The Numbers Behind Back Pain: What Science Shows

Age-related spine changes are common — even in people without pain.
A large review published in the American Journal of Neuroradiology (AJNR) found that signs of disc degeneration appear on MRI in about
37% of people in their 20s and rise to 96% by age 80.^[1] In other words, what’s often called “degenerative disc disease” is frequently a normal part of aging — not automatically a reason to have surgery.

Many “abnormal” MRI findings are completely pain-free.
Classic studies in the New England Journal of Medicine and the Journal of Bone and Joint Surgery showed that healthy volunteers with no back pain often had disc bulges, protrusions, or even herniations on MRI.^[2][3] More recent reviews report disc bulges in roughly 30% of adults in their 20s and 84% of adults in their 80s — many without symptoms.^[4]

Some herniations even shrink on their own.
Research describes spontaneous resorption — herniated disc material shrinking over time — which supports a trial of high-quality conservative care before surgical decisions.^[5]

Bottom line: Imaging findings are only one piece of the puzzle. At ProActive Physical Therapy and Wellness, we match what’s on the scan with how you move, feel, and function — then build a plan that fits your goals.

Why Some People Drift Toward Surgery

• Inactivity and poor trunk/hip strength
• Prolonged sitting and slouched posture
• Heavy or awkward lifting without solid mechanics
• Excess body weight and systemic inflammation
• Smoking and low-quality sleep or nutrition
• Waiting too long to address early warning signs

How to Avoid Low Back Surgery: What Works

1) Get evaluated early

A focused exam can spot movement faults, mobility limits, and nerve irritation before they escalate. Early physical therapy often leads to faster, longer-lasting results.

2) Build a stronger “corset”

Target the deep core stabilizers (transverse abdominis, multifidus), hips, and glutes; restore hip and thoracic mobility; and retrain fundamental patterns (hinge, lift, carry, walk). Many people with lumbar disc problems improve with conservative care when they follow a progressive program.

3) Adjust the daily load on your spine

• Hinge at the hips; avoid twisting while lifting
• Take micro-breaks during prolonged sitting
• Sleep in a neutral, supported position
• Prioritize healthy weight, anti-inflammatory nutrition, and hydration

4) Hands-on care that accelerates progress

Joint and soft-tissue mobilization, gentle traction, and nerve glides — paired with the right exercise dose — can reduce pain and improve motion so you can move more, sooner.

5) Education & consistency

We teach you how to manage flare-ups, read your body’s signals, and keep your gains long-term.

Real Louisville Success: Gary’s Story (Chronic Low Back Pain)

“Those core exercises and lower back exercises that Dr. Brandon taught me have made all the difference because I’m not even sore anymore.” — Gary

People Also Ask

Can physical therapy really help me avoid back surgery?

Often, yes. Many people improve with strengthening, mobility work, and better movement patterns — especially when care starts early. Some herniations even shrink over time (spontaneous resorption).^[5]

When should I consider surgery?

Seek urgent care for red flags (progressive weakness, bowel/bladder changes). Otherwise, guidelines typically support a high-quality trial of conservative care before surgical consult.

Is degenerative disc disease permanent?

Aging changes are normal — but you can still reduce pain and improve function with stability, mobility, and smarter daily mechanics. The presence of degeneration on MRI does not automatically predict pain.^[1]

References

1. Brinjikji W, Luetmer PH, Comstock B, et al.
   Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.
   AJNR Am J Neuroradiol. 2015;36(4):811-816.
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2. Jensen MC, Brant-Zawadzki MN, Obuchowski N, et al.
   Magnetic resonance imaging of the lumbar spine in people without back pain.
   N Engl J Med. 1994;331(2):69-73.
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3. Boden SD, Davis DO, Dina TS, et al.
   Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects.
   J Bone Joint Surg Am. 1990;72(3):403-408.
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4. (Review summarizing prevalence by age)
   Degenerative and herniated disc findings in asymptomatic adults.
   Am J Med. 2023;136(10):e.g. overview of prevalence by decade.
   Link
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5. Zhong M, Liu JT, Jiang H, et al.
   Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis.
   Pain Physician. 2017;20:E45-E52.
   PDF
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