Degenerative Disc Disease

What Are the Stages of Degenerative Disc Disease?


Medically reviewed by Misty Seidenburg

Degenerative disc disease is the wearing away of the rubbery discs located between the vertebra of the spine. Despite the name, it is a natural occurrence that is part of the aging process.

As these discs deteriorate due to injury, age, or disease, the bones begin to rub together and can cause mild to severe pain and stiffness. Degenerative disc disease is classified in stages based on your symptoms and the extent of deterioration.

Because wear and tear are a natural part of the aging process, most adults have some degree of degeneration. Read on to learn more about the stages of degenerative disc disease.

Stage 1: Dysfunction

The first stage of degenerative disc disease (DDD) is often painless. There can be subtle changes in the curvature of the spine which you may or may not notice. As the spine loses its normal arch, your posture is affected, placing added stress on the spinal nerves and hastening their aging process.

At this stage of DDD, the affected discs may stop working as well. Physical therapy can be helpful to provide a comprehensive strengthening and mobility plan to maintain range of motion despite the disc changes.

Stage 2: Dehydration

At the second stage of DDD, spinal discs begin to dry out and lose some height. Typically, there are little or no spinal changes to the bony structures of the spine in this stage. Many people are at Stage 2 by the age of 40.

Stage 3: Stabilization

At stage 3, postural changes are more pronounced and visible. The formation of hard bumps of extra bone may begin to form on the end of bones- called bone spurs- as the spine attempts to create a more secure spinal base. As these spurs grow, mobility of the back can become limited.

The stabilization process can also lead to spinal stenosis in some patients. As the body tries to restabilize, the space inside the backbone can narrow, placing excess pressure on the spinal cord and the nerves traveling through the spine.

Stage 4: Collapsing

In the final stage of DDD, the discs are very thin with minimal disc material remaining. Severe bony changes of the spine may be present. Bones can fuse together to compensate for the lack of rubbery cushioning between them.

Will I have pain if diagnosed with DDD?

Degeneration of the spine is a normal part of the aging process and occurs over the course of 20-30 years. These changes are slow and develop over time.

The anatomic changes themselves don’t cause pain for everyone, but some people do develop pain. For individuals with symptomatic DDD, they will typically complain of minor discomfort and fatigue of the muscles of the back.

As changes progress, some individuals do not have increased complaints of episodes of back pain while others will have increased discomfort and fatigue. If the nerves of the spine are involved, symptoms can radiate into the buttocks or legs and cause numbness and tingling.

Mild pain may advance to moderate pain or discomfort in the neck and back. Fatigue and exhaustion are also common at this stage of progression. Symptoms begin to interfere with exercise, work, and sleep, and may become a chronic part of daily life.

Muscular aches and pains are also common in DDD that has progressed to this point. From stages 1-3, DDD is considered “moderate” and potentially still responds well to nonsurgical symptom management.

How Fast Does Degenerative Disc Disease Progress?

It is hard to say. Every person and every case are unique but generally occurs over the period of many years. DDD is chronic and irreversible. As we mention at the top of the article, most adults have some level of deterioration of the spinal discs.

The speed at which your symptoms progress depends on several variables, many of which are under your control. Here are some tips to slow the progression of DDD and manage your symptoms:

  • Avoid or quit smoking.
  • Achieve and maintain a healthy body weight.
  • Exercise often to increase strength and flexibility.
  • Manage your stress and prioritize mental health, especially if you are living with chronic pain.

Some people do go on to need surgical intervention for their symptoms. Surgery may be recommended to retain mobility and prevent permanent impairment. Once post-surgical patients are cleared for activity, they can resume activity safely and gradually under the supervision of their physical therapist.

Physical therapy offers several safe, gentle, evidence-based modalities for combatting DDD symptoms and promoting pain-free movement. Are you ready to schedule a comprehensive evaluation? Find a physical therapy clinic near you.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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