Diagnosis and symptoms6 min read
What is degenerative disc disease, and why is the name misleading?
Degenerative disc disease describes the loss of water content and height in the lumbar discs with age. Frequently appearing in MRI reports, the phrase is usually perceived as far more serious than it is because of the word 'disease'.
Why it is not a 'disease'
Disc degeneration begins in almost everyone from their thirties. It is found on MRI in most people over fifty, and a significant proportion of that group have no symptoms at all.
Calling a process that occurs in everyone a 'disease' is like calling greying hair a disease. The term is established in the literature but misleads in patient communication.
Sharing this is part of the treatment. A patient avoiding movement because they believe their disc is 'wearing away' genuinely worsens the picture through muscle loss.
What changes in the disc
A disc consists of a strong outer ring and a gel-like inner core. With age the core's water content falls and the disc flattens.
As disc height reduces, the vertebrae come closer and part of the load shifts to the facet joints behind. That shift is usually the mechanical source of pain.
The process is slow and advances over years. Smoking, inactivity and prolonged heavy loading are modifiable factors that accelerate it.
Symptoms and the MRI relationship
The typical complaint is dull low back pain increasing with prolonged sitting and forward bending. Easing with movement and changes of position is normal.
Morning stiffness is common and usually resolves within thirty minutes. Stiffness lasting hours calls for assessment of an inflammatory process.
No reliable relationship has been shown between the degree of degeneration on a report and the severity of pain. For a finding to be meaningful it must match symptoms and examination.
Key points
- Despite the name, it is an age-related process occurring in everyone.
- It begins in the thirties and is found in most people over fifty.
- As the disc flattens, load shifts to the facet joints.
- Smoking and inactivity are modifiable factors that accelerate it.
- There is no reliable link between degree of degeneration and pain severity.
Frequently asked questions
Can I stop it progressing?
The age-related process cannot be stopped. Factors affecting its pace can be managed, however: stopping smoking, regular movement and trunk endurance.
Does it turn into a herniation?
The likelihood is somewhat higher in a degenerated disc but it is not inevitable. Most people with degeneration never develop one.
Does it reduce height?
Reduced disc height can contribute to a few centimetres of height loss over years. Rapid height loss suggests vertebral fractures and should be assessed separately.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.