS, is a treatment that delivers small electrical impulses to your body to help ease pain. The treatment shouldn't feel painful, but more like a tingling sensation. You can buy a TENS device over-the-counter and use it at home. Ask your doctor to help you pick out the right TENS device for you and to show you how to use it.

  • Correct your posture. By sitting and standing with a proper posture, you keep your spine in alignment and ease its workload. That can help prevent back pain. Your physical therapist may give you exercises to improve your posture. 

  • Exercise regularly. Lots of different types of exercise can help ease your back pain. These include yoga, tai chi, Pilates, and stretching. Talk to your doctor before you begin a new exercise program.

  • Try hot and cold therapy. Apply a heating pad for 10 to 15 minutes to your back, then swap it out for a cold pack for another 10 to 15 minutes. Do this three to four times daily to ease pain and inflammation.

If other treatments don't work, your doctor may recommend surgery. There are several options to consider, including:

Spinal fusion. In this procedure, the damaged disk is removed and replaced by bone that connects to the bones above and below where the disk used to be. This eases pain and helps your back work better.

Diskectomy. Part of the degenerated disk is removed. This relieves pressure on the nerves, easing pain, numbness, and weakness.

Foraminotomy, laminotomy, and laminectomy. During these procedures, the surgeon removes a portion of bone in your back in order to reach the problem disk and cut out the damaged portion to relieve pressure on the nerves. You may undergo a combination of these procedures.

Artificial disk replacement. Your surgeon will remove the disk that’s causing your pain and replace it with a disk made of metal or metal and plastic. 

You can help your back by avoiding the following:

Smoking. As mentioned earlier, smoking can worsen your pain. It also can make treatment for degenerative disk disease less effective.

Heavy lifting. Lifting heavy weights puts strains and stresses the disks in your back, especially when done frequently, such as for work.

Overdoing it with alcohol. Excessive drinking raises your risk of back pain.

Sitting for long periods. Your back will feel better when walking rather than spending too much time at your desk or on your couch.

High impact exercise. Exercises and sports that involve running, jumping, twisting, and other high-impact movements -- think football, weightlifting, tennis -- can be hard on your back. Try low impact exercises like walking and swimming instead.

While you can’t stop getting older -- the No. 1 risk factor for degenerative disk disease -- you can make some changes that may help prevent or slow the damage to your spinal disks:

  • Maintain a healthy weight.

  • Quit smoking, or don’t start.

  • Get regular exercise to keep your back strong and flexible. But always talk to your doctor before beginning a new exercise program.

Degenerative disk disease is a condition where your spinal disks break down with age and daily activity. Regular, low-impact exercise like swimming or yoga can help prevent the onset or slow the progression of the condition. While there are many nonsurgical and at-home treatments you can take to manage your pain, surgery may be necessary for long-term relief. Talk with your doctor to figure out the best treatment plan for you.

  • How serious is degenerative disk disease?

    Disks degenerate as you age. It’s a natural part of getting older, and you may not develop symptoms. But the degeneration can cause severe, even disabling pain. See your doctor if you develop any of the symptoms mentioned above.

  • What can be done for degenerative disk disease?

    Lifestyle changes, such as weight loss and exercise, can ease your symptoms. Ibuprofen, aspirin, and other over-the-counter pain relievers also can help, as can steroid anesthetic shots. Your doctors have other treatments, including surgery, in their toolbox.

  • What triggers degenerative disk disease?

    Lots of things up your odds of degenerative disk disease, but older age is the main risk factor. Most people over 60 show some signs of disk degeneration. Back injuries, even minor ones, and activities that put strain on your back can add up over time and contribute to degenerative disk disease. So can obesity. And, finally, if it runs in your family, degenerative disk disease may be in your future.

  • What are the four stages of degenerative disk disease?
  1. Dysfunction. The disks have begun to degenerate, and you may develop mild to moderate pain.
  2. Dehydration. At this stage, your spinal disks begin to dry out. This causes them to lose flexibility and some of their height. Your pain may worsen at this stage and become an everyday experience.
  3. Stabilization. Your spine attempts to stabilize itself. This can lead to spinal stenosis and more severe pain.
  4. Collapse. As the disks continue to shrink, the bones in your spine rub together and the damaged disks press against nerves. This causes severe pain.