Massage therapy · Kitchener–WaterlooDegenerative Disc Disease (DDD)

Just about everyone will have some type of lower back pain at some point in their lifetime. Pain can range from mild to severe. It can last for a long time or be short-lived. Whatever the cause, pain in the lower back can make many normal everyday activities difficult.

Changes in the discs are a normal part of ageing. Signs of disc change can be seen as early as the teenage years (Urban and Roberts, 2003), and almost everyone has some disc degeneration after the age of 40, even if it causes no symptoms (Cleveland Clinic, 2025). The soft centre of each disc (the nucleus) is around 80% water, and it is surrounded by a tough outer ring of fibrocartilage known as the annulus (Urban and Roberts, 2003). As we get older, the centre of the disc naturally loses some water, so the disc becomes thinner and does not absorb shock as well (Cleveland Clinic, 2025). This drying out is an early part of degeneration. Small cracks can appear in the outer ring, and the disc may bulge outwards. If the outer wall cracks open, disc material can push out (a herniated, slipped or prolapsed disc), which may press on a nerve (Cleveland Clinic, 2025; Urban and Roberts, 2003). Despite its name, degenerative disc disease is not really a disease but a condition in which the discs wear down; when more than one disc is affected it is called multilevel degenerative disc disease (Cleveland Clinic, 2025).

Causes of Degenerative Disc Disease

• Hereditary/Genetic: disc disease can run in families, so if a parent, brother or sister has it, you are more likely to get it too (MedlinePlus Genetics, 2016).
• Ageing (wear and tear): disc changes become more common as we get older (Urban and Roberts, 2003; Cleveland Clinic, 2025).
• Smoking and excess weight: both are linked to a higher risk of disc degeneration (Urban and Roberts, 2003; MedlinePlus Genetics, 2016).
• Heavy physical work and injuries: a physically demanding job, heavy work, and acute injuries such as falls can increase the risk (Cleveland Clinic, 2025; Urban and Roberts, 2003).

Degenerative Disc Disease Anatomy

How to Treat Degenerative Disc Disease

Tips

• Combining aerobic exercise with specific strengthening and stretching exercises will help to keep your back muscles flexible and strong.
• Make sure to lift heavy objects using your legs and not your back, and avoid frequent heavy lifting where you can (Cleveland Clinic, 2025).
• Maintaining a healthy weight helps reduce strain on the lower back (Cleveland Clinic, 2025).
• Smoking is linked to disc degeneration and can make back pain worse (Urban and Roberts, 2003; Cleveland Clinic, 2025).
• Avoid sitting for long periods – get up and move around regularly (Cleveland Clinic, 2025).

Treatments you may want to discuss with your family doctor or nurse practitioner

Disc changes are a normal part of ageing and don't mean a fragile back. Staying active usually helps more than resting. My aim is to ease pain and muscle guarding, keep your back moving, and build the strength and confidence for work, training and daily life.

I start by checking for the rare signs of something more serious, then assess how your back and hips move, your strength and, if you have leg symptoms, your nerves (sensation, reflexes and strength). I also look at which positions ease your symptoms, since that shapes your exercises.

When It Flares

• Massage, trigger point and myofascial work to ease guarding muscles in the back, hips and hamstrings
• Gentle mobilisation of stiff segments, with no quick thrusts, and never on segments that are already too loose
• Warm applications in the clinic, and comfortable positions such as lying on your side or with knees bent and supported
• Staying active: rolling, getting up, sit-to-stand and short walks you build on day by day

Building Strength

• Deep trunk work, progressing to bridges, lunges and hip-hinge bending
• Exercises guided by what eases your symptoms, whether that's bending forward or gently arching back
• Strength work with weights and regular aerobic exercise; if you lift, I'll help you rebuild hinges, squats and deadlifts step by step
• Learning to move into bending, lifting and twisting without bracing or holding your breath

Daily Habits

1. Urban, J.P.G. and Roberts, S. (2003) 'Degeneration of the intervertebral disc', Arthritis Research & Therapy, 5(3), pp. 120–130. doi: 10.1186/ar629
2. Cleveland Clinic (2025) Degenerative disk disease. Available at: https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease (Accessed: 7 October 2026).
3. MedlinePlus Genetics (2016) Intervertebral disc disease. Available at: https://medlineplus.gov/genetics/condition/intervertebral-disc-disease/ (Accessed: 7 October 2026).
4. National Institute for Health and Care Excellence (NICE) (2016, updated 2026) Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59) – Recommendations. Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).
5. NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 7 October 2026).
6. Middleton, K. and Fish, D.E. (2009) 'Lumbar spondylosis: clinical presentation and treatment approaches', Current Reviews in Musculoskeletal Medicine, 2(2), pp. 94–104. doi: 10.1007/s12178-009-9051-x