Degenerative Disc Disease: Symptoms, Causes & PT Treatment
Updated July 20261 minute read
Degenerative disc disease (DDD) is the natural drying and thinning of spinal discs as we age — it's so common that most pain-free adults have it on scans. When it does cause symptoms, you may feel achy, stiff low back pain that flares with certain activities. It is not a progressive "disease," and physical therapy helps you stay strong and active. Surgery is rarely needed.
What is degenerative disc disease?
Despite the alarming name, DDD describes normal age-related changes — discs lose water and height over time. It's better thought of as "disc aging" than a disease, and the changes are often painless.
Symptoms
When symptomatic, DDD typically causes low back aching and stiffness that's worse with prolonged sitting, bending, or after rest, and sometimes eases with movement. Flares come and go. Significant leg symptoms suggest a different or additional problem.
What causes it / risk factors
Age is the main driver; genetics, smoking, repetitive heavy loading, and inactivity contribute. The presence of DDD on imaging does not mean your back is "wearing out."
How it's diagnosed
DDD is diagnosed from history and exam, sometimes noted on imaging done for other reasons. Because it's so common in pain-free people, findings are interpreted alongside your symptoms.
Physical therapy treatment
What a PT does. Your therapist reframes the diagnosis (it's not damage that movement worsens), then builds strength, mobility, and activity tolerance. Exercises & progression (overview). Core and hip strengthening, mobility work, aerobic activity, and pacing strategies. Staying active is protective. Recovery timeline. Flares usually settle in weeks; ongoing exercise keeps symptoms low.
Treatment options compared
Exercise and education are first-line. Medication helps short-term flares. Injections and surgery are rarely indicated for DDD alone.
Red flags
Seek care for groin numbness, loss of bladder/bowel control, leg weakness, fever, or unexplained weight loss.
Frequently asked questions
Sources (4)
- Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015. — PubMed
- George SZ, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Clinical practice guideline. J Orthop Sports Phys Ther. 2021. — JOSPT
- Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017. — American College of Physicians
- MedlinePlus Medical Encyclopedia: Low back pain - chronic. — NIH/MedlinePlus
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.