Degenerative Disc Disease

Degenerative disc disease refers to the gradual breakdown of one or more intervertebral discs. Despite its name, it is not strictly a disease, it is a degenerative process that occurs to varying degrees as part of normal ageing, though certain factors can accelerate it.

The intervertebral discs sit between each vertebra and act as the spine’s shock absorbers. Each disc consists of a fluid-filled inner core (the nucleus pulposus) encased by a tough outer ring of fibrocartilage (the annulus fibrosus). A healthy disc is well-hydrated and able to absorb and distribute spinal load effectively. Disc degeneration begins when the disc loses fluid content, reducing its height and load-bearing capacity. This can trigger a cascade of changes, including facet joint stress, bone spur formation, disc bulging and nerve irritation, depending on the degree and location of the degeneration.

Importantly, degenerative changes on imaging do not always correspond to pain. Many people have significant disc degeneration with no symptoms at all. The clinical picture; how your pain behaves, what aggravates and eases it, and how it is affecting your function, matters far more than what a scan shows.