Comorbid Conditions Influencing Degenerative Disc Disease

Metabolic and Endocrine Comorbidities

Obesity is recognized as a musculoskeletal complication that includes degenerative disc disease of weight‑bearing joints and the spine. [@1]
Diabetes mellitus is identified as a key comorbidity among patients with degenerative disc disease, influencing disease progression and treatment planning. [@1]

Cigarette smoking is linked to higher rates of complications, earlier worsening of disease course, and reduced response to medical therapy across multiple musculoskeletal conditions in individuals with degenerative disc disease. [@2, @3]
Smoking cessation provides substantial benefit in slowing disc degeneration and improving outcomes. [@4]
A sedentary lifestyle and physical inactivity are acknowledged risk factors for degenerative disc disease, although evidence supporting physical‑activity interventions in established disease remains limited. [@5]

Hypertension is common in middle‑aged and older adults with degenerative conditions, with approximately 63 % of adults with chronic illnesses having concurrent hypertension. [@6]
Hypertension and degenerative disc disease share interdependent mechanisms, notably activation of the renin‑angiotensin‑aldosterone system. [@6]
Dyslipidemia (hypercholesterolemia) affects about 63 % of adults with chronic conditions in this age group and is a frequent comorbidity. [@6]
Dyslipidemia contributes to degenerative disc disease through systemic atherosclerotic processes. [@7]

Chronic obstructive pulmonary disease and other conditions that lower oxygen saturation are associated with increased severity of degenerative disc disease. [@8]

Depression is listed as a psychological complication associated with obesity and chronic musculoskeletal conditions, including degenerative disc disease. [@1]
Body‑image disturbance and psychological stress are common among individuals with chronic pain conditions such as degenerative disc disease. [@1]

Chronic fatigue affects more than 40 % of individuals with chronic inflammatory and degenerative conditions, underscoring the need for holistic assessment and management. [@2, @3]