Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system (CNS), which includes the brain, optic nerve, and spinal cord. Degenerative disk disease (DDD) is a common medical condition that affects the bones and joints of the spine. When DDD in the lower back causes changes in the vertebral bodies (bony structures) next to the disk, it’s called degenerative endplate sclerosis. Some people may have MS and DDD — including endplate sclerosis — at the same time.

“After years of not knowing what was the explanation for my crumbling lower vertebra and spinal disks, it was degenerative disk disease,” one MyMSTeam member said. “It all makes sense now, MS combined with DDD — a debilitating combination if ever there was one.”

MS, DDD, and endplate sclerosis are chronic, degenerative conditions, which means they’re long term and often get worse with time. In MS, the immune system causes inflammation and scarring (called plaques or lesions) in the CNS, which can lead to problems with nerve signals and muscle control. DDD affects the disks that cushion and protect the spinal cord and is a leading cause of back pain. Endplate sclerosis happens when the bony structures that sit between each disk and the vertebrae (bones of the spine) harden or thicken.

DDD and MS can have similar symptoms and often show up around the same age, usually in a person’s 30s. “They were looking for spine lesions and found I had DDD as well,” one member of MyMSTeam reported.

This article looks at how degenerative disk disease and endplate sclerosis relate to MS.

What Is Degenerative Disk Disease?

DDD occurs when the disks in your spine start to wear down. If the disks bulge or dry out, they may press on nerves and ligaments, causing pain, numbness, tingling, or weakness.

Signs and Symptoms of Degenerative Disk Disease

DDD can cause low back pain, neck pain, and pain in the thighs or buttocks, as well as numbness or weakness. Imaging tests like X-rays or magnetic resonance imaging (MRI) often show signs such as:

• Shrunken disks
• Osteophytes (bone spurs)
• Disk herniation (slipped or bulging disks)

When DDD affects the lower back, it’s called lumbar disk disease. When it affects the cervical spine (neck), it’s called cervical spondylosis. Degenerative changes in the disks can lead to more serious problems, such as a pinched nerve in the spine — for instance, sciatica — or spinal cord compression.

“My degenerative disk disease started in my thoracic spine, which is unusual because it’s not an area that gets a lot of wear and tear,” a MyMSTeam member said. “It rapidly spread to my cervical spine over the next nine months. Within another two months, bulging disks and spinal stenosis in my lumbar region knocked me on my ass.”

What Is Endplate Sclerosis?

Some people with degenerative disk disease also develop changes in the nearby vertebral bodies — an area called the endplate. Endplates are thin layers of bone and cartilage that sit between each spinal disk and the vertebrae.

Endplate sclerosis may occur when these structures harden or thicken, often as a response to stress or injury. When they stop working properly, it can allow the disk to bulge into the bone next to it. If you have DDD, your doctor may tell you that you also have endplate sclerosis. They might also describe it as “signal changes,” “Modic changes,” or “Modic type 1.”

Can MS Cause Endplate Sclerosis?

There’s no evidence that MS causes endplate sclerosis or vice versa. MS and intervertebral disk degeneration are different conditions that can happen at the same time.

Do MS and Degenerative Disk Disease Cause Similar Symptoms?

DDD and MS can have some overlapping symptoms. “One of the problems with MS (out of its many problems) is that doctors, friends — even yourself — can get into a pattern of blaming every symptom or illness on MS,” one MyMSTeam member said. “Like, ‘Back pain? Must be my MS’ when you could have a herniated disk or DDD.”

Both MS and DDD can cause different types of pain, including:

• Neuropathic pain — Damage to the nerves or other parts of the nervous system may cause burning or stabbing sensations and make the affected area very sensitive.
• Musculoskeletal pain — Muscles, bones, joints, and soft tissues may feel achy or sore.

Pain from DDD tends to get worse with sitting, twisting, and lifting. You may feel better when moving around, walking, running, or lying down. DDD-related pain can be recurring (coming and going), acute (sudden and temporary), or chronic (persistent and long-lasting).

