The pain in your back or neck isn’t going away. You’ve tried resting, stretching, and maybe even some over-the-counter pain relievers. Perhaps you saw a doctor and heard the words “degenerative disc disease.” So now you’re trying to figure out what that means. Is it serious? Will it get worse? What can you actually do about it?
Living with this kind of chronic spinal pain can be exhausting. It affects everything. Your work. Your sleep. Your ability to do everyday things like bending over to tie your shoes or sitting comfortably through a long meeting. It’s natural to worry about what this all means for your future.
Here’s what we want you to know: You have options when it comes to back and neck care. At Henry Community Health, our team of experts has years of experience helping people understand what’s really happening and explore care options.
In this guide, you’ll hear from Andrew M. Davisson, MD, one of those experts who works with patients dealing with disc degeneration every day. He shares insights from his practice to help you understand this condition and the treatments that might work for you. Read on to find out more about:
- What is degenerative disc disease?
- Disc degeneration symptoms
- How doctors diagnose DDD
- Intervertebral disc degeneration treatments
- FAQs about degenerating discs
- Back and neck care at HCH
Keep reading to learn more about what’s actually happening in your spine if you have this condition, what’s involved in the diagnosis process, and how different treatments can help you get back to doing what you love.
What is degenerative disc disease?
Degenerative disc disease is a common condition that describes age-related wear and tear on one or more of the 23 intervertebral discs in your spine. These discs act like shock absorbers. They provide spongy, cushioned support between the spine’s bones (vertebrae).
Over time, these spinal discs can lose moisture, becoming thinner and developing small tears. When these things happen, you might experience back or neck pain, stiffness, or periodic flare-ups.
Degeneration of discs occurs most commonly in two areas: the lower back (lumbar spine) and the neck (cervical spine). The condition can also affect the mid-back (thoracic spine), but this type is much less common.
Other terms for degenerative disc disease
There are several names for degenerative disc disease. You might also hear it called disk degeneration, degenerating disk disorder, disc degeneration disease, intervertebral disc degeneration, or even spinal disk degeneration. All of these different terms refer to the same condition.
How disc degeneration affects different people
How degenerative disc disease affects you can vary widely from person to person. Some people have noticeable symptoms that limit their daily activities. Others have disc degeneration visible on imaging but experience no pain at all.
“In some patients, they can have degenerative disc disorder, and it may not be noticeable,” says Dr. Davisson. “It doesn’t necessarily cause pain or dysfunction. Many people walking around who might say, ‘I have no back pain,’ may actually have some element of disk degeneration, and they don’t know it.”
This wide variation in how symptoms show up is precisely why treatment plans are tailored to your individual situation. Each patient’s goals matter. For some, that might be just reducing pain and improving mobility. For others, that might mean improvements that also allow them to get back to work or the activities they enjoy.
“Each of my patients is unique,” says Dr. Davisson. “And, every person has their own set of distinctive circumstances. The most important thing for me is really listening when they come in. I want to hear your story, learn about the nature of your pain and when it bothers you, and understand what you need and want out of treatment.”
Understanding the condition’s progression
The name can make the condition sound worse than it is. While discs do gradually wear down over time, this is a natural process that affects everyone as they age. Having degenerative disc disease on imaging doesn’t mean you’re destined for worsening pain or disability.
Many people find significant relief through lifestyle changes and conservative treatment options. Surgery is rarely needed.
“Degenerative disc disease is probably the most common condition of the spine. In fact, throughout our lifetimes, we’re all guaranteed to have some level of disc degeneration.”—Dr. Andrew Davisson
Causes of neck and back pain from degenerative discs
Several factors contribute to disc degeneration. The most common culprit behind degenerative disc disease, as already mentioned, is aging, since as we get older, our discs naturally lose water content and become less flexible.
