Degenerated Discs are Normal as We Age

It has been known and documented for decades that discs lose water content and become less flexible as you age.  I will never forget a Golf Digest article many years ago showing Jack Nicklaus’s golf swing his first years on the tour compared to 20 years later.  In his early swing there is a beautiful “C” shape of his lower back at the completion of his swing.  Twenty years later, his lower back was almost straight.

However, a less flexible spine does not necessarily correlate with a painful spine.  There have been multiple studies done in the cervical, thoracic, and lumbar spine demonstrating that there is little correlation between a degenerated, herniated, bulging, or ruptured disc and back pain.

If you take 100 people of the street who have NEVER experienced significant low back pain, by age 50, the majority of them have bone spurs, herniated or ruptured discs, disc bulges, or “degenerative disc disease”.

There was a study done in the 1950’s that showed that after a disc operation, the chance of having low back pain after surgery was less if there was more degeneration of the disc and therefore less motion.

I have undergone two low back surgeries and my three lower discs are severely degenerated on MRI.  Nonetheless, it is my right arthritic knee that slows me down, not low back pain.

I see patients every week who have severe sciatica from a bone spur.  Frequently, they have severe degeneration of their spine at multiple levels as seen on X-ray and/or MRI.  Often, if not most of the time, they do not have significant low back pain.

Discs can sometimes cause pain.  Before my first back operation, I would experience severe episodic bouts of low back pain.   After the rupture of my L5-S1 disc relieved the pressure on my disc, my back pain disappeared.

Another historic study regarding the role of surgery in sciatica showed that the average duration of episodic back pain was about 10 years prior to the rupture of the disc. The symptoms associated with the ruptured disc were similar to these prior episodes.

Even though discs can cause low back pain, they only do so a minority of the time, and we do not have the diagnostic tools to accurately discern the disc from the surrounding soft tissues as the source of pain. Even if we were certain it was the disc, we couldn’t tell which level might be causing your pain.

You might be making the decision to have surgery performed on a structure that is completely normal for your age.