Both DDD and MS can also cause:

• A vibrating or buzzing feeling
• Sensory changes like numbness and tingling
• Leg weakness, sometimes leading to foot drop (trouble lifting the front part of the foot)

One MyMSTeam member said, “I have several herniated disks and torn disks that appear to be causing some tingling in my feet and significant back pain.”

Another said, “My left leg goes numb due to my back, my right leg due to MS. Both have severe burning sensations when I stand or walk too far.”

What Are the Risk Factors of These Conditions?

Degenerative disk disease is often part of the natural aging process, but it can also develop after an injury. Multiple sclerosis, on the other hand, is caused by a mix of factors, including genetics, the environment, past infections, and immune system issues.

Both DDD and MS are linked to low levels of vitamin D, a nutrient that’s crucial for bone health. People with DDD may have a higher risk of spinal cord compression and nerve damage. For those with MS, nerve damage may already be happening due to demyelination — when the immune system attacks the myelin sheath (the protective covering around nerves).

Researchers are still learning about how MS and DDD may be connected. In one study, people with progressive MS had higher rates of cervical DDD. Some studies suggest that people with MS might develop DDD in the neck earlier and more severely than people without MS. “I was diagnosed with DDD when I was 30,” shared one member of MyMSTeam about their surprising double diagnosis.

How Are MS, Endplate Sclerosis, and Degenerative Disk Disease Treated?

Several treatment options can help relieve symptoms of DDD, endplate sclerosis, and MS. Managing pain often requires a personalized approach — sometimes through a specialized pain management clinic. Finding the right combination of treatments can take time and often involves some trial and error.

Medical Treatment Options

Common treatments for DDD include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Over-the-counter painkillers (such as acetaminophen)
• Muscle relaxers
• Nerve injections (such as epidural steroid injections or nerve root blocks)

Having both MS and DDD can complicate overall health management. “I went through physical therapy and two rounds of epidural steroid injections,” one MyMSTeam member said.

Another noted, “I’ve had injections, physical therapy, and fluoroscopy (discogram, I believe), but I just don’t get enough relief, and it’s getting exhausting being in pain all the time.”

Surgical Treatment Options

If medications and physical therapy don’t help enough, neurosurgery may be an option for treating DDD. Common procedures include:

• Spinal fusion — Connecting two or more bones in the spine to stop painful movement
• Artificial disk replacement — Removing a damaged disk and replacing it with an artificial one

“If you can get in to get surgery, I do recommend it. Mine was filled with complications, but the disk pain I had for 15 long months is gone completely,” one MyMSTeam member said. “Had I had surgery sooner, the outcome would have been better.”

However, MS can sometimes complicate DDD treatment and vice versa. “My disks are crumbling and bulging — holding off on surgery (many years) because my largest lesion is in the same spot,” one member explained.

In some cases, the damage from DDD is beyond surgical repair: “I have DDD, and all my lumbar disks are bone on bone without any surgical option,” a member shared.

Researchers are still looking into the best ways to treat endplate sclerosis. If you’re living with DDD or endplate sclerosis along with MS, talk to your healthcare provider about which treatments may be right for you.

Alternative Treatments and Lifestyle Options

Many people look for ways to manage DDD and MS beyond medical treatments and surgery. Lifestyle changes and home remedies can help reduce pain and improve everyday function. You might try:

• Eating a healthy, balanced diet with a variety of nutrient-rich foods
• Getting regular exercise to strengthen muscles
• Wearing a supportive back brace to take pressure off the spine
• Using heated pads or ice packs to ease pain and inflammation

One MyMSTeam member offered this advice: “The BEST thing you can do for your spine is to exercise your CORE! Strong core muscles and good posture will prevent many spine issues and/or keep them from becoming worse.”

Always check with your doctor or physical therapist before starting new exercises or treatments, especially if you’re living with both MS and DDD. Your healthcare team can help you stay active and manage symptoms more effectively.

Find Your Team

MyMSTeam is the social network for people living with multiple sclerosis (MS) and their loved ones. On MyMSTeam, members come together to ask questions, give advice, and share stories about life with MS.

Do you have degenerative disk disease or endplate sclerosis with MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.