“A disc is full of gel,” says Dr. Davisson. “Typically, what happens first is that the gel in a disc becomes dehydrated. The gel is mostly water, so when it becomes slightly dehydrated, it will lose some of its cushion and, subsequently, some of its height. Over time, as it loses more of that height, there’s less space between the vertebrae. That can create local inflammation and swelling.”
This process starts as early as our 20s or 30s for some people. Symptoms may not appear until later, though. Beyond aging, several other factors can accelerate disc degeneration:
- Daily wear and tear: Years of everyday activities, such as bending, lifting, and twisting, gradually cause stress on your spinal discs.
- Genetics: Some people are more prone to disc problems due to their family history.
- Smoking: Tobacco use can reduce oxygen supply to discs and speed up degeneration.
- Repetitive motions: Jobs or sports that involve repeated lifting, twisting, or high-impact activities can accelerate disc wear.
- Previous injuries: A back or neck injury can sometimes trigger or worsen disc degeneration.
- Body weight: Excess weight places additional stress on the discs in your lower back.
Disc degeneration symptoms
Symptoms linked to degenerative disc disease vary widely. Some people experience background stiffness and a dull ache. Others have periodic, sharper flares. As Dr. Davisson notes, some individuals with disc degeneration that shows up on imaging will exhibit no symptoms at all.
When symptoms do appear, they typically show up in one of three ways: in the lower back, in the neck, or as nerve-related sensations that travel from the spine into your limbs. The location and type of pain often depend on which part of your spine is affected.
Signs in your lower back
The symptoms of degenerative disc disease in the lower back include a dull, band-like ache and a stiff, tight feeling. Patients sometimes notice this pain after bending, lifting, or twisting. People also report feeling discomfort and stiffening up when they get up after extended periods of sitting or when trying to roll over in their beds.
The pain typically remains in the lower back or upper buttocks region. It doesn’t consistently travel below the knee. This localized pattern helps distinguish degenerative disc disease from sciatica, where pain radiates down the leg.
Signs in your neck
When disc degeneration affects the cervical spine, the most common symptom is an achy or stiff neck. This can include pain between the shoulder blades. It can make it hard to turn your head. People with neck disc issues typically experience pain with specific movements, such as looking up.
Extended periods in one position can worsen symptoms. Think road trips where you’re driving for a long time or long workdays of staring at a computer screen for hours on end. Some people also experience headaches that start around the base of the skull.
Nerve-related signs
Sometimes, degenerative disc disease causes nerve-related symptoms that travel beyond the spine. These sensations can include pain, tingling, or numbness. They can signal that a nerve is being affected by the changes in the disc.
In the lower back, these symptoms tend to move from the spine into the buttocks and down the leg. This is often called sciatica. In the neck, nerve-related symptoms can travel into the shoulder, arm, or hand.
“If it’s a radicular pain, meaning it’s going down the arm or going down the leg, typically that’s a nerve that’s being pinched or compressed,” says Dr. Davisson. “Either by the disc itself or something next to the disc.”
These sensations can come and go during flares. You may notice them more frequently during specific activities or positions. You may find relief by changing what you’re doing.
Red flags and when to call your specialist
Dr. Davisson tells his patients to pay attention to patterns. Most flare-ups will subside with rest and by switching to gentler movements.
New or rapidly worsening symptoms deserve attention. Most symptoms from degenerative disc disease are manageable with treatment. However, certain warning signs warrant prompt medical attention. Contact your specialist the same day if you experience:
- Clearly worsening numbness or tingling
- New weakness in an arm or leg
- Rapidly escalating pain that isn’t responding to your usual measures
- Fever along with spine pain
- New pain after a fall or accident
Seek urgent or emergency care immediately for:
- Trouble controlling your bladder or bowels
- New urinary retention or numbness in the groin or saddle area
- Sudden inability to walk or use a limb
- High fever with severe spine pain
“More red flag symptoms are things that are in addition to an intensification of normal pain, such as weakness or dysfunction of the use of your arm or leg, or falling because your leg won’t hold your weight,” says Dr. Davisson “Particularly worrying is someone that says they have a new numbness in the groin or can’t tell whether or not they need to use the restroom or have incontinence.”
