Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Persistent back or neck pain can greatly interfere with daily life. One common reason for these symptoms is degenerative disc disease (DDD), a term that describes the spine’s natural ageing process. As the discs gradually lose height and hydration, they may no longer cushion the spine effectively, sometimes triggering nerve irritation. Here, we take a closer look at the causes, symptoms and treatment options for DDD.
What Is Degenerative Disc Disease (DDD)?
Degenerative disc disease refers to the gradual, age-related changes that occur within the spinal discs—the soft, cushioning structures between each vertebra. Over time, these discs naturally lose moisture and elasticity, making them less effective at absorbing shock and supporting spinal movement.
While disc degeneration happens to everyone as they age, not everyone develops discomfort. Problems arise only when the structural changes affect how the spine moves or when inflammation and nerve irritation occur.
Impact of Degenerative Disc Disease
- Loss of water content, which reduces the disc’s ability to absorb shock
- Reduced disc height, leading to less space between vertebrae
- Small tears in the outer disc layer, which may cause localised pain
- Disc bulging, which can place pressure on the surrounding nerves
- Changes in nearby joints and ligaments, often linked to wear and inflammation
Why Does Disc Degeneration Occur?
- Age-related Changes: As we grow older, spinal discs naturally lose water content, making them less flexible and more prone to wear.
- Genetics: Some people inherit a tendency for discs to break down earlier or more quickly than others.
- Repetitive Stress: Jobs, sports or daily movements that involve frequent bending, lifting or twisting can place extra strain on the discs over time.
- Previous Injuries: Trauma from falls, accidents or heavy lifting can injure a disc and accelerate the degenerative process.
- Lifestyle Factors: Smoking reduces blood supply to the discs, and prolonged sitting can increase pressure on the spine, both of which may affect disc health.
Common Symptoms to Look Out For
Localised Neck or Back Pain
Pain often centres around the affected disc and may worsen with bending, twisting, lifting or prolonged sitting. Many people describe a dull ache that intensifies during certain movements or at the end of the day.Radiating Pain
If disc degeneration irritates or compresses a nerve root, pain may travel along the nerve’s pathway. This can appear as:- Pain spreading from the neck into the shoulder, arm or hand
- Pain radiating from the lower back into the buttock, thigh or leg
Stiffness and Reduced Flexibility
Degeneration can limit the spine’s normal movement. Patients may find it harder to bend forward, lean backwards or rotate the spine without discomfort.Numbness, Tingling or Weakness
When nerve compression is present, sensory changes or muscle weakness can occur in the arms or legs. These symptoms may indicate more significant involvement of the nerve.How Degenerative Disc Disease Is Diagnosed
Medical History and Physical Examination
During the consultation, the doctor will assess your symptoms and identify which activities make them worse. This may include:- Asking about movements, positions or tasks that aggravate pain
- Evaluating your spine’s range of motion
- Checking for nerve-related symptoms such as numbness, tingling or radiating discomfort
- Testing muscle strength to detect possible weakness
- Assessing reflexes to identify signs of nerve root involvement
Imaging Studies
Depending on your condition, the doctor may recommend one or more imaging tests:- X-rays are used to assess disc height, spinal alignment and any visible structural changes in the vertebrae.
- MRI scans provide detailed information about disc hydration, nerve involvement and the condition of surrounding soft tissues.
- CT scans may be recommended when a clearer, more precise view of the bone structures is required.
Treatment Options for Degenerative Disc Disease
Physiotherapy
A structured physiotherapy programme is often the first line of management. It may include:- Core-strengthening exercises to support the spine
- Stretching routines to improve flexibility
- Posture and ergonomic training to reduce strain during daily activities
- Manual therapy to ease stiffness and improve mobility
Medications
Doctors may prescribe medications such as anti-inflammatories, muscle relaxants or neuropathic pain relievers to ease discomfort and manage inflammation.Lifestyle Adjustments
Several practical changes may help support spine health, including:- Regular low-impact exercise, such as walking or swimming
- Weight management to reduce load on the spine
- Avoiding long periods of sitting or poor posture
- Smoking cessation, as smoking may affect disc nutrition and healing
Image-Guided Injections
When inflammation around a disc contributes to persistent symptoms, image-guided steroid injections may be considered. These injections deliver medication directly to the irritated area and can provide relief for selected patients. They are usually part of a broader treatment plan rather than a standalone solution.Surgery for Degenerative Disc Disease
Surgery is generally considered only when conservative treatments have not provided sufficient relief. This intervention is reserved for cases where nerve compression results in weakness or when imaging reveals significant structural changes that clearly correspond with the patient’s symptoms. Common surgical procedures include:- Discectomy: This procedure involves removing the portion of the disc that is pressing on a nerve and causing symptoms.
- Spinal Fusion: This surgery stabilises a segment of the spine that has become unstable due to degeneration or structural damage.
- Artificial Disc Replacement: In selected cases, the damaged disc is replaced with an artificial one to preserve motion at the affected spinal level.
Find Relief From Chronic Back Pain at Oxford Spine & Neuro
Persistent back or neck pain shouldn’t be ignored, especially when it begins affecting your work, sleep or mobility. If you’ve been living with symptoms that come and go or flare up with certain activities, getting a clear diagnosis can help you understand what’s manageable on your own and what may benefit from medical or even surgical treatment.
For more information and assistance, please contact us to make an appointment with our experienced spine specialist, Dr Colum Nolan, today.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
