What age do you normally get degenerative disc disease?

By age 60, over 90% of people show signs of disc degeneration on imaging, but symptomatic degenerative disc disease often affects individuals much earlier. While the wear and tear process begins in early adulthood, painful symptoms typically become noticeable in the 30s and 40s.

Quick Summary

The normal onset for symptomatic degenerative disc disease often begins around age 30 to 40, though the underlying disc degeneration can start in one's 20s. While most people will show signs of disc degeneration with age, not everyone will experience the pain and symptoms associated with the disease.

Key Points

• Prevalence with Age: While disc degeneration is common by age 35, with over 90% of people having some by 60, symptomatic degenerative disc disease is not universal.

• Typical Onset: Symptomatic degenerative disc disease (DDD) often begins causing noticeable pain in middle age, typically affecting people in their 30s and 40s.

• Not a 'Disease': Degenerative disc disease is a natural aging process that only becomes a clinical 'disease' when the degeneration causes pain and other symptoms.

• Multiple Risk Factors: Age is a key factor, but other risks include genetics, obesity, smoking, and certain physically demanding activities.

• Conservative Treatment: Most cases of DDD can be effectively managed with nonsurgical treatments, such as physical therapy, medication, and lifestyle adjustments.

• Surgery is Last Resort: Surgical options are typically reserved for severe cases where conservative treatments have failed to provide adequate relief.

Understanding Degenerative Disc Disease

Degenerative Disc Disease (DDD) is a term that describes the symptoms caused by the natural age-related wear and tear on your spinal discs. The spinal discs are soft, compressible cushions that separate the interlocking bones (vertebrae) that make up the spine. They act as shock absorbers for the spine, and allow for bending and twisting. As a normal part of aging, these discs can lose water content, become thinner, and develop small cracks or tears.

It is crucial to understand the difference between disc degeneration and degenerative disc disease. Disc degeneration is a normal and often painless part of the aging process that happens to everyone. Degenerative disc disease, on the other hand, refers to the condition where this degeneration causes pain, stiffness, and other symptoms. Many people with degenerated discs never experience pain, while others can suffer significantly.

The Role of Age in Degenerative Disc Disease

While age is the most significant risk factor for developing symptomatic DDD, the process of disc degeneration begins much earlier than most people realize. Studies show that roughly 30% of people show evidence of disc degeneration by age 35, and this figure increases to over 90% by age 60. This does not mean everyone will develop pain, but it highlights how common the physical changes are with advancing age.

Here is a breakdown of what happens to the discs as we age:

• Dehydration: As we get older, the gelatinous inner core of the discs naturally loses water. This makes the discs less flexible and effective as shock absorbers.
• Cracking and Tearing: Over time, the tough outer layer of the disc can develop small tears or cracks. These minor injuries can be near nerves and cause pain.
• Herniation: In more advanced cases, the inner core can bulge or rupture through a crack in the outer wall, potentially compressing a spinal nerve.

Beyond Age: Other Contributing Factors

While advancing age is a primary driver, several other factors can increase the risk of developing symptomatic degenerative disc disease:

• Genetics: A family history of DDD can increase your risk, suggesting a genetic component.
• Obesity: Excess body weight puts greater stress on the spinal discs, accelerating wear and tear.
• Smoking: Tobacco use reduces blood flow to the discs, hindering their ability to receive nutrients and heal.
• Physical Labor: Physically demanding jobs that involve heavy lifting or repetitive motions can put extra strain on the spine.
• Acute Injuries: A sudden injury, like a fall, can also contribute to the onset of DDD.

Comparing Degenerative Disc Disease and Spinal Osteoarthritis

It is common for people to confuse degenerative disc disease with spinal osteoarthritis, but they affect different structures of the spine. While they often occur together and share similarities, their primary differences are important to understand.

Feature	Degenerative Disc Disease (DDD)	Spinal Osteoarthritis
Affected Structure	Primarily the intervertebral discs (the cushions between vertebrae).	Primarily the facet joints (the small joints connecting the vertebrae).
Underlying Mechanism	Breakdown of disc tissue, leading to loss of height and flexibility.	Breakdown of cartilage in the facet joints, leading to inflammation and bone spurs.
Common Symptoms	Pain worsened by sitting, bending, or twisting; numbness or weakness radiating into limbs.	Localized pain and stiffness, especially in the morning; pain often relieved by rest.
Diagnostic Imaging	Shows disc height loss, disc bulging, and tears.	Reveals bone spurs and narrowing of joint spaces.

