Degenerative Disc Disease

Degenerative disc disease, or DDD, describes age-related and injury-related changes in the spinal discs. These discs sit between the bones of the spine and help absorb shock while allowing movement. Over time, discs can lose water content, height, and flexibility. Small tears in the outer disc layer may also develop. DDD is common and does not always cause symptoms. When a disc is painful or affects nearby nerves, it can contribute to chronic low back or neck pain, stiffness, and limitations in daily activities.

Common Symptoms

There is no single treatment that reverses disc degeneration. Standard care is usually based on a person’s symptoms, imaging findings, activity level, and overall health. Many people improve with a combination of conservative treatments.

Standard Treatment Categories

• Physical therapy and exercise: Programs may improve strength, flexibility, movement patterns, and daily function.
• Medication: Anti-inflammatory medicines, acetaminophen, or other medications may be considered when appropriate.
• Lifestyle and supportive care: Activity modification, weight management, sleep, and smoking cessation can support spine health.
• Interventional care: Some people may consider injections or other procedures when symptoms persist.
• Surgery: Surgery may be considered when there is significant nerve compression, instability, progressive neurologic symptoms, or pain that has not responded to appropriate nonsurgical care.

Stem cell therapy for degenerative disc disease and platelet-rich plasma, or PRP, are being studied because cell-based approaches may influence inflammation and the environment within damaged spinal discs. Researchers are evaluating different products, including mesenchymal stromal cells, mesenchymal precursor cells, and bone marrow concentrate.

What Researchers Are Studying

• Influence inflammatory signaling within the disc
• Support the disc environment and surrounding tissue
• Be delivered safely into the affected disc
• Improve pain, function, or other patient-reported outcomes

Researchers are also studying PRP and PRP releasate as separate injectable approaches. These products are prepared differently, and findings from one product or treatment protocol should not be assumed to apply to another.

Note: Regenerative therapies for degenerative disc disease are not FDA-approved and are investigational. Early studies have reported changes in pain and function, but controlled trials have not established a reliable benefit across all products and patient groups.

How Stem Cell Therapy for Back Pain Is Being Studied

Cell-based therapies are being studied for their potential to influence inflammation and support the disc environment. Mesenchymal stromal cells, mesenchymal precursor cells, and bone marrow concentrate are prepared differently and are not interchangeable, even though all may be described broadly as stem cell approaches. In early clinical studies, some participants have reported reduced pain and improved function. Many studies are small, lack a control group, or use different products and treatment methods. Larger controlled trials have not consistently demonstrated a benefit over placebo or sham injection. PRP is made from a person’s own blood and contains platelets and signaling proteins. Related but distinct preparations are also under study, including PRP releasate, the fluid collected after platelets are activated rather than the platelet-containing preparation itself. Findings from one of these preparations should not be assumed to apply to the other.

2025: MPC Plus Hyaluronic Acid Reduced Pain at 12 and 24 Months

Efficacy and Safety of Allogeneic Mesenchymal Precursor Cells With and Without Hyaluronic Acid for Treatment of Chronic Low Back Pain: A Prospective, Randomized, Double-Blind, Concurrent-Controlled 36-Month Study — Read Study

This phase III trial enrolled 404 people with chronic low back pain and compared mesenchymal precursor cells with hyaluronic acid, mesenchymal precursor cells alone, and saline control. The prespecified composite primary endpoint and secondary responder endpoints were not met across all participants. Mesenchymal precursor cells with hyaluronic acid did reduce adjusted mean low back pain scores compared with control at 12 and 24 months. Several other favorable findings were limited to a prespecified subgroup with shorter symptom duration. The study was funded by the product developer, and its findings need confirmation in additional independent trials.

2024: MSC Injections Demonstrated a Favorable Safety Profile

Allogeneic Bone Marrow-Derived Mesenchymal Stromal Cell-Based Therapy for Patients With Chronic Low Back Pain: A Prospective, Multicentre, Randomised, Placebo-Controlled Trial (RESPINE Study) — Read Study

This multicenter, double-blind trial randomized 114 participants with chronic low back pain to a single intradiscal injection of allogeneic bone-marrow-derived mesenchymal stromal cells or a sham placebo injection. At 12 months, the primary outcome was not met: 74 percent of the cell-treated group and 69 percent of the placebo group met the responder definition, a difference that was not statistically significant. The groups did not differ on secondary outcomes, and no serious adverse events related to the intervention occurred. The study did not demonstrate efficacy.

2023: Allogeneic MSC Injections Associated With Pain and Disability Improvement

Pain Relief After Allogeneic Stem Cell Disc Therapy — Read Study

This retrospective observational study followed 33 people treated with intradiscal allogeneic mesenchymal stromal cells. Participants reported improvement in pain and disability scores at approximately two years of follow-up. The authors reported that no participant required additional treatment for low back pain at the injected level. Because it did not include a control group, the improvements cannot be attributed to the treatment alone, and the findings come from a single-center retrospective series at a practice that provides the therapy, so larger, controlled studies across independent centers would help confirm and extend the results.

2022: PRP Releasate Produced Pain Relief Comparable to Corticosteroid

Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial — Read Study

This small randomized, active-controlled study included 16 participants with discogenic low back pain and compared PRP releasate with corticosteroid rather than placebo. The primary pain outcome at eight weeks did not differ significantly between groups, and the authors described pain improvement after PRP releasate as comparable to corticosteroid. While MRI degeneration grading did not differ significantly between groups, the results support continued investigation. Because the study was funded by the product developer, independent research will be valuable in confirming the findings.

2021: Mesenchymal Precursor Cells Reported Pain Improvements

Allogeneic Mesenchymal Precursor Cells Treatment for Chronic Low Back Pain Associated With Degenerative Disc Disease: A Prospective Randomized, Placebo-Controlled 36-Month Study of Safety and Efficacy — Read Study

This randomized, placebo-controlled study evaluated 100 participants across several treatment groups, including two doses of mesenchymal precursor cells with hyaluronic acid, hyaluronic acid alone, and saline placebo. The study reported differences in pain and disability at selected time points. While MRI degeneration grading did not differ significantly between groups, the findings help inform continued research in this area, and independent studies will be important to confirm the results.