Condition
Degeneration and Arthritis
Degeneration shows up on imaging for a large share of adults over 40. The image is not your sentence. Stiffness, morning start-up pain, and activity limits are what we treat.
It is worth being blunt about how weak the link is between what a scan shows and how someone feels, because a great deal of unnecessary fear comes from that gap. Disc degeneration, facet arthrosis, and bone spurs are extremely common findings in people who have never had back pain in their lives, and the prevalence rises steadily with every decade. Meanwhile plenty of people in genuine pain have unremarkable imaging. A report describing degenerative change tells you something about the age of your spine. It does not tell you why you hurt, and it certainly does not tell you what you are still capable of.
What does correlate with how people function is motion, strength, and load distribution — and those are the things that can actually be changed. When one segment has stiffened, the segments above and below take up the slack and become symptomatic. When a hip has quietly lost rotation, the low back rotates instead. When supporting muscle has deconditioned, the joint carries what the muscle used to. Restoring motion where it has been lost and unloading the segment doing too much is not cosmetic — it is most of the difference between a degenerative spine that limits your week and one that does not.
The first-visit conversation is usually about expectations. We cannot regrow a disc or remove a bone spur, and anyone offering that is not being straight with you. What is realistically available is better morning start-up, longer standing and walking tolerance, fewer flares, and shorter ones when they happen. For most people that is the difference that matters, and it is durable when the exercise side is taken seriously rather than treated as an optional extra.
Technique selection matters more with degeneration than with almost anything else we see. An older, arthritic, or osteopenic spine is not a candidate for a forceful rotary adjustment, and it does not need one. Instrument adjusting, drop-table work, flexion-distraction, and mobilisation all restore motion at considerably lower load. Screening comes first regardless: inflammatory arthritis, instability, and fracture risk are looked for before anyone is treated, and cases with red flags are referred rather than adjusted.
Low-force techniques, decompression when discs are part of it, and shockwave for stubborn peri-articular pain in three clinics keep this from being a “you’re just getting old” visit.
Related conditions
Services that often help
Doctors to start with
Patients from Bear, Glasgow, and Pike Creek typically use Newark. Brandywine Hundred, Claymont, and Hockessin use Wilmington. Capital-area patients use Camden/Dover. Smyrna covers Route 13 and Saturday mornings.
FAQ
If I have arthritis, can I still be adjusted?
Usually yes, with technique changes. Inflammatory and unstable cases are screened.
My scan says degenerative disc disease. How bad is that?
Less bad than the name. It is a description of what discs look like with age, not a progressive illness, and it is present on imaging in a large share of people who have no pain at all. The findings on your report and the pain in your back are two separate facts that may or may not be related, and the exam is what connects them.
Will adjusting make worn joints worse?
Not when the technique matches the joint. What is inappropriate for a degenerative spine is a forceful rotary adjustment applied without thought. What is appropriate is instrument adjusting, drop-table work, flexion-distraction, and mobilisation — all of which restore motion without loading the joint the way a heavy manual thrust does. The exam decides which, and you should be told why.
Is there any point, or am I just getting older?
There is a point, and it is not that we can reverse the wear. Two people with identical scans can have completely different lives depending on how much the surrounding joints move, how strong the supporting muscle is, and how much load the bad segment is carrying. All three are changeable. The scan is not.
When does this stop being a chiropractic problem?
When there is progressive neurological loss, when walking distance is collapsing month by month, when night pain is unrelenting, or when the picture suggests inflammatory arthritis rather than mechanical wear. Those get referred rather than treated, and the exam is looking for them from the first visit.