Effective Management and Treatment Options

For most people, symptoms of degenerative disc disease can be managed effectively without surgery. Treatment plans are often tailored to the individual and may include:

1. Lifestyle Modifications: Maintaining a healthy weight to reduce pressure on the discs, and quitting smoking to improve blood flow to the spine.
2. Physical Therapy: A physical therapist can guide you through exercises to strengthen core muscles, improve flexibility, and enhance spinal stability.
3. Medication: Over-the-counter anti-inflammatory drugs like ibuprofen can help manage pain and inflammation. Prescription pain relievers may be used for more severe cases.
4. Injections: Steroid injections can provide temporary relief by reducing inflammation around affected nerve roots.
5. Surgery: Surgical intervention, such as a spinal fusion or artificial disc replacement, is typically reserved for severe cases that do not respond to conservative treatments.

Living Actively with Degenerative Disc Disease

While DDD is a long-term condition, it does not have to mean a sedentary life. By adopting healthy habits and managing symptoms, you can maintain an active and productive life.

• Focus on Low-Impact Exercise: Activities like walking, swimming, and cycling are excellent choices that strengthen the back muscles without putting excessive strain on the discs.
• Maintain Good Posture: Whether sitting, standing, or lifting, proper posture is crucial to minimize stress on the spine. Consider an ergonomic chair if you sit for long periods.
• Strengthen Your Core: Building strong core muscles provides essential support for the spine. Yoga and Pilates are great for improving core strength and flexibility.
• Listen to Your Body: Avoid high-impact activities or movements that cause pain. Pain is your body's signal to slow down or modify your activity.

For more detailed information on managing chronic back pain, the National Institutes of Health provides excellent resources NIH Back Pain Information.

Conclusion

While disc degeneration is a universal part of aging, the painful condition known as degenerative disc disease typically presents in middle age. Understanding the difference between the asymptomatic age-related changes and the symptomatic disease is key. While age is a primary factor, genetics, weight, smoking, and lifestyle all play a role. The good news is that with proactive management through lifestyle changes, exercise, and medical treatment, it is possible to effectively control symptoms and maintain an active, fulfilling life, even with a diagnosis of degenerative disc disease.

Frequently Asked Questions

What is the primary cause of degenerative disc disease?

Aging is the primary cause of degenerative disc disease, as the natural wear and tear process causes spinal discs to lose water content, flexibility, and height over time. Other factors like genetics and obesity can also accelerate this process.

Can degenerative disc disease be prevented entirely?

You cannot completely prevent disc degeneration as it is a natural part of aging. However, you can significantly slow its progression and minimize symptoms by maintaining a healthy lifestyle, exercising regularly, and avoiding smoking.

Are there exercises I should avoid with degenerative disc disease?

Yes. People with DDD should avoid high-impact activities like running or jumping, as well as heavy lifting and poor bending techniques, which put excessive strain on the spinal discs. Low-impact exercises like swimming and walking are better options.

Is surgery necessary for degenerative disc disease?

Surgery is not necessary for most people with degenerative disc disease. The majority of cases are successfully managed with conservative treatments such as physical therapy, medication, and lifestyle changes.

How is degenerative disc disease diagnosed?

A doctor can diagnose degenerative disc disease by performing a physical examination and asking about your symptoms. Imaging tests, such as X-rays, MRI, or CT scans, may be ordered to confirm the diagnosis and rule out other conditions.

What are the common symptoms of degenerative disc disease?

Common symptoms include chronic pain in the back or neck, which can be mild or severe. The pain may radiate to the arms, hands, buttocks, and thighs. It can also worsen with prolonged sitting, bending, or twisting.

Does degenerative disc disease happen to everyone?

While disc degeneration is a near-universal part of the aging process, degenerative disc disease—the symptomatic version—does not happen to everyone. The majority of people with disc degeneration do not experience pain.

Can weight loss help with degenerative disc disease?

Yes, maintaining a healthy weight is highly beneficial for managing DDD. Excess weight places additional stress on the spine, and weight loss can help reduce this pressure and alleviate symptoms.