“Those symptoms are significant red flags of an emergency, but they occur very rarely. More than 90% of the time when someone has worsening back pain that we would consider a flare-up, it’s not something that requires seeking emergency care right then and there.”
How doctors diagnose DDD
When diagnosing degenerative disc disease, a specialist considers many things—from your medical history and findings from a targeted physical exam to imaging results that can help confirm what’s suspected to be the cause of your symptoms.
What happens during your appointment
At a consultation appointment with a specialist, the doctor will likely begin the conversation by asking detailed questions about your medical history and symptoms you’re experiencing, such as:
- Where is the pain? What makes it better or worse?
- How long has it been going on?
- Have you had similar episodes before?
- What are the demands of your work or sports activities?
- What treatments have you tried already?
Your answers to these questions help paint a complete picture of what’s going on. The appointment will also include a physical examination, which will allow your doctor to observe your posture and movement. They may assess your spine’s range of motion and gently test the strength and sensation in your arms and legs. They may also perform specific maneuvers designed to reproduce or ease your symptoms as a way to pinpoint your pain’s source.
Imaging, blood tests, and other studies
Most of the time, doctors will obtain imaging because it can help confirm the diagnosis of degenerative disc disease. They may request an X-ray (which can show overall alignment and disc height) or MRI imaging for more detailed analysis (which can show detailed views of your discs themselves and nearby nerves).
In rare cases, your specialist might request blood tests or other studies if they suspect an infection, inflammatory disease, or another underlying condition is causing your symptoms.
What you have to say
Many people have disc changes visible on scans that don’t cause any symptoms. That’s why your doctor will combine what you say along with exam findings, medical history information, and imaging results to develop a treatment plan to ensure their recommendations give you the best chance of relief.
“Your story matters more than any imaging or any diagnostic tests we can run,” says Dr. Davisson. “I listen to my patients’ stories and correlate what they tell me about their experiences and symptoms with what I can see on their imaging results before diagnosing them with degenerative disc disease.”
“Whether it’s disc degeneration or a pinched nerve, everything together is what gives me the confidence to tell a patient here’s how you’re likely to respond if we decide to try treating your condition this way or that way.”—Dr. Andrew Davisson
Related terms you might hear
As you go through the diagnostic process and your specialist goes through the process of figuring out what’s causing your pain, you may hear several medical terms. Here’s what they mean:
- Discogenic pain: This is the term used to describe pain that originates from the disc itself (rather than from surrounding structures) as a result of losing height/becoming dehydrated, and it is now causing local inflammation and pain in the spine.
- Bulging disc: This condition (which is a common finding on imaging and doesn’t always cause symptoms) occurs when a disc extends beyond its normal boundary, but it hasn’t torn through its outer layer.
- Herniated disc: More severe than a bulging disc, this condition happens when the inner gel-like material of a spinal disc pushes through a tear in the outer layer. “There’s a difference between degenerative disc disease, which is typically noticed as back or upper hip pain, and having a herniated disc,” says Dr. Davisson. “A herniated disc bulges into a nerve and then, by way of pinching on the nerve, the disc causes pain down your leg.”
- Spondylosis: This is a general term for age-related wear and tear affecting the spine, which includes disc degeneration, bone spurs, and arthritis.
- Spinal stenosis: A narrowing of the spaces in your spine (due to disc degeneration and/or arthritis) over time can put enough pressure on your nerves to cause radiating pain.
- Facet joint arthritis: In some patients, the small joints at the back of the spine can develop arthritis alongside disc degeneration, contributing to the development of back pain.
Intervertebral disc degeneration treatments
Care for degenerative disc disease at HCH is always tailored to each patient. Most people begin with non-surgical options, and many find significant improvements without requiring more invasive treatments.
