Degenerative disk disease (DDD) is a condition where the intervertebral disks gradually break down leading to pain, stiffness, and reduced flexibility in the spine. While DDD is influenced by factors such as aging, mechanical stress, obesity, inflammation, trauma, and genetics, the exact mechanism that triggers the condition is not well understood. In recent years, scientists have begun looking toward the gut as a potential cause of DDD.

The gut microbiome is the diverse community of trillions of microorganisms, including bacteria and fungi, that live in the digestive tract and play a crucial role in our overall health. The types of bacteria that comprise the gut microbiome depend mainly on our lifestyle, particularly the food we eat. Bacteria that thrive on foods that are rich in vitamins, nutrients, and fiber tend to have a positive effect on the body. On the other hand, bacteria that rely on processed food and added sugars (and other “unhealthy” foods) are likely to have a negative impact. When there are too many “bad” bacteria present, it can lead to a host of problems with respect to digestion, mood, immune function, and more.

Some researchers propose that increased gut permeability (leaky gut), triggered by an imbalance of gut bacteria, may allow bacterial toxins to enter circulation, promoting systemic inflammation that could contribute to spinal disk degeneration. Over the long term, continual inflammatory responses can be detrimental to body tissues, including the intervertebral disks. A 2024 study analyzing stool samples from 60 adults (40 with DDD) found that individuals with DDD had a higher concentration of gut bacteria linked to systemic inflammation, suggesting a possible relationship between gut health and disk degeneration. Another study, also published in 2024, came to a similar finding for patients suffering from regional and chronic pain.

More research is needed before treatment guidelines for DDD can be updated to include addressing dysbiosis in the gut microbiome as part of a multimodal treatment plan for DDD. However, with the various positive benefits linked to improved gut health, it may be worth pursuing anyway. Strategies for improving gut health include adopting a Mediterranean-style diet, increasing dietary fiber intake, consuming fermented foods (e.g., yogurt, kimchi, sauerkraut), avoiding processed foods, regular exercise, staying hydrated, managing stress, avoiding excessive alcohol consumption, and getting quality sleep. Chiropractic care for DDD often includes spinal adjustments, mobilization techniques, and soft tissue therapies aimed at improving joint mobility, reducing muscle tension, and addressing biomechanical imbalances that may contribute to disk degeneration.