Everyone’s discs degenerate as we get older. Disc degeneration can also be seen as early as the late teens as a result of trauma, surgery, or just bad genetics. Most people with degenerative disc disease can manage their ongoing pain, as well as more painful flare episodes, with conservative (non-surgical) care.

Disc degeneration comes with age, and sometimes start to impact daily activities. Watch: Lumbar Degenerative Disc Disease Video

Yet, for a small percentage of patients surgery may become the right option because conservative degenerative disc disease treatment has not worked well, and their severe pain and muscle spasms make it difficult to function normally. While it is sometimes true that the pain from a degenerated disc can subside after the disc has fully degenerated, this process can take years and is highly variable.

See Surgical Treatments for Degenerative Disc Disease


For people with ongoing severe, disabling pain and associated symptoms (e.g., numbness, tingling, difficulty sitting) it is sometimes not possible to wait for non-surgical therapy to work and/or for nature to run its course. Consequently, surgery—either the more standard Types of Spinal Fusion or the newer artificial disc replacement surgery—may be warranted if patients meet the following criteria:

  • They have conscientiously engaged in at least six months of non-surgical pain treatment and active exercise-based physical rehabilitation for core strengthening;
  • Their pain is still significant, both in terms of magnitude and its inability to be controlled with acceptable doses of medication or treatment, and, most importantly;
  • Their ability to function in every day activities is seriously diminished. Patients may be advised to apply “the every day test.” This means that if they are making concessions to their normal lifestyle every day of their lives because of their back pain, despite adequate non-operative treatments, then a surgical consultation is appropriate.

Dr. Jack Zigler is an orthopedic surgeon at the Texas Back Institute and Co-Director of its Spine Fellowship Program. He has more than 30 years of experience performing spine surgery. He serves as the Co-Director of the Center for Disc Replacement at the Texas Back Institute and teaches around the work on surgical techniques for artificial disc replacement surgery.

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