Degenerative changes in the spine are those that cause the loss of normal structure and/or function. They are not typically due to a specific injury but rather to age. Repeated strains, sprains, and overuse of the back cause a gradual degeneration of the disks of the spine. Nearly everyone experiences some disk degeneration after age 40.Since most patients do improve with time and non-operative treatment, surgery is only recommended when degeneration or disk herniation produces persistent back pain or leg pain from nerve compression. A comprehensive back program, combining physical therapy, activity modification, pain management, and appropriate surgery when indicated provides each individual with his or her best chance of recovery. Degenerative back conditions erode the disk’s ability to handle mechanical stress, leading to back pain. Many patients with persistent pain are found to suffer from symptomatic disk degeneration, a condition in which the disk loses its normal water content and its ability to absorb weight and shock during motion. These changes are part of the normal aging process, in that everyone experiences disk degeneration as they age, but only some of the disks with these changes ever produce symptoms of pain.