Short answer
These terms describe age-related changes that show up on most spine scans after 40, including in people with no pain at all. One large review found disc degeneration in about 80% of pain-free 50-year-olds1. Changes on a scan do not predict how much you will hurt or what you can do. Pain usually improves with the right exercise, activity and a clear understanding of what the findings mean2.
Answered by Dr. Manan Patel, PT, DPT, TPS, Certified Vestibular Specialist and Therapeutic Pain Specialist. Updated October 18, 2026.
Is degenerative disc disease really a disease?
Not in the usual sense. It describes the drying, height loss and bulging of discs that happen to most people with age, much like gray hair on the inside1. It can contribute to pain, but many people with marked changes have none. The label can create fear that limits movement, and that fear can make pain worse.
What about spinal stenosis and facet arthritis?
Spinal stenosis is narrowing around the nerves, which can cause leg pain or heaviness when standing or walking that eases with sitting or bending forward. Facet arthritis affects the small joints at the back of the spine and often causes stiffness and aching with standing or arching. Both are common, and both usually respond to exercise and activity changes.
What helps back and neck pain after 40?
- Progressive strength and mobility exercise, adjusted to your symptoms3
- Walking programs, often with forward-bent positions for stenosis
- Hands-on care to ease pain and stiffness
- Pain neuroscience education to reduce fear of movement4
- A gradual return to the activities you value
Where can I get spine care for back pain in Alpharetta or Cumming?
Dr. Patel is a certified Therapeutic Pain Specialist, combining exercise and hands-on care with pain science at our Cumming and Alpharetta clinics. Patients come from Johns Creek, Milton, Roswell, Suwanee and Forsyth County, and the $129 self-pay rate covers a full 60-minute visit.
Where can I get help in Alpharetta, Cumming and nearby?
Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
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References
- Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology. 2015.
- Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017.
- George SZ, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy. 2021.
- Louw A, et al. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 2016.
This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.
