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​Degenerative Disc Disease

Back pain is frustrating. While anyone can have back pain, it's more common as you get older and have more wear and tear on your body.

Degenerative disc disease is one of those problems that can happen with age. Less a disease than a normal part of aging, it's a type of arthritis.

Many nonsurgical treatments can help with degenerative disc disease. But UPMC neurosurgeons also have ways to treat this health issue for people whose pain doesn't improve.

Some people with degenerative disc disease might need surgery at some point. UPMC offers the latest, least invasive types of surgery. We're also experts in traditional surgery for people who need it.

Our spine care team is here for you. Because no one should have to live with chronic back pain.

On this page:

What Is Degenerative Disc Disease?

Though it's called degenerative disc disease, it isn't truly a disease because it affects every person. It's the natural process of the discs in your spine wearing out. Just as knees get sore from arthritis, so does your back.

Your discs cushion your vertebrae (the bones in your spine). These discs absorb shock for your back and enable you to bend, flex, and twist your spine.

Your discs have two layers:

  • A tough, firm outer layer.
  • A soft, jelly-like core.

As you get older, discs start to dry out and lose flexibility, and can't cushion as well. The outer layer can also tear, causing the soft material in the core to leak out.

The disc may then bulge or rupture. Bulging discs and ruptured discs are some of the most common causes of low back and neck pain. Injured discs can press on nerves and cause pain in your back, neck, legs, and even arms.

How common is degenerative disc disease?

Degenerative disc disease is the most common reason for back pain.

By looking at imaging, researchers have found that more than 30% of 20-year-olds have some disc degeneration.

The older you get, the higher the likelihood gets. Most people over age 40 have at least one degenerated disc and 96% of 80-year-olds do.

However, not all people who have degenerative disc disease have pain.

What causes degenerative disc disease?

The main cause of degenerative disc disease is aging.

Other causes of disc degeneration include:

  • Injury to the spine — such as trauma from falls or car crashes.
  • Lifting heavy objects without using the proper technique.
  • Repetitive motions — which can make discs wear out more quickly.

What are degenerative disk disease risk factors?

You may have a greater risk of degenerative disc disease if you have a family history of spine problems or arthritis.

Though you can't control aging or genetics, there are factors you can control. Some things that may increase your risk include:

  • Having a lifestyle where you sit more than stand or move around.
  • Having an unhealthy diet.
  • Not drinking enough water.
  • Smoking.

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What Are the Signs and Symptoms of Degenerative Disc Disease?

Normal activities of life can cause bouts of pain. You might sleep funny or twist too quickly, and your back or neck hurts for a few days. Many of these painful flare-ups go away on their own.

But for some people, disc degeneration causes chronic pain. The most common symptoms are:

  • Foot drop — not being able to raise your foot at the ankle.
  • Numbness and tingling in your legs or arms.
  • Pain in the low back, butt, thighs, or neck.
  • Pain that worsens when you sit, bend, lift, or twist but may get better when you walk, change positions, or lie down.
  • Times of severe pain that gets better in a few days or months.
  • Weakness in your legs or arms.

When should I see a doctor about my degenerative disc disease symptoms?

Your symptoms are your guide for when to see a doctor. Seek care if:

  • Pain gets in the way of daily activities and limits what you can do.
  • You have bouts of pain that keep causing severe discomfort.

You often can start with your primary care doctor. They may prescribe physical therapy or refer you to a specialist.

If you have any of these symptoms, see your doctor right away:

  • Leg weakness.
  • Loss of bowel or bladder control.
  • Numbness or tingling in your legs.

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How Do You Diagnose Degenerative Disc Disease?

To diagnose degenerative disc disease, your doctor will examine you and ask about your symptoms. They'll also ask about past injuries, illnesses, and physical activities that cause pain.

The doctor may test your range of motion and look for:

  • Changes in reflexes.
  • Numbness.
  • Tender spots.
  • Tingling.
  • Weakness.

Tests to diagnose degenerative disc disease

If your doctor thinks that disc problems are causing your symptoms, they may order imaging tests, such as:

  • CT myelogram — Uses contrast dye to better show the structures of your spine.
  • MRI — Shows damage to discs that an X-ray can't see.
  • X-ray — Shows fractures.

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How Do You Treat Degenerative Disc Disease?

At UPMC, we start by trying to improve your symptoms. Our goal is to ease your pain and help you move around better.

Nonsurgical treatments for degenerative disc disease

There are many noninvasive ways to treat disc pain.

At UPMC, we often prescribe:

  • Ice and rest — Ice helps to bring down inflammation. While complete rest (like bed rest) can make the problem worse, taking a break from strenuous activities is helpful.
  • Medicine — Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce swelling and ease pain. These include over-the-counter (OTC) options like ibuprofen (Advil) and naproxen (Aleve). Your doctor may also prescribe a stronger anti-inflammatory.
  • Physical therapy — The focus of PT is to stretch and strengthen your back. It can be very helpful for osteoarthritis, a herniated disc, or spinal stenosis (narrowing of the spinal column).

Most people see pain relief within a month or two with conservative treatment. UPMC's research has found that people who first seek PT or chiropractic care for low back pain have:

  • Better outcomes.
  • Shorter bouts of acute care.

Learn more about physical therapy and other nonsurgical treatments at the UPMC Center for Spine Health.

Surgery for degenerative disc disease

At UPMC, we offer the most advanced surgical treatments for disc problems and debilitating back pain.

Though spine surgery may seem scary, our goal is always to help you have a better quality of life. Most people will not need surgery, but for those who do, it can be life-changing.

Surgery may help if you:

  • Haven't gotten relief from conservative treatments.
  • Have severely limited daily activities.

At UPMC, our neurosurgeons specialize in minimally invasive techniques that may allow for a faster recovery.

When possible, we use an endoscopic approach. An endoscope is a long instrument with a camera at the end. It has a small tunnel the surgeon uses to pass instruments through, often to remove damaged discs.

We also use robotic techniques. With robotics, the surgeon is still in charge but can be even more precise.

What are the types of surgery for degenerative disc disease?

The most common surgeries for people with severe disc degeneration are:

  • Artificial disc replacement — We can replace a damaged disc in your back. The new disc helps you move your spine in a more normal way. It also helps prevent other places in your spine from breaking down because of increased stress.
  • Microdiscectomy — Often outpatient, this technique only requires a small incision. Then, we use microsurgical tools to remove the ruptured part of a disc that's causing pain.
  • Spinal fusion — Spinal fusion stops the motion in the segment of your spine where your pain is. Using a small incision, we remove the disc between two vertebrae then fuse them together.

Medically reviewed by Georgios Zenonos, MD on 9-10-24.