Degenerative Disc Disease Isn't a Disease

“You have degenerative disc disease.”

I regularly saw patients who’d been told that they had “arthritis, bulging discs, herniated discs, bone on bone, ruptured discs or degenerated discs”. They were terrified that they would become increasingly disabled and needed to be especially protective of their spines. Surgeons could be aggressive in pointing out how their lifestyle might become quite limited or they might end up in a wheelchair without surgery.

We know that if you view any body part as “damaged”, you’ll tend to focus on it and the sensations from that area become magnified. Then the next logical step in thinking your spine is “a disaster” is to be worried about becoming paralyzed and again surgeons will often state this. None of this is true. We generally don’t know the exact source of neck/thoracic/back pain (axial pain) most of the time. But we actually do know that the discs between the vertebrae are not the source of chronic pain.

Discs lose water content and become stiffer as we age. Since MRI scans are dependent on the signals created by water, less hydration means less signal and a darker disc on scan. That’s it. That is all it means. It doesn’t mean it’s a source of pain. A more accurate term for this condition would be “normally aging discs” instead of “degenerative disc disease.” It’s not a disease.

You do stiffen up as you age

A less flexible spine doesn’t correlate with a painful spine. There have been multiple studies done in the cervical, thoracic, and lumbar spine demonstrating that there is little correlation between a degenerated, herniated, bulging, or ruptured disc and back pain. For example, if you randomly study 100 people who have NEVER experienced significant low back pain, by age 50, the majority of them have bone spurs, herniated or ruptured discs, disc bulges, or “degenerative disc disease”. By age 65, it approaches 100%.

There was a study done in the 1950’s that showed that after a disc operation, the chance of having low back pain after surgery was less if there was more degeneration of the disc and therefore less motion.