The intervertebral disc is a cartilaginous structure similar to articular cartilage in biochemistry but distinct in morphology. It degenerates earlier than other connective tissues and is clinically significant due to its association with back pain. Current treatments are mainly conservative or surgical, but new genetic and biological approaches may improve diagnosis and treatment. The disc's structure includes an outer fibrous ring (annulus fibrosus) and a gelatinous core (nucleus pulposus), with the nucleus containing collagen and elastin fibers embedded in a highly hydrated aggrecan-containing gel. Degeneration leads to structural changes, such as irregular lamellae, loss of hydration, and increased cell death. Biochemically, degeneration involves loss of proteoglycans, collagen denaturation, and increased enzymatic activity. Genetic factors also play a role, with mutations in genes like COL9A2 and COL9A3 linked to lumbar disc degeneration. Nutritional pathways and mechanical loads contribute to disc degeneration, and new therapies, including cell-based and gene therapies, are being explored. Despite advances, disc degeneration remains a significant public health issue with economic and social impacts. Research is ongoing to better understand and treat this condition.The intervertebral disc is a cartilaginous structure similar to articular cartilage in biochemistry but distinct in morphology. It degenerates earlier than other connective tissues and is clinically significant due to its association with back pain. Current treatments are mainly conservative or surgical, but new genetic and biological approaches may improve diagnosis and treatment. The disc's structure includes an outer fibrous ring (annulus fibrosus) and a gelatinous core (nucleus pulposus), with the nucleus containing collagen and elastin fibers embedded in a highly hydrated aggrecan-containing gel. Degeneration leads to structural changes, such as irregular lamellae, loss of hydration, and increased cell death. Biochemically, degeneration involves loss of proteoglycans, collagen denaturation, and increased enzymatic activity. Genetic factors also play a role, with mutations in genes like COL9A2 and COL9A3 linked to lumbar disc degeneration. Nutritional pathways and mechanical loads contribute to disc degeneration, and new therapies, including cell-based and gene therapies, are being explored. Despite advances, disc degeneration remains a significant public health issue with economic and social impacts. Research is ongoing to better understand and treat this condition.