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A Working Definition of Disc Degeneration

Just exactly what is "disc degeneration"? Having a working definition of degenerative disc disease (DDD) would be very useful. It would help researchers look for risk factors. It would give a legal way to tell the difference between normal changes and a disease process.

Toward this goal of writing a definition, the authors of this report review disc anatomy, metabolism, healing, and aging. The causes of DDD are also included along with a discussion of disc prolapse and pain.

For the medical professional, disc degeneration is defined as an aberrant cell-mediated response to progressive structural failure. For the patient, this means too much of a load on the disc damages it and starts a series of responses at the cellular level. The result is even more disruption and damage to the disc.

Anything that can weaken a disc or keep it from healing can lead to DDD. Usually this is injury or wear and tear from repeated bending, twisting, and compression. But increasing age, poor nutrition, and genetics can weaken some discs enough that even a small thing like a cough or a sneeze can lead to disruption of the disc.

Age-related changes can be distinguished from a damaged or degenerative disc. With aging, the disc structure remains intact and painless. When pain occurs and/or structural failure is seen, then the condition is called a "disease." Structural failure could be disc collapse, prolapse, or fissures.

References: Michael A. Adams, PhD, and Peter J. Roughley, PhD. What is Intervertebral Disc Degeneration, and What Causes It? In Spine. August 15, 2006. Vol. 31. No. 18. Pp. 2151-2161.

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