For those who need additional help, several degenerative disc treatments are available, ranging from targeted steroid injections to innovative options, such as the VIA Disc NP procedure. In select cases where these haven’t provided adequate relief, surgery may be recommended.
How treatment decisions are made
Treatment recommendations depend on several things, such as:
- The severity of your symptoms (and how long you’ve been experiencing them),
- What you’ve already tried,
- Your current health and medical history, and
- Your personal goals.
The goal is to find sustainable solutions that work for your lifestyle, not just offer up temporary fixes.
“I tell patients I’m looking to do the least amount to get you the ‘most better’ to meet your quality of life and functional goals. I’m never going to tell someone that one specific treatment is their only option.”—Dr. Andrew Davisson
Dr. Davisson says doctors will meet their patients where they are in their pain journey because they know that by the time patients see a specialist about their neck or back issues, they’re ready for solutions. This isn’t usually pain that just started yesterday. They may have tried to manage it on their own for months. They’ve seen their primary care provider. They’ve bought every over-the-counter remedy available.
Non-surgical care
For many people, conservative care provides meaningful relief.
Physical therapy and exercise
Gradual mobility exercises and strengthening play an essential role in managing symptoms. “All the muscles in our core and along your spine are what protect the back and neck from the wear and tear damage,” says Dr. Davisson. “Creating and maintaining a strong core helps stabilize and support the spine.”
Physical therapy offers guided movement to restore motion, helping you build core strength and teaching you strategies for managing flare-ups on your own.
However, PT isn’t always the first step. When patients come in unable to walk from their bedroom to the kitchen without hurting, beginning care with physical therapy can feel overwhelming. In those cases, doctors often treat patients’ symptoms first.
Once degenerative disc disease symptoms are under control and improving, then it’s time to start physical therapy for strengthening and building a solid foundation that can help prevent recurrence.
Targeted pain injections
If your symptoms continue to limit your daily life despite trying other non-surgical approaches above, your specialist might recommend targeted pain injections. They can potentially reduce pain enough to allow you to resume physical therapy and your day-to-day activities.
For nerve-related symptoms (such as pain that radiates down your leg or arm), epidural steroid injections can reduce inflammation around the affected pathway. If pain stems from a different source (such as facet joint arthritis that is coexisting with disc degeneration), other types of image-guided injections might be more appropriate.
The goal with epidural steroid injections is 80% or more pain relief for at least six months. Sometimes individuals with degenerative disc disease experience relief for one to two years or occasionally longer. When relief doesn’t meet that threshold, it may be time to consider other options.
With steroid injections, as soon as the steroid is out of the system, if the root cause hasn’t been addressed, the inflammation recurs, and that’s when patients often report needing injections two or three times a year.
If the relief isn’t significant enough or lasts for too short a time, it may be time to consider alternative degenerative disc treatments. For Dr. Davisson specifically, he is only willing to continue recommending injections for patients under two conditions:
- Does the patient feel like they are helping them?
- Does his patient feel they’re worth it?
VIA Disc® NP
VIA Disc NP is an innovative, minimally invasive treatment that’s different from traditional injections for degenerative disc disease. Rather than just managing symptoms, the VIA Disc NP procedure solves the issue because the NP injection restores disc height and hydration to the degenerated disc.
The VIA Disc NP injection, which is the only procedure of its kind for revitalizing discs, uses an allograft (a processed, natural disc material from a human donor) to rehydrate and restore tissue loss.
“When you have a flat tire, your car won’t function right and you won’t get good gas mileage until you refill it,” says Dr. Davisson. “The same is true for a degenerated disc. We can do other injections to treat the symptoms caused by disc degeneration, or we can blow up your tires and use the VIA Disc NP procedure, which will actually fix the root cause of your problem.”
Who benefits from VIA Disc NP injections?
The ideal candidates for VIA Disc NP injections are patients with chronic, deep aching pain in the lower back that comes from disc degeneration.
