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    At A Glance

    • Degenerative disc disease is a common term that refers to the natural spinal degeneration process, called the “Degenerative Spine Cascade.”
    • The structures involved are the vertebral body endplates, the intervertebral disc, the facet joints, and the surrounding ligaments, tendons and muscles.
    • The spinal cord, spinal nerves and spinal blood vessels can be involved as well.
    • As with all other medical conditions, the key to successful treatment is early and accurate diagnosis.
    • Also called internal disc disruption, acute annular tear, black disc disease, discogenic pain syndrome, axial low-back pain


    Symptoms of Degenerative Disc Disease

    Deep, constant pain. “Deep,” “grabbing,” “nauseating,” and “unrelenting”  are terms patients have used to describe the level of discomfort. These periods of pain will come and go. Depending on the severity of disc degeneration, they may last from a few days to a few months before.  Severe muscle spasms can also accompany painful degenerative discs.

    Back pain or neck pain. Depending on the location of the degenerated disc(s), you will either feel back pain or neck pain. Degenerative disc disease pain should only affect the neck, back, buttocks and sometimes the thighs and groin area. Nerve pain or sciatica is usually not present.  Pain from degenerative disc disease can often be mistaken for hip disease.

    Pain when sitting. While in a seated position, pain from degenerated discs will generally become worse. The discs are under greater stress loads while you are seated then when you are standing. Walking and standing in one position can also be symptomatic.  Similarly, lying down and taking the load off painful discs can reduce pain.


    Anatomy & Causes

    Spinal disc degeneration can occur at any level of the spine and at different points in time. This natural deterioration is known as the Degenerative Spine Cascade, which describes this natural process of spinal degeneration, the accompanying symptoms, and the available treatments.

    Spinal degeneration, also called spondylitis and spondylosis and is more commonly known as “arthritis of the spine.”  Ninety percent of the population will develop it to some extent throughout life. It can start as early as the teenage years and can last a lifetime.

    Doctors believe the process starts as an injury to the outer rings of the disc called the annulus fibrosis.  There are 24 spinal vertebrae and 23 spinal motion segments (a vertebrae above and below with an intervertebral disc in between).  The annulus is much like a ligament in that it connects two vertebrae and seals the disc space between them.

    If the injury tears the annulus, like a torn ligament, it will affect the disc’s physical properties and cause pain.  It can also cause instability allowing the vertebrae to move too much.

    This will also affect the internal structure of the disc called the nucleus pulposis – or the “biological sponge”.  When both structures are damaged, degeneration of the disc occurs over time, especially if there are recurrent injuries.

    When injuries occur and reoccur, the disc has very limited capabilities to heal itself due to the fact that the internal structure of the disc does not have a blood supply, much like the joints in our extremities.

    Healing and normal function have to rely on complex chemical reactions in the disc space and that ability is lost during the degenerative process.

    The three phases in the degenerative spine cascade are the injury phase, the instability phase, and the stabilization phase. It can take 10 to 40 years to go through these phases.

    About 90 percent of people with degeneration experience no symptoms and are unaware that anything is happening.  The final phase of disc degeneration is disc space collapse and natural fusion, or stabilization.  If multiple discs undergo this process, it can result in a loss of height of up to several inches.

    Common findings associated with degenerative disc disease include:

    Black Disc. A radiological term for how an abnormal intervertebral disc appears on an MRI scan.

    Desiccated Disc. Desiccation means “to dry up.” In a young person, the nucleus of an intervertebral disc has high water content, and appears as a bright white signal on an MRI scan (the opposite of the black disc above).

    The chemical structure of the nucleus changes with age, and the nucleas dries up as part of the degenerative process. It loses its ability to serve as a biological sponge to absorb water and act as a hydraulic shock absorber.

    Inflamed Disc. This is a term from magnetic resonance imaging (MRI), describing inflammatory changes identified in the vertebral bone called the endplates on either side of the intervertebral disc. They are also called “Modic Signs” after the radiologist who first discovered them.

    The clinical significance of these finding are still unclear but may have some association with symptomatic patients that have degenerative discs or discogenic pain syndrome.

    Symptomatic degenerative disc disease is usually diagnosed as a process of exclusion.  Other potentially serious conditions are ruled out such as a fracture, infection, tumor, herniated disc, spinal stenosis, or cancer.

    Testing usually includes MR scans, X-rays, bone scan, blood tests, and a test called a discogram.  Discograms, or discography, is an interactive and invasive test that tries to accurately determine if a person’s pain is originating from the disc space by placing a needle into the disc using television x-ray and injecting a special dye.

    This test will usually reproduce a person’s pain if the disc is problematic.  This is called finding the “pain generator”.

    Learn about Degenerative Disc Disease treatment options.

    Frequently Asked Questions

    What can I do to help keep my back healthy after treating my degenerative disc disease?
    Does all degenerative disc disease require treatment?
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    Treatments for Degenerative Disc Disease

    It is important to understand that doctors currently do not have a cure for spinal degeneration and the many conditions associated with this process such as degenerative disc disease.  There is not a consensus among physicians and surgeons on what the best treatment should be, if any.

    Patients are always encouraged to seek second opinions especially if surgery is recommended.  On the positive side, this may be the first spinal condition that can be successfully treated with adult stem cell therapy.  There are studies currently being done and early results are encouraging!

    Since degenerative disc disease essentially includes almost all areas of spinal medicine, there are many treatment approaches.  The following offer a range of possible treatments for symptoms associated with painful degenerative disc disease. Click on the treatment to learn more about it.

    Non-Surgical Treatments

    Pain Management

    Surgical Treatments

    OTC Medicine
    Water Exercises
    “Core” Exercise Program Including Pilates and Yoga
    Aerobic Conditioning and Personal Training
    Intradiscal Electrothermic Therapy
    Nucleous Replacement Disc Stabilization Arthroplasty
    Artificial Disc Replacement
    Artificial Facet Replacement


    Frequently Asked Questions

    Will treatment “cure” degenerative disc disease?
    more faqs »