Degenerative disc disease

What it is

The discs between the bones of your spine act as cushions and shock absorbers. As we get older, they slowly dry out, become thinner and less springy. The gaps between the bones narrow, and small bony growths called osteophytes (bone spurs) may form. Doctors may call this disc degeneration, spondylosis or "wear and tear".

These changes are a normal part of ageing, like grey hair. A large review of scans of people with no back pain found disc wear in about 37 in 100 people aged 20, rising to about 7 in 10 at age 40 and 96 in 100 at age 80.

This means that disc wear on a scan doesn't always explain pain. Pain is affected by many things, including muscle strength, fitness, sleep, stress and how sensitive the nervous system has become. For some people, a worn disc does become a source of pain, or narrows the space around a nerve.

Disc changes are more likely with age, family history, smoking, carrying extra weight, and heavy physical work.

Types and related conditions

Disc wear can affect any part of the spine. It can also lead to other problems.

Symptoms and how it changes

Many people with disc wear have no symptoms at all. When there are symptoms, they may include:

• Aching back or neck pain
• Stiffness, often worse in the morning
• Pain after sitting or standing a long time
• Reduced movement
• Tight muscles
• Pain spreading to the buttocks or shoulders
• Tingling or numbness, if a nerve is affected

Disc wear usually changes slowly over many years. Symptoms tend to come and go rather than steadily get worse. For many people, pain eases over time as the spine stiffens and settles.

1. Everyday symptoms

   Long term, often mild to moderate

   Aching and stiffness that vary from day to day. Staying active, building strength and pacing usually help most.

2. Flare-ups

   Often settle within weeks. Some last 3 to 4 months

   Times when pain gets worse, often after doing more than usual, poor sleep or stress. A flare-up doesn't mean the spine is getting badly damaged. Gradually getting back to normal activity is the best way through.

3. Nerve symptoms

   Varies

   If a disc bulges or the space around a nerve narrows, you may get pain, tingling or weakness in an arm or leg. Tell your GP or physio, as this may need different treatment.

When to get urgent help

Rarely, disc problems press on the nerves at the bottom of the spine (cauda equina syndrome) or on the spinal cord in the neck (cervical myelopathy). Both need urgent treatment to prevent lasting damage. Don't drive yourself to A&E.

Diagnosis and scans

A GP or physiotherapist will ask about your symptoms and examine you. Disc wear is often first mentioned on an X-ray or MRI done for another reason.

NICE advises against routine scans for low back pain in GP surgeries. Because disc wear is so common in people without pain, scans rarely change treatment. A specialist may order an MRI if you have nerve symptoms, warning signs, or if surgery is being considered.

If symptoms aren't improving, your GP may refer you to physiotherapy, a community musculoskeletal (MSK) service, a pain clinic or a spinal team. In many areas you can refer yourself to NHS physiotherapy. Check get NHS help for back or joint problems for your area.

Treatments and medicines

Most people are helped by physiotherapy, medicines and lifestyle changes. Activity is one of the most effective ways to improve pain.

Specialist options and surgery

Surgery is rarely needed for disc wear alone. It is mainly used when a nerve or the spinal cord is being squeezed.

1. Radiofrequency denervation

   Relief can take 1 to 2 weeks, and lasts days to months

   For pain from the facet joints. NICE says it can be considered if pain is moderate or severe and a test injection (medial branch block) helped first.

2. Decompression surgery

   Back to work after about 4 to 6 weeks. Full recovery up to 12 weeks

   Removes bone or disc pressing on a nerve, for example with sciatica or spinal stenosis. You usually stay in hospital for 2 to 5 days. It mainly helps leg or arm pain, not back pain.

3. Spinal fusion

   Office work after about 4 weeks, heavier work after about 8 weeks

   Joins two or more bones together. NICE says fusion should not be offered for low back pain alone, except in a research trial, and disc replacement should not be offered. It may still be used for other reasons, such as instability or a slipped vertebra. In one NHS trust, about 7 in 10 people had good relief. Avoid heavy lifting for 3 months, and full recovery can take up to a year.

   Risks: include infection, blood clots, nerve damage and the bones not fusing. Ask your surgeon about the benefits and risks for you, and consider a second opinion.

Self-help and living well

Tips for getting the best treatment

Questions to ask

• What does my scan report mean for me, and does it explain my pain?
• Can I refer myself to physio or see a first contact physiotherapist?
• Is there a group exercise class or pain management programme near me?
• Are my medicines still right for me?
• When would it be worth seeing a spinal or pain specialist?
• Can I have a fit note suggesting changes at work?

You can ask for a second opinion, especially before major surgery. In England you usually have the right to choose which hospital you are referred to.

Disc problems and work

Staying active and at work, with the right support, usually helps. You don't have to be pain-free to work.

Long-term back or neck pain from disc wear can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has a substantial (more than minor) effect on your daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count.

If it does, your employer must make reasonable adjustments. These might include:

• An ergonomic chair with adjustable lumbar support
• A sit-stand desk
• A monitor arm to raise your screen to eye level
• A headset for phone calls
• A workstation assessment
• Less lifting, or lifting aids
• Regular breaks to move and stretch
• Flexible hours or working from home

Access to Work is a government grant that can pay for specialist equipment and support at work. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you are off work, you may get Statutory Sick Pay from your employer for up to 28 weeks. If your condition makes everyday tasks or getting around hard, you may get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, whether or not you work. If you can't work, check Employment and Support Allowance or Universal Credit. Turn2us and Citizens Advice can help you check.

Support and sources

Last reviewed: October 2026.