“If a patient’s primary concern is sciatica, this is not the procedure for them,” says Dr. Davisson. “VIA Disc NP is not for neuropathy. It’s not for nerve pain down your leg. VIA Disc NP is for chronic low back pain from degenerative disc disease that hasn’t resolved with more conservative measures.”
VIA Disc NP isn’t appropriate for patients with a suspected or confirmed infection, significant spinal instability, large herniation with progressive neurologic loss, uncontrolled medical issues, or if they’re unable to participate in post-procedure activity progression.
What happens during a treatment using VIA Disc NP?
VIA Disc NP is an outpatient degenerative disc procedure. “The injection only takes about five minutes,” says Dr. Davisson, who performs it using X-ray guidance to ensure precise placement.
“You’ll walk in and walk out the same morning. You’ll have three days of kind of taking it easy after, and then you’ll be back to your routine—even if that means you work in a construction or at an assembly-line type job where you’re lifting repeatedly.”
What are common concerns about the VIA Disc NP allograft?
The use of human donor tissue is one of the most common concerns that patients raise with Dr. Davisson. Some of his patients worry about rejection, like with a liver transplant or a heart transplant. Others worry about contracting hepatitis or HIV. His answer is reassuring.
“We’ve had zero cases of any of those issues,” says Dr. Davisson. “In fact, because discs aren’t well vascularized (meaning, they don’t have a good blood flow), there’s no risk of rejection. And this material, when it’s made, is thoroughly examined to ensure that the donor material doesn’t have any of those conditions. The VIA Disc NP procedure is very safe.”
What results are typical after getting a VIA Disc NP injection?
VIA Disc NP results for relieving symptoms of degenerative disc disease can be long-lasting.
“The research findings from studies have been promising. There’s clinical data from three to five years out showing 80% of patients won’t need a repeat VIA Disc NP injection in that time frame.”—Dr. Andrew Davisson
What are the pros and cons of VIA Disc NP?
Some of the benefits of getting a VIA Disc NP for treating degenerative disc disease include:
- It’s a minimally invasive procedure,
- It offers a quick recovery time, and
- It addresses the underlying problem rather than just masking symptoms
After one injection, patients have the potential to resolve their back pain and return to full function—without needing ongoing treatments or more invasive surgery.
Dr. Davisson explains that, with X-ray guidance and experienced physicians, “we’ve had excellent outcomes with next to no side effects or adverse events.” That said, like any medical procedure, though, VIA Disc NP carries potential risks, such as:
- Bleeding,
- Infection, or
- Nerve injury.
Additionally, although currently not all insurance plans cover the new procedure as a treatment for disc degeneration, Medicare and some commercial insurers do provide coverage.
HCH’s expertise with VIA Disc NP
Henry Community Health is at the forefront of degenerative disc treatments and one of the few healthcare organizations in the U.S. offering the advanced VIA Disc NP procedure. “Dr. Taylor and I have done more VIA Disc NP injections in our practice than any other location in the state, or—for that matter—in the Midwest,” says Dr. Davisson.
HCH is also one of only 20 clinical sites nationwide participating in a level one randomized controlled trial for VIA Disc NP. “From New York to California, our practice in New Castle, Indiana, is a part of that clinical trial,” says Dr. Davisson.
“Our goal is to bring real-world data, clinical data that’s going to show the effectiveness of this procedure compared to placebo, and ideally convince a broader scope of insurance to approve and cover the procedure that can really help patients with degenerative disc disease.”
Surgery
A specialist may recommend a surgical solution (such as spinal fusion, decompression, or artificial disc replacement) for treating disc degeneration when previous care options haven’t brought adequate pain relief or restored mobility. That said, most people with disc degeneration improve over time with conservative care and less invasive treatments, making surgery rarely necessary.
“Spines are complicated. There are a multitude of things that can create pain, from issues with discs and problems in the vertebrae themselves to even arthritis.”—Dr. Andrew Davisson
With so many variables, accuracy in diagnosis is crucial and makes a significant difference in treatment recommendations.
