What is Degenerative Disc Disease?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Degenerative Disc Disease is a common underlying condition that results in bulging discs, sciatica, pinched nerves, and many other painful conditions. It is essentially a form of arthritis of the spine and can be caused by the normal wear-and-tear associated with aging or repetitive activities. Less commonly, it can be a result of an injury. Pain from Degenerative Disc Disease may be felt almost anywhere – knees, hips, neck, even occasionally in the arms.

In a non-diseased spine, healthy discs are surrounded by rubbery, firm, and moist material that prevents vertebral bones from rubbing against each another. Degenerative Disc Disease wears down and dries out the intervertebral material. This makes your bones likely to rub together and cause pain.

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More About Degenerative Disc Disease

lumbar foraminotomy

Disc inflammation and structural problems can be caused by the constant friction of degenerative discs. In advanced cases, bones may chip, leaving fragments to wander through your body. When the cartilage wears out completely, pain—and perhaps structural problems—may make moving difficult.

Degenerative Disc Disease is believed to strike about 50% of adults, most commonly in the knees or back. Most of these people are over age 65, but the condition can strike in people much younger, particularly if they engage in work- or leisure-related repetitive activities, like lifting or bending.

Symptoms of Degenerative Disc Disease

The most common symptom of Degenerative Disc Disease is pain. The pain may be especially present after waking up or resting, and periods of activity may intensify the pain. Where the pain presents depends on which disc or area if affected.

The most common symptoms of Degenerative Disc Disease are:

  • Stiffness or motion limitations
  • The sound of cracking or clicking during movement
  • Swelling in the affected area
  • Pain that intensifies after motion

Different areas of the body may be affected in different ways. Here are some common symptoms based on area of the body:

  • Knees: a scraping or grating sensation may be felt during motion
  • Feet: pain and tenderness—maybe swelling—may be felt around the toes and ankles
  • Hips: the buttocks, groin, and inner thigh may be painful
  • Fingers: redness and swelling may accompany tenderness

How is Degenerative Disc Disease Diagnosed?

  • Physical Examination: Your physician will then examine the location of your pain, looking especially for signs of disc damage, like spurs, tenderness, or swelling.
  • Symptom Assessment: Your physician will ask you to explain what you are feeling and where.
  • Medical History: Your physician will inquire about any other medical issues – sometimes an underlying condition will provide a diagnostic clue. Your physician may also ask about family history and your daily activities or habits.
  • Diagnostic Imaging: MRI scans and X-rays might be used to asses the presence and extent of disc damage.

What are the Causes of Degenerative Disc Disease?

low back pain

Several factors can contribute to the development of degenerative disc disease. In order of importance:

  • Wear-and-tear: Age and repetitive motion can cause discs to degenerate. In a sense, this is a natural process, but because it causes pain, it is considered a disease
  • Genes: Researchers have discovered evidence that Degenerative Disc Disease can disproportionately affect one family or another, making a genetic predisposition likely.
  • Injury: Car accidents and sports injuries may begin or accelerate the process of degenerative disc disease. Symptoms, however, may not be felt for many years.
  • Weight: Carrying extra pounds will add pressure to your knees, hips, and back. This might contribute to Degenerative Disc Disease.

How is Degenerative Disc Disease Treated?

Treatment and procedure options for Degenerative Disc Disease range from conservative options like injections to more intensive procedures like spinal fusions.

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.


Minimally invasive decompression surgery aims to relieve pressure on the nerves of the spine. This pressure is often caused by stenosis, bulging or herniated discs, and more. Relieving this pressure can be achieved by reducing or removing soft tissue (disc material or scar tissue) or bone (bone spurs, a section of the lamina or foramina) to decompress the affected nerve. When the compression is caused by soft tissue material, a surgical laser may be used to shrink the impinging material.


Fusion surgeries are similar in goal–to remove damaged disc tissue and fuse the bones together–but differ in approach, including the use of specialized hardware to reinforce stability, and the location used to gain access to the spine. A related procedure is an artificial disc replacement, in which a damaged cervical disc is replaced with a synthetic disc, and the vertebrae are not fused.

How Much Does Treatment Cost?

Treatment cost depends on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.


Calculate how much you've spent on back pain this year.


This past year you have spent on your pain treatment:

Get surgery now. Getting surgery now is the smartest financial move. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. You’ve spent that much or more this year to manage your back pain than you could to fix it.

Get surgery soon. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. At your current rate, you will spend that much or more within the next two years. The sooner you get treatment, the sooner it will pay for itself.

Keep an eye on your spending. Currently, you are managing your pain efficiently from a financial perspective but over time, your expenses could add up. Surgery should be strongly considered if you start missing more work or spending more on treatment medication.

Great job! You are spending very little on your back pain. Keep it up!

Equipment Used in Diagnosis and Treatment of Degenerative Disc Disease

When diagnosing for this disease, the most commonly used equipment are X-rays and Magnetic Resonance Imaging (MRI) scans.

  • X-rays. X-rays can show the space between bones, which indirectly paints a picture of missing or deteriorated cartilage.
  • MRI Scans. MRI scans allow physicians to see tissue and disc damage directly.
  • CT Scan. A computed tomography (CT) scan is like a more detailed x-ray. It may allow your physician to confirm that Degenerative Disc Disease is present.

If you have an MRI, X-ray, or CT Scan, the North American Spine medical staff will review it for free to see if you are a candidate for a procedure.

How Does Degenerative Disc Disease Compare to Similar Conditions?

Diseases that are compared with Degenerative Disc Disease typically fall in the arthritis family, since DDD is a form of arthritis. These include:

  • Rheumatoid arthritis, an autoimmune disease that attacks joints and discs. It can cause pain and stiffness.
  • Lupus is like rheumatoid arthritis, except it targets tendons, ligaments, and other connective tissues.
  • Gout results from the buildup of uric acid crystals, which can cause pain similar to the pain felt during DDD.
  • Bursitis results from the irritation of fluid-filled sacs in the discs, called bursa.
  • Tendinitis/Tendonitis is not an arthritic problem, but it can also mimic the symptoms of Degenerative Disc Disease.

Analogy: An Old Ladder

Degenerative Disc Disease can be compared to an old ladder. Each rung in a normal, new ladder will bear weight and contribute to the ladder’s overall stability. If a ladder could have Degenerative Disc Disease, one or more rungs would be rotten, hollow, or broken, making the rung unable to bear much weight and causing instability in the ladder itself.

Old Ladder

New Ladder

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