What is Degenerative Disc Disease?

Degenerative disc disease is the natural aging or traumatic breakdown of a spinal disc, which causes the spine’s anatomy to be altered from ‘normal’. This typically takes the form of a shrunken spinal disc— with the possibility of the disc’s gel-like center leaking out, similar to a jelly donut being squeezed as the donut goes flat and the filling oozes out.

Degenerative disc disease can cause symptoms such as pain in some people, while in others it can lead to issues such as numbness or tingling sensations. Degenerative disc disease doesn’t only lead to a shrinking of spinal discs. If the acidic central material of the disc leaks, it can press against surrounding tissue, irritating or impinging it. The shrinking of the disc height can also result in pain or discomfort since the disc’s height allows the various parts of the spinal bones, or vertebrae, to maintain openings within the spinal column. As discs lose height, these openings narrow—potentially pinching nerves that provide sensation at each level of your body.

What are the Stages of Degenerative Disc Disease?

Degenerative disc disease is often described as a ‘cascade’, as symptoms gradually worsen over time. It is sometimes brought on by a traumatic incident like an accident, but it also progresses as we age. Because everyone is unique, this can begin and proceed at very different rates.

There are four stages of degenerative disc disease. The visual above, and the following table may help to better understand how these stages differ, and potentially what stage you may be in.

Stageⁱ	Stage 1	Stage 2	Stage 3	Stage 4
Will I feel pain?	Possibly, but most people do not— except after a traumatic incident, such as an accident.	Sometimes. It may depend upon compression of the spinal cord or nerves.	Quite often you will have either pain or other nerve related issues (tingling).	You may often experience considerable pain on a frequent basis.
What does this look like on my X-ray/MRI?	X-rays can show a loss of curvature of the spine at this stage.	Discs will look thinner at affected levels of the spine on an X-ray, and MRIs can show impingement of nerves. Bone spurs can also begin to form in Stage 2.	Spinal bones (vertebrae) can begin to become misshapen, and discs are much thinner than normal.	Discs are very thin or completely gone, with vertebrae possibly trying to fuse together ‘bone on bone’.
How can this potentially be treated?	Maintain proper diet, exercise, fluids, and avoid bad posture and overstraining.	Manage episodes with rest, ice/heat, and non-steroidal anti-inflammatory (NSAIDs) medications.	Nerve impingement may potentially need surgical management. Some have found inversion tables and stretches/exercises to prolong relief. Epidural or other injections may also potentially provide extended relief.	This stage commonly requires surgical intervention to resolve pain. Common potential procedures include disc replacement and fusion.
When should I consider seeing a doctor?	See a doctor if conservative treatments (shown to left) fail and symptoms persist for more than a week or prevent you from going to work.	If symptoms persist for more than a week or prevent you from going to work.	If symptoms persist for more than a week or prevent you from going to work, or if nerve-related issues are progressively getting worse.	At this stage you are likely already seeing a provider. Traumatic events and progressive nerve-related issues may warrant additional treatments through a provider.

About the Author:

Dr. Dasher is a board certified, fellowship trained orthopedic spine surgeon, who specializes in the conservative and surgical management of all spinal conditions. He has special interest and significant experience in spine conditions such as scoliosis, degenerative lumbar disorders including spinal stenosis/disc herniation, disc replacement and lumbar instability.

Dr. Dasher is trained in the latest minimally invasive robot-assisted techniques for nerve decompression and fusion that provides for a shorter hospital stay, less recovery time, less blood loss and hyper-accurate hardware placement.

ⁱLanman, T. (2023, Nov 28). 4 Stages of Degenerative Disc Disease – Spine MD. https://www.spine.md/insights/stages-of-degenerative-disc-disease.

Opinions expressed herein are those of Dr. Woods based upon his qualifications as a surgeon.

Important Note: The patient information presented is for general education purposes only. As with any spine surgery, there are potential benefits, complications, and risks associated with disc replacement and spinal fusion procedures. Individual results may vary. It is important that you discuss the possible risks and potential benefits of various procedures with your doctor prior to receiving treatment, and that you rely on your physician’s best judgment. Only your doctor can determine whether you are a suitable candidate for a specific surgical procedure.

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