Physiotherapy Q&A: I’ve been told I have degenerative disc disease, could physiotherapy make it worse?

I have had lower back pain for the past 6 months. I did not injure my back but the pain has not gone away and it hurts with any bending or lifting movements. My GP organised an MRI which has shown ‘degenerative disc disease’ and I have been told I have some bulging discs. I am only 38. I have been told I need physiotherapy but I am now worried that I am going to make my back worse and that I won’t be able to run in the future.

Adam Slater, Chartered Physiotherapist and Extended Scope Practitioner, answers:

Thank you for your question which highlights a common problem we see when treating people with lower back pain. What you are experiencing is not uncommon as almost all of us at some time in our lives will get some back pain. However, MRI scans are very rarely able to ‘diagnose’ the problem to identify a specific structure that is causing the pain.

Degenerative disc disease is the term used to describe normal changes in our discs as we get older and is actually not a disease at all! A recent study that looked at MRI scans of people without any pain showed that 30% of people aged 20-30 had degenerative discs and this number increased so that by the time we are 80, 96% of people will have this.

We also see lots of disc bulges in people who have no pain. There are a small number of conditions that can be diagnosed with MRI scans but these only make up about 15% of the total number of people we see for back pain and can usually be determined by the signs and symptoms you describe before any MRI is done.

Therefore, unless you describe any of these signs, we see limited benefit in MRI scans as they often don’t help in your management and can often worry people unnecessarily. The MRI scan you have described would be considered normal for a 38-year-old and I agree that physiotherapy would be a good way to improve your symptoms.

I certainly would reassure you that with a structured exercise program there is no reason why you would not be able to return to running or do any exercise for that matter. It is also very unlikely you will damage your back with a graded return to exercise.

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