Degenerative Disc Disease: What the Diagnosis Means

By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published November 2026

You finally got an MRI for your back pain, and the report says "degenerative disc disease" at a few levels. The words sound alarming. You start wondering if your spine is wearing out, whether it will keep getting worse, and if you should stop lifting, running, or playing with your kids.

Degenerative disc disease is one of the most common findings on spine imaging, and it's also one of the most misunderstood. This article explains what the term really means, why it's so common even in people without pain, what helps, how physical therapy fits in, and which symptoms need a physician.

The short answer

"Degenerative disc disease" describes age-related changes in the discs between the vertebrae, such as drying out and thinning. Despite the name, it isn't really a disease. A review of imaging studies in 3,110 people without back pain found disc degeneration in 37% of 20-year-olds and 96% of 80-year-olds, and the authors concluded many of these changes are likely part of normal aging (Brinjikji et al., 2015). The APTA low back pain guideline supports exercise, staying active, education, and hands-on treatment for back pain (George et al., 2021). Most people with disc changes can stay active and improve. Numbness, weakness, or bladder or bowel changes need a physician. In California, you can see a physical therapist without a referral.

What is degenerative disc disease?

Between each pair of vertebrae is a disc, a tough outer ring with a softer center. Discs absorb shock and allow the spine to bend and twist. Over time, discs naturally change:

• They lose some water and become a little thinner
• The outer ring can develop small tears
• The space between vertebrae can narrow
• Small bone spurs may form nearby

These changes are similar to gray hair or wrinkles: they happen to almost everyone with age, at different rates.

Is degenerative disc disease serious?

For most people, no. The name sounds worse than the condition. In the review of 3,110 people with no back pain (Brinjikji et al., 2015):

• Disc degeneration showed up in 37% of 20-year-olds and 96% of 80-year-olds
• Disc bulges showed up in 30% of 20-year-olds and 84% of 80-year-olds
• The authors concluded that many of these features are likely part of normal aging and not linked to pain

That means a disc finding on your MRI may or may not explain your pain. Back pain usually depends on many factors, including how active and strong you are, sleep, stress, and how sensitive your nervous system has become.

Will it get worse?

Disc changes can progress slowly with age, but pain doesn't follow the same path. Many people with significant changes on imaging have little or no pain, and back pain often comes and goes over time. Staying active and strong is one of the best ways to keep doing what you enjoy.

What helps degenerative disc disease?

The APTA low back pain guideline supports (George et al., 2021):

• Exercise: strengthening, trunk control, and general fitness
• Staying active: keeping up daily activities as much as you can
• Education: understanding what imaging findings mean and how pain works
• Hands-on treatment: manual therapy combined with exercise for some people

Things that often help day to day:

• Walking, swimming, or cycling
• Changing positions regularly instead of sitting for hours
• Building hip and core strength
• Getting good sleep

Questions about medication, injections, or surgery are best directed to your physician.

How can physical therapy help?

A physical therapy evaluation may include:

• Your symptoms, what makes them better or worse, and your goals
• Back and hip motion, strength, and endurance
• A neurological screen for nerve involvement
• Going over your imaging report together, while your physician explains your specific results
• Screening for signs that need a physician's evaluation

A typical plan may include:

• Progressive strengthening for the back, hips, and core
• Mobility exercises and hands-on treatment when helpful
• Education about disc changes and back pain
• A plan for staying active and managing flare-ups
• A home program you can keep doing on your own

Physical therapy doesn't guarantee a specific result or timeline. At Nova Physical Therapy in North Hollywood, back pain and spine conditions, including degenerative disc disease and herniated discs, are among our core services, and every plan starts with an evaluation so treatment fits what we find. For related reading, see our posts on herniated discs and spinal stenosis.

When should I see a doctor?

Get emergency care if you have:

• Loss of bladder or bowel control
• Numbness in the groin, buttocks, or inner thighs
• Sudden or worsening weakness in one or both legs

See a physician promptly if you have:

• Numbness, tingling, or weakness spreading down a leg
• Fever, unexplained weight loss, or a history of cancer
• Back pain after a fall or significant injury
• Pain at night or at rest that doesn't ease with changing position

We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.

Do I need a referral for physical therapy in California?

Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage or see our insurance page.

Frequently asked questions

Is degenerative disc disease serious?
Usually not. Disc changes are very common with age, including in people with no pain. Most people with these findings can stay active and improve with the right plan.

Can degenerative disc disease be reversed?
Disc changes on imaging don't usually reverse, but pain and function often improve a lot with exercise, activity, and time.

What exercises are good for degenerative disc disease?
Strengthening for the back, hips, and core, along with walking, swimming, or cycling, often help. A physical therapist can tailor exercises to your symptoms.

Should I avoid lifting with degenerative disc disease?
Not necessarily. Many people can keep lifting with gradual training and good strength. Your physical therapist can help you build up safely.

Does degenerative disc disease always cause pain?
No. Many people with disc degeneration on MRI have no back pain at all.

Can physical therapy help degenerative disc disease?
Yes. Exercise, education, and staying active are recommended for back pain, and a physical therapist can build a plan around your goals.

Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.

About Nova Physical Therapy

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from back and neck pain, sports injuries, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.

Schedule an evaluation

If an MRI report or ongoing back pain has you worried, an evaluation can help you understand what it means and build a plan to stay active.

Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online

Disclaimer

This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Back pain has many causes, and only an in-person evaluation can determine what is right for you. We do not interpret imaging in place of your physician. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.

References

1. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. Link
2. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1–CPG60. Link