Imaging findings that sound alarming are, for the most part, ordinary. The single most useful study on this question pooled imaging from 3,110 people who had no back pain at all, and reported how often each “degenerative” finding turned up by age.1
What the scans actually show
| Finding | Age 20 | Age 50 | Age 80 |
|---|---|---|---|
| Disc degeneration | 37% | 80% | 96% |
| Disc bulge | 30% | 60% | 84% |
| Disc protrusion | 29% | 36% | 43% |
| Annular fissure | 19% | 24% | 29% |
Every person in that table was symptom-free. By eighty, having a degenerated disc is not the exception — it is close to universal.
The authors concluded that many imaging-based degenerative features are part of normal ageing and are unassociated with pain.1
Why this matters for what you do next
If a finding is present in most pain-free people of your age, then finding it on your scan does not explain your pain. It may be incidental. This is the reasoning behind guideline advice to avoid imaging in the absence of red flags: a scan that reports age-normal change can lead to worry, more tests and treatment aimed at something that was never the problem.
It also reframes prevention. You cannot keep discs looking twenty at sixty, and the attempt is not what determines whether your back hurts. What you can change is load tolerance — how much your tissues handle before they complain — and that responds to activity throughout life.
What does change with age, and matters
- Reduced capacity. Muscle mass and endurance fall unless trained. This affects how long you can hold any position before it becomes uncomfortable.
- Stiffer segments. Range of motion narrows gradually. Movement variety matters more, not less.
- Bone density. In some people this becomes clinically relevant — see osteoporosis of the spine.
- Thoracic kyphosis. Increases with age, but only a minority of even severe cases involve vertebral fractures.
None of these are reasons to move less. All of them respond, at least partly, to continued loading.
Related
Age related changes in the shape of the upper back are covered in neck hump and hyperkyphosis. Why imaging findings and posture are poor guides to pain is discussed in posture and pain and what good posture is.
Footnotes
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Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR, 2015. ↩
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