Author: Dr Lize-Mari Erasmus | Co-Author: Dr Michelle-Cheri Beech Cloete
What is Degeneration? (Scarcia et al., 2022)
Degenerative Disc Disease (DDD) is a common condition that affects the spine. Despite its name, it is not actually a disease but rather a natural process of aging that affects the discs between your vertebrae (think of it as the grey hair of the spine). These discs act as cushions, absorbing shock and allowing movement in the spine. Over time, they can wear down, leading to pain and reduced flexibility.
How do spinal discs work? (Scarcia et al., 2022)
Each spinal disc is made up of two main parts:
- Nucleus Pulposus – The soft, gel-like centre that provides cushioning.
- Annulus Fibrosus – The tough outer ring that holds the nucleus in place and keeps the spine stable.
These discs are important because they help absorb pressure from activities like walking, bending, and lifting. However, as we age, the discs lose water and flexibility, making them more prone to damage.
Facet joint involvement: (Mann, Viswanath, & Singh, 2023)
Facet joint arthropathy is a condition that affects the small joints at the back of your spine, known as facet joints.
These joints help support movement and stability, but over time, they can wear down due to aging, excess weight, poor posture, repetitive strain, and small, repeated injuries (microtrauma).
Research shows that facet joint degeneration is closely linked to the breakdown of the intervertebral discs. In most cases, disc degeneration happens first, causing increased pressure and mechanical stress on the facet joints, which leads to further damage.
However, some studies suggest that if the facet joint influences the integrity of the annulus, then a loss of facet function could contribute to annular degeneration. This may occur due to disrupted blood flow, affecting the annulus’s ability to absorb fluids through osmosis (Boshoff, n.d.).
How Your Spine Changes Over Time (And What You Can Do About It!) – (Kirkaldy-Willis & Cassidy, 1985)
Your spine goes through a natural aging process, but for some people, this leads to pain and discomfort. The Kirkaldy-Willis Model describes this process in three stages:
Dysfunction Phase | Instability Phase | Stabilization Phase | |
Anatomical changes | Early changes in the spinal joints, discs, and ligaments occur. Minor injuries and biomechanical stresses contribute to instability. | Structural weakening of the spine due to degeneration. Progressive loss of normal spinal movement, leading to instability. | The body adapts by forming osteophytes (bone spurs) and fibrotic changes. The condition becomes chronic but less symptomatic due to natural stabilization. |
Symptoms | Your back feels stiff or sore from posture, strain, or wear. Occasional pain arises after sitting or activity. Restricted spinal movement causes muscle tightness. | Back pain becomes more frequent, sometimes radiating to legs. Instability makes bending and twisting uncomfortable. | Pain may lessen, but mobility decreases. Movement feels restricted or locked up. |
How spinal manipulation helps. | Restores normal joint movement and flexibility. Reduces pain by stimulating the body’s natural pain-blocking systems. Prevents further damage by keeping the spine moving properly. | Relaxes tight muscles that are overcompensating for weak areas. Improves spinal stability by keeping everything moving as it should. | Keeps the spine as mobile as possible by loosening stiff joints. Reduces pressure on surrounding nerves, preventing unnecessary pain. Helps relieve tension in muscles that may be working too hard. |
Causes of Disc Degeneration: (Scarcia et al., 2022)
- Genetics: Some people are more prone to disc degeneration due to their genes.
- Injury or Trauma: Accidents, falls, or repeated strain on the spine can accelerate degeneration.
- Lifestyle Factors: Smoking, obesity, and poor posture can weaken the discs.
- Inflammation: Chemicals released by the body can break down disc tissue and cause pain.
Preventing Further Degeneration: (Scarcia et al., 2022)
- Regular Chiropractic Care: Spinal manipulation will help restore movement, reduce pain, and slow down the progression of spinal degeneration.
- Stay Active: Low-impact exercises like swimming, walking, or yoga can keep the spine flexible.
- Use Proper Lifting Techniques: Bend your knees, not your back, when lifting heavy objects.
- Stay Hydrated: Water helps maintain disc structure and function.
- Sleep on a Supportive Mattress: A good mattress can reduce spinal stress.
The Bottom Line:
Degenerative Disc Disease is a natural part of aging, but with the right approach, you can manage symptoms and maintain spinal health. Spinal manipulation is a safe, natural treatment that helps restore movement, reduce pain, and slow down the progression of spinal degeneration. It is most effective in the early and middle stages, when your spine still has the ability to heal and recover.
If you’re experiencing back pain, don’t wait until it gets worse. Seeking care early can help you stay active, pain-free, and prevent long-term issues. Talk to your chiropractor or healthcare provider to see if spinal manipulation is right for you!
Referencing:
Boshoff, W.H. (n.d.). Secondary Degenerative Changes in the Intervertebral Disc Due to Zygapophyseal (Para-Vertebral) Facet Joint Lesions. Private Practice Chiropractic, Wilgeheuwel Hospital; Hon. Research Associate, School of Anatomical Sciences, University of the Witwatersrand, Faculty of Health Sciences.
Kirkaldy-Willis, W.H. & Cassidy, J.D., 1985. Spinal Manipulation in the Treatment of Low-Back Pain. Canadian Family Physician, 31, pp.535–540.
Mann SJ, Viswanath O, Singh P. Lumbar Facet Arthropathy. 2023 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30855816.
Scarcia, L., Pileggi, M., Camilli, A., Romi, A., Bartolo, A., Giubbolini, F., Valente, I., Garignano, G., D’Argento, F., Pedicelli, A., & Alexandre, A.M. (2022) ‘Degenerative Disc Disease of the Spine: From Anatomy to Pathophysiology and Radiological Appearance, with Morphological and Functional Considerations’, Journal of Personalized Medicine, 12(11), p. 1810. doi: 10.3390/jpm12111810.
