Why do disc problems cause pain in some people but not in others?

It's clear from X-ray and MRI studies that degenerative disc disease (DDD) doesn't always cause pain. And the amount of pain isn't based on the severity of changes seen in the imaging studies.

Knowing this, researchers are looking for explanations for low back pain caused by DDD. Right now, all we have are theories to go on. Some of these theories include nerve entrapment from disc herniations and inflammatory responses of the tissue around the disc herniation.

Other experts propose that nerve ingrowth occurs after rupture of the outer surface of the disc. The same thing can happen when the endplate between the disc and the bone ruptures.

Any of these effects can also lead to changes in the biomechanics of the spine. Biomechanics refers to the position of the spinal parts. How each component of the vertebral segment moves and functions is also a part of biomechanics.

In the last 10 years, more studies have pointed to a possible genetic influence in low back pain. Genetics may be linked to the development of disc narrowing and disc degeneration. Genetics may even have an effect on types of jobs people choose and how they spend their leisure time. Back pain may be linked to these factors as well.

There isn't a simple answer to your question just yet. More studies are needed to identify risk factors and predictive factors for disc degeneration and low back pain.