The lower back is an intricate structure of interconnected and overlapping elements:

• Tendons and muscles and other soft tissues
• Highly sensitive nerves and nerve roots that travel from the lower back down into the legs and feet
• Small and complex joints
• Spinal discs with their gelatinous inner cores

Degenerative disc disease describes the symptoms of pain and possibly radiating weakness or numbness stemming from a degenerated disc in the spine.

Generally, the pain associated with degenerative disc disease is thought to stem from two main factors:

1. Inflammation
   • In the lumbar disc space, the low back pain can radiate into the hips. The associated pain can also travel down the back of the leg and possibly into the foot and toes.
   • In the cervical disc space, the neck pain may be local or may radiate into the arm, shoulder and possibly into the hand.
2. Abnormal micromotion instability
   If the annulus – the outer rings of the intervertebral disc – degenerates and wears down, it is not as effective in resisting motion in the spine. This condition has been termed “micromotion” instability because it is usually not associated with gross instability.

Both the inflammation and micromotion instability can cause lower back or neck muscle spasms. The muscle spasm is the body’s attempt to stabilize the spine. It is a reflex, and although the body’s response of muscle spasm is not necessary for the safety of the nerve roots, it can be quite painful.

The muscle spasms associated with the instability are thought to cause the flare-ups of intense pain often associated with degenerative disc disease.

There are several common symptoms that are fairly consistent for people with lower back pain or neck pain from degenerative disc disease, including:

• Activity-related pain that will flare up at times but then return to a low-grade pain level, or go away entirely
• Severe episodes of back or neck pain that will generally last from a few days to a few months before the patient goes back to his or her baseline level of chronic pain
• The amount of chronic pain varies between individuals and can range from almost no pain/just a nagging level of irritation, to severe and disabling pain

• Chronic pain that is completely disabling from degenerative disc disease is relatively rare
• Certain types of activity will usually worsen the pain, especially bending, lifting, and twisting
• Certain positions will usually make the pain worse–sitting vs standing
• Walking, and even running, may actually feel better than prolonged sitting or standing
• Patients will generally feel better if they can change positions frequently