Degenerative disc disease: symptoms, causes and treatment

The spine is made up of 24 bones called vertebrae stacked on top of each other, with discs between them. Arthritis UK explains that the discs cushion the bones and help the spine move, and that ligaments and muscles support and stabilise it. Small facet joints run up and down each side of the spine.

"Degenerative disc disease" is a popular name for age-related wear in these discs. It is not a disease in the usual sense. Arthritis UK uses the term spondylosis for the same pattern: the discs become thinner, the spaces between the vertebrae become narrower, and little pieces of bone called osteophytes may grow at the edges of the vertebrae and facet joints. It says this is very similar to the changes caused by osteoarthritis.

Arthritis UK says that as we grow older, the joints, discs and ligaments of the spine age as well. They remain strong, but it is usual for your back to get stiffer.

Many people with disc wear have no symptoms at all. When it does cause problems, the NHS and Arthritis UK describe pain and stiffness in the back or neck, and sometimes symptoms from a nearby nerve being pressed on. The NHS lists these symptoms for a slipped disc, which can be one result of disc changes.

• Lower back pain, or neck pain.

• Numbness or tingling in the shoulders, back, arms, hands, legs or feet.

• Problems bending or straightening your back.

• Muscle weakness.

• Pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica).

• Pain that travels from the back or buttock down the leg towards the foot (Arthritis UK).

The NHS says that back pain often improves on its own within a few weeks, and there are things you can do to speed recovery. Arthritis UK says taking painkillers, staying active and doing specific exercises are generally the most helpful treatments for people with back pain, although some people will need further medical treatment.

If pain is severe or not getting better, the NHS says you may be prescribed painkillers, and that other treatments may be recommended if pain does not improve after a few weeks. For a slipped disc, the NHS says you might be prescribed a stronger painkiller, a steroid injection or a muscle relaxant for the short term, and if symptoms do not get better you may be referred for further tests such as an MRI scan, and may also need physiotherapy.

Arthritis UK says back pain often does not have one simple cause. It may be due to lack of exercise causing the spine to stiffen and muscles to weaken, muscle strains or ligament sprains, poor posture, or inadequate work or home set-up. Specific conditions linked with back pain include spondylosis, slipped disc, sciatica, and spinal stenosis (narrowing of the space around the nerves in the lower spine).

The NHS lists what can contribute to a slipped disc: ageing, exercising too hard, lifting heavy objects the wrong way, sitting or driving for long periods, and being inactive or overweight. It advises not smoking, because nicotine weakens the disc tissue in the spine.

The NHS says back pain, particularly lower back pain, is very common and usually improves within a few weeks, but can sometimes last longer or keep coming back. Arthritis UK says up to 6 in 10 people will have back pain at some time in their lives.

The NHS says to see a GP if your pain does not improve after treating it at home for a few weeks, if it is stopping you doing your day-to-day activities, or if you are struggling to cope. Disc wear itself is part of ageing and does not go away, but pain linked to it often settles and can be managed.

Arthritis UK says doctors often start with a watch-and-wait approach because most back pain improves within a few weeks. Your GP will talk to you about your symptoms and may examine your back, and most back problems can be diagnosed in this way without tests.

You may be sent for a scan if you have had an injury such as a bad fall, your doctor suspects an underlying cause, or the pain has lasted unusually long. Arthritis UK notes that X-rays are rarely used for back pain because many causes involve soft tissues that do not show up on an X-ray. The NHS says that for a slipped disc you may be asked to raise your arms or do simple leg exercises to find out where the problem is.

Back pain is rarely a sign of something serious, but the NHS lists symptoms that need immediate attention.

• Call 999 or go to A&E if you have back pain with pain, tingling, weakness or numbness in both legs, a loss of feeling around your genitals or anus, or changes in your bladder or bowels such as difficulty peeing or peeing or pooing yourself.

• Call 999 or go to A&E for changes in how your penis or vagina feels during sex, not being able to get or keep an erection, or not being able to orgasm, chest pain, or if the pain started after a serious accident such as a car accident.

• Ask for an urgent GP appointment or call NHS 111 if you feel hot, cold, shivery or generally unwell, or the pain is severe, starts suddenly or is getting worse quickly.

• See a GP if you have lost weight without trying, there is a lump or swelling in your back or your back has changed shape, it is worse at night or does not improve after resting, or it is worse when sneezing, coughing or pooing.

Disc and joint wear can affect the neck as well as the back. The NHS says most neck pain only lasts a few weeks, and suggests paracetamol or ibuprofen, a low firm pillow, heat or cold packs and neck flexibility exercises. It advises against wearing a neck collar because it is better to keep your neck moving unless a doctor tells you not to.

The NHS says to see a GP if neck pain or stiffness does not go away after a few weeks, painkillers have not worked, you are worried about the pain, or you have other symptoms such as pins and needles or a cold arm, which could be something more serious.

Arthritis UK says there are no special diets that have been shown to help or prevent back pain, but if you are overweight, changing your diet and exercising regularly to lose weight can reduce strain on your back. It advises bending your knees when lifting, keeping the weight close to your body and avoiding twisting.

The NHS says to keep active and use a safe technique when lifting, and not to smoke. Arthritis UK says staying in awkward positions or the same position for too long may increase your pain or recovery time, and the NHS gives similar advice for neck pain, so change position regularly.

On the NHS, back pain is usually assessed by a GP, and in many areas you can refer yourself to community musculoskeletal (MSK) services for physiotherapy without a GP referral. The NHS notes that NHS physiotherapy might not be available everywhere and waiting times can be long, and that you can also get it privately.

The NHS says manual therapies such as osteopathy may help ease lower back pain and usually have to be paid for privately. Private spinal clinics offer scans and specialist review, but the NHS advice on red flags and when to seek urgent help applies whichever route you choose.