What is Lumbar Degenerative Disc Disease?
Age-related change in the lumbar discs, which lose water and flexibility and begin to bulge — a bit like a bike tyre that is not fully inflated. This is a normal part of ageing but can produce mechanical back pain and, when combined with bulges, herniations and arthritis at adjacent joints, become a significant source of symptoms due to pressure on the nearby nerves.
Causes
Age, genetic predisposition, smoking reduces blood supply to the disc, being overweight, occupations involving heavy lifting, repetitive bending or prolonged sitting, sustained poor posture, and a sedentary lifestyle that weakens the supporting muscles.
Symptoms
Mechanical low back pain — typically a dull ache that worsens with bending, lifting, sitting and prolonged standing, often worse first thing in the morning. Pain may radiate into the buttocks. Disc-related pain frequently coexists with leg pain sciatica when a nerve is compressed.
Diagnosis
Careful history pattern, triggers, prior episodes, red flags and examination — spinal range of movement, neurological assessment of the legs, and provocative tests. Most cases need no imaging in the acute phase…
Imaging
X-ray for alignment, instability and degenerative change. MRI when there is leg pain, weakness or persistent symptoms — the investigation of choice for showing the discs, nerves and soft tissues. CT when MRI is not possible or bony detail is required. MRI abnormalities are extremely common in pain-free people, so findings must be interpreted alongside symptoms.
Treatment
Most episodes settle with sensible self-care. Stay active within sensible limits, address modifiable risk factors weight, smoking, sleep, mental health, pace activity, build core, gluteal and hip strength. Medications paracetamol, NSAIDs, nerve-pain agents pregabalin, gabapentin, amitriptyline, short courses of muscle relaxants or opioids during flares, topical preparations. Physiotherapy and CT-guided spinal injections where indicated. Surgery is reserved for clear structural problems unresponsive to non-surgical care.