FAQs about degenerating discs
Here are answers to questions patients frequently ask about degenerative disc disease.
What type of doctor is best for disc degeneration care?
An interventional spine and pain specialist is probably the best option for managing and treating disc degeneration.
“My background—and my partner’s background—is in physical medicine and rehabilitation, which is a small specialty that’s really focused on restoring function as opposed to just treating imaging findings,” says Dr. Davisson. “I’m always concerned with finding out each patient’s goals, because the goals of a college-age athlete are often going to be much different than, say, those of an 87-year-old woman.”
Your primary care provider can help guide you and provide initial treatment recommendations. But a specialist in interventional pain management has specific expertise in diagnosing the source of spine-related problems and can offer comprehensive back and neck pain management options (including cutting-edge degenerative disc treatments like VIA Disc NP).
What can be mistaken for degenerative discs?
“Several conditions like arthritis and even muscle strain can cause symptoms similar to degenerative disc disease,” says Dr. Davisson. “Occasionally, people can have compression fractures of their vertebrae that can simulate severe pain that stays in the back.”
Disc degeneration’s overlapping symptoms with other issues are just another reason why a thorough evaluation is so critical to identify what’s really causing your pain.
Can degenerative disc disease be detected on an MRI?
Yes—absolutely. MRI imaging, which provides detailed views of discs, can show signs of degeneration, such as:
- Loss of disc height,
- Dehydration of disc material, and
- Any tears in the disc’s outer layer.
That said, what shows up on imaging doesn’t always correlate with symptoms. According to Dr. Davisson, many people with disc degeneration that’s visible on MRI may not experience pain or other symptoms.
Is surgery inevitable if you have disc degeneration?
“No, surgery isn’t inevitable for patients diagnosed with degenerative disc disease,” says Dr. Davisson.
Many patients find relief through conservative degenerative disc treatments like physical therapy, lifestyle modifications, and medications. And, increasingly, others are benefiting from injections or innovative, minimally invasive care options, such as the VIA Disc NP procedure.
Can I exercise with degenerative disc disorder?
Yes. In fact, appropriate low-impact exercise is one of the most beneficial things you can do for degenerative disc disease. Specifically, Dr. Davisson recommends “doing some level of strength training—even if it’s as simple as a few body weight squats at home versus going into a gym—to help maintain flexibility” for his patients who aren’t dealing with any major balance or stability difficulties.
Does disc degeneration make you tired?
Yes, any source of chronic pain can cause fatigue, including degenerative disc disease, because your body is under constant stress, which can be physically and mentally draining.
With disc degeneration, you may also experience pain that disrupts your sleep and leaves you feeling tired during the day.
Can losing weight help with pain from degenerating discs?
Yes—maintaining a healthy body weight can make a significant difference in patients with degenerative disc disease. “Healthy body weight reduces the load of gravity on the back,” says Dr. Davisson.
Excess weight places additional stress on the discs in your lower back, particularly around the midsection, which can worsen pain. Even modest weight loss can help reduce symptoms for many people. However, it’s essential to approach weight loss in a way that doesn’t exacerbate your back pain, such as by incorporating low-impact exercises into your routine and working with trained healthcare providers for nutrition guidance and other support.
Why choose HCH for degenerative disc disease care
If you’re dealing with disc degeneration, you don’t have to travel far to find quality care. At Henry Community Health, we take a comprehensive approach to treating individuals with degenerating discs. From your first appointment through your recovery, we’re here and will be by your side to help.
Our interventional pain management providers—leaders in the field of back and neck care—have extensive experience helping patients navigate degenerative disc disease and finding relief for pain caused by other spine-related conditions.
At HCH, we offer convenient, proven non-surgical treatments, such as physical therapy, and the latest minimally invasive solutions, including the innovative VIA Disc NP procedure.
Take the next step and schedule a consultation with our interventional pain management team for comprehensive, personalized care tailored to your specific symptoms, lifestyle, needs, and goals.
