Will I Eventually Need Surgery for Degenerative Disc Disease?

Question: I'm 60, and I just found out that I have degenerative disc disease (DDD). Since it's a degenerative condition, I assume it'll just get worse as I get older. What's the likelihood of me needing surgery for DDD?
—Ottawa, Ontario
Doctor with pateint examining x-rayAnswer: This is a very common question I get from patients who have degenerative disc disease (DDD). And for the majority of my patients, the answer is: "No, you probably won't need surgery." In fact, there are several requirements you need to meet in order for your doctor to recommend spine surgery for DDD.

Some of the requirements for DDD surgery:

  • You've tried non-surgical treatments (eg, exercise, weight loss, medications, changes to your activity level) for several months and they haven't helped address your back pain.
  • The disc degeneration involves only 1 or 2 discs (not multiple discs).
  • You're in good overall health, which means that you're more likely to bounce back from surgery.

In my opinion, degenerative disc disease isn't actually a disease. The term "disease" often carries a negative tone, but the reality is that degeneration of your intervertebral discs is actually a natural part of the aging process—it's just that some people respond differently to this process.

Healthy discs are well-hydrated, but with age, they can become dehydrated. This can result in weakened, stiff, and rigid discs, which may change the way your spine moves, causing back pain, nerve problems, and other DDD symptoms.

Your doctor has probably mentioned the importance of exercise and the need to strengthen your abdominal muscles (the core) for DDD. With DDD, your spinal mechanics (the way your spine moves) can shift the stress from your discs to the facet joints (joints in the spine), which can affect the muscles and ligaments that connect these bony structures.

Strong core muscles can help to support degenerated discs. And fortunately, when it comes to preventing DDD from getting worse, you have several treatment options in addition to exercise. Work with your doctor to create a treatment plan for your DDD—one that may include a combination of exercise, physical therapy, and medications.

I want to reiterate that most patients with DDD will not need surgery. However, if you develop significant nerve problems or loss of bowel and bladder control, which is a serious disorder called cauda equina syndrome (which can affect your nerves), surgery may be required. If you notice these symptoms, call your doctor immediately.

But in general, taking good care of your body (ie, eating healthy, exercising regularly, and maintaining a healthy weight) can make it less likely that you'll ever need surgery for degenerative disc disease—regardless of your age.