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Sadly, there is no cure for degenerative disc disease (DDD). Medical treatment for degenerative disc disease targets the symptoms of the disease in an attempt to reduce pain and dysfunction.

Surgery for degenerative disc disease can be nearly curative in that it can reduce or eliminate symptoms at affected spinal levels. Unfortunately, however, patients who are predisposed to degenerative disc disease tend to have disease in multiple spinal discs over time, which may necessitate multiple spine surgeries. In this article, we review what you need to know about degenerative disc disease.

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What is Degenerative
Disc Disease

While the precise definition of degenerative disc disease may vary, it is generally defined as structural changes in at least one intervertebral disc that causes pain or certain other symptoms. The reason the widely used definition of degenerative disc disease requires both disc abnormalities and symptoms is because some people will have severe disc abnormalities on MRI and not have symptoms. Because treatment is not needed until symptoms occur, the diagnosis of degenerative disc disease usually requires the presence of at least one symptom of the disease.

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What Causes Degenerative
Disc Disease

The most common causes and risk factors of degenerative disc disease are age, physical strain, genetics, and inadequate nutrition.

Risk Factors for Degenerative
Disc Disease

Age. Age is by far the most common risk factor for degenerative disc disease. Just like every other part of the body, our spinal discs age. An aging spinal disc loses water and structural integrity, which makes the disc more susceptible to rupture and herniation.


Genetic predisposition. Like aging, we cannot control our genetics. Degenerative disc disease is well known to run in families; thus, there must be one or more genes that predispose to degenerative disc disease. If you have relatives with degenerative disc disease, there is a reasonable chance you will, too.


Mechanical stress. Mechanical stress causes degenerative disc disease by stressing and straining the spinal discs. We know this because people in certain professions are more likely to develop degenerative disc disease than people in other professions. For example, degenerative disc disease is more common in long-haul truck drivers and carpenters than in office workers or school teachers. Interestingly, repeated stresses (carpentry) or long periods of inactivity (long-haul trucking) are both bad for spinal health.


Obesity. Excess weight puts excess strain on the spine, meaning the spinal discs have to withstand greater forces. Indeed, people who carry excess weight are at increased risk for degenerative disc disease.


Inadequate nutrition. Fortunately, most Americans get all of the calories, vitamins, and mineral they need from their diets. However, the blood vessels around the spine do not always deliver nutrient-rich blood to the places that need it. This is likely related to age but may also be related to diseases that damage small blood vessels, like diabetes.


Smoking. Smoking appears to speed up the process of disc aging, making them more prone to degenerative disc disease.

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Types Of Degenerative
Disc Disease

Risk Factors for Cervical
Degenerative Disc Disease

Cervical degenerative disc disease is wear and tear of the spinal discs in the neck that causes symptoms. The cervical spine includes vertebral bones from C1 to C7, but the discs that can be affected are below C2, C3, C4, C5, C6, and/or C7. Cervical degenerative disc disease typically causes neck, shoulder, and arm pain, as well as tingling, numbness, and weakness in one arm or the other.

Thoracic Degenerative Disc Disease

Thoracic degenerative disc disease affects the spinal discs in the middle of the back. The thoracic spine includes vertebral bones from T1 to T12, but the discs that can be affected are just below each of these levels. Because the thoracic spine does relatively little bending and stretching, thoracic degenerative disc disease is rather uncommon. If it causes symptoms, thoracic degenerative disc disease causes upper back pain rather than lower.

Lumbar Degenerative Disc Disease

Lumbar degenerative disc disease affects the spinal discs in the lower back. The lumbar spine includes vertebral bones from L1 to L5, but the discs that can be affected are below L1, L2, L3, L4, and/or L5. Lumbar degenerative disc disease typically causes lower back and leg pain, as well as tingling, numbness, and weakness in one leg or the other.

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How Fast Does Degenerative Disc Disease Progress?

It is impossible to predict how quickly degenerative disc disease will progress. In some, the process takes more than 20 years. In others, symptoms may occur within a few years of anatomic changes. People with more risk factors are more likely to have a faster progression of degenerative disc disease, in general.

What are the Stages of
Degenerative Disc Disease

While there are no true stages of degenerative disc disease, the disease process does tend to progress in three phases: dysfunction, relative instability, and re-stabilization.


Stage 1: Dysfunction. If you could look directly at the spinal disc during this stage, you would see small tears in the outer layer of the annulus fibrosis (outer ring of the spinal disc).


Stage 2: Relative instability. The nucleus pulposus (inner disc material) starts to extend beyond the annulus fibrosis.


Stage 3: Re-stabilization. Bone spurs appear at the edges of the disc, essentially fixing the damage in place. The patient may no longer have dysfunction, but the height between the spinal bones is shorter, and the disc is more likely to rupture in the future.

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What is the Best Treatment for Degenerative Disc Disease

The best treatment for degenerative disc disease is the one that works for you. Unfortunately, it is difficult to know which treatment will work for which person. Therefore, spine surgeons take a phased approach to degenerative disc disease that escalates if one phase is unsuccessful. In most cases, the first best treatments for degenerative disc disease are conservative measures, such as selective rest, low-impact exercise, non-opioid pain medications, smoking cessation, and physical and occupational therapy.

If conservative measures fail to provide relief, the next best treatments for degenerative disc disease are non-surgical interventions such as steroid injections, manual manipulation (chiropractic), and massage therapy.

If non-surgical interventions fail to provide relief, the best and potentially curative treatment for degenerative disc disease is a surgical intervention. The two main surgical interventions for degenerative disc disease are spinal fusion or artificial disc replacement. Both procedures reduce symptoms by removing the damaged or diseased disc, but artificial disc replacement preserves a degree of spinal mobility that spinal fusion cannot.

Degenerative Disc Disease:
Commonly Asked Questions

Can I play golf with Degenerative Disc Disease?

Yes, but it may be more difficult. Degenerative disc disease may also affect your golf game. A golf swing, particularly teeing off, puts tremendous stress on your spine. Many people with degenerative disc disease find that playing golf makes their pain and symptoms worse. Moreover, this pain can negatively affect their golf handicap. So, while you can play golf with degenerative disc disease, you may not always have the best game.

Can you become paralyzed from degenerative disc disease?

Yes, it is possible to become paralyzed from degenerative disc disease, but unlikely. In cauda equina syndrome, for example, a severe lumbar disc herniation causes saddle anesthesia, mobility issues, and urinary and fecal incontinence. If left untreated, it can cause permanent paralysis.

Is walking bad for degenerative disc disease?

No. Walking can actually be good for mild to moderate degenerative disc disease. Walking, like water aerobics and yoga, is a low impact form of exercise. Low-impact exercises can help strengthen your back muscles and improve flexibility. That being said, people with degenerative disc disease should speak with a spine surgeon or physical therapist before starting exercises to treat degenerative disc disease.

Can degenerative disc disease cause headaches?

Surprisingly, yes, degenerative disc disease can cause headaches in some cases. While uncommon, patients who have degenerative disc disease that affects the nerve or nerves in the upper cervical spine can experience headaches, eye pain, and ear pain. However, people with chronic or severe headaches should speak with a physician to determine if some other cause of headaches is to blame.


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