I came across an article on “Disc Issues” and it is fascinating that some of these old ideas are still being shared.
“Disc Disease” is the loss of fluid/flattening of a disc as it sits between two vertebrae in the spine. This is usually a normal part of the aging process. We are moving through space as gravity is pushing down on us leading to these changes. It appears in the neck this aging process starts to happen around the 2nd decade of life and then in our lumbar spines by the 5-6th. These findings are on MRIs all the time and have been found in studies of patients that have no pain at all! Disc Bulging usually accompanies Disc Disease. Imagine the disc as a balloon and as it gets "squeezed" from the top to bottom it will spread out to the sides. This is more common in the lower back due to a narrowing of the ligament (posterior longitudinal ligament) that is supposed to hold them in place. “Disc Herniations” are where the inside of a disc (nucleus pulposus) extrudes outside of the disc. This is frequently described as if the jelly inside of a jelly donut were to squirt out. It has been proposed that this can cause an immune reaction due to a foreign substance and result in inflammation and pain. This process can be quite painful, but is believed to resolve over 4-6 weeks. Pain can also happen when a disc is pressing on nerves, resulting in “Nerve Impingement”. In the past, tears on the outside of the disc, called Annular Tears, were considered a cause of pain, but that has fallen out of favor recently. In my clinical experience, I feel these are a cause of pain which can be very difficult to manage.
This all being said, the vast majority of back pain issues are mechanical in nature and not related to these normal aging processes that are found on both symptomatic and asymptomatic people.