Degenerative disk disease is a common condition that can occur with aging. It's an expected change in the spine over time. While it can lead to occasional discomfort, most people with DDD continue to lead active and fulfilling lives.

The spinal column, or backbone, provides support, flexibility, and protection for our spinal cord. The spine is made up of a series of bones called vertebrae. Each vertebra "stacks" on top of another in a column-like structure spanning five regions:

• Cervical (neck).
• Thoracic (chest).
• Lumbar (lower back).
• Sacrum (the triangular bone located between the two hip bones). It stabilizes the pelvis).
• Coccyx (tailbone).

Between each vertebra are disks that function as shock absorbers and allow for smooth movement. Each disk has a tough outer layer (annulus fibrosus) and a gel-like inner core (nucleus pulposus).

Disks may gradually lose some thickness and flexibility, leading to degenerative disk disease. However, you can maintain a strong and flexible spine with proper care and healthy lifestyle choices. It is important to support the health of your spine and minimize potential discomfort by:

• Staying active.
• Practicing good posture.
• Engaging in exercises that strengthen your muscles.

You are more likely to develop DDD if you:

• Are obese.
• Smoke.
• Are physically inactive.
• Reach advanced age.

Your health care providers will consider three main components to make a diagnosis, including:

• Your medical history.
• Findings from a physical exam.
• Results from tests, including any diagnostic imaging.

Your physical therapist will conduct a thorough clinical evaluation. They will review your health history and use screening tools to determine the impact of DDD. Your physical therapist may:

• Ask questions about the specific location and behavior of your pain and other symptoms.
• Conduct tests of your muscle strength, coordination, and flexibility.
• Examine your posture and watch how you walk and do other activities.
• Measure the range of motion of your spine, arms, and legs.
• Use manual (hands-on) therapy to evaluate the mobility of the joints and muscles in your spine.
• Conduct a basic neurologic exam. This exam assesses your muscle strength, pain and numbness, and deep tendon reflexes.

Your physical therapist may work with your medical doctor if they find the following:

• Signs of progressive muscle weakness.
• Loss of feeling.
• Severe pain.

In such cases, diagnostic imaging tests (such as an X-ray or MRI) can help confirm a diagnosis. In some states, physical therapists can order these tests, but in others, your physician will.

It is often a relief when both a physical exam and diagnostic results align. However, considering all three criteria — health history, a clinical exam, and imaging — is essential for an accurate diagnosis.

DDD is a natural result of aging. However, you can make choices that lessen its impact on your life and slow its progression. Your physical therapist can offer you advice on staying strong and fit. Some physical therapy clinics conduct seminars to help people learn how to take care of their backs and necks.

Your physical therapist can help you develop a fitness plan that takes your DDD into account. There are specific exercises that are better than others for people with DDD. Your physical therapist will choose the right ones for you. Following these research-backed recommendations can help you take control of your spinal well-being:

Trying physical therapy first. Research shows that physical therapy can improve quality of life, reduce pain, and help you return to daily activities. This can reduce any need for surgery.

Maintaining regular physical activity. Various types of activity and exercise may be beneficial for recovery and prevention. Exercising in water, weight training, or walking on level ground can help you stay active if other forms of exercise cause pain.

Reducing mechanical stress. Exercises involving repeated twisting and bending should be done with caution. If you start noticing pain after exercising, consult a physical therapist. They can improve how you move, adjust your exercises, and help reduce or eliminate your back or neck symptoms.

Addressing other factors. A person's behaviors, environment, genetics, and nutrition can affect spine health. Consult with a health care professional to get help addressing your specific needs. You can improve your overall health through lifestyle changes such as quitting smoking and avoiding weight gain.

All physical therapists are prepared through education and experience to treat people who have DDD. You may want to consider:

• A physical therapist who is experienced in treating people with pain, orthopedic, or musculoskeletal (muscles, bones, and joints) diagnoses.
• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or geriatric physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can search for physical therapists in your area with these or other credentials by using Find a PT, a tool built by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family, friends, or other health care providers.
• Ask about the physical therapists' experience in helping people with degenerative disk disease.
• Be prepared to describe your symptoms in as much detail as possible and say what makes your symptoms better or worse.