What Is The Role of Type II Collagen In Degenerative Disc Disease And How Do Collagen Supplements Help

7 April 2023

What is degenerative disc disease, and how common is it?

Degenerative disc disease (DDD) is a leading cause of back pain. It occurs when the spinal discs —intervertebral discs—begin to degrade. The intervertebral discs lie between the bones of the spine (vertebrae) and act as shock absorbers. These sponge-like structures bear the load and, not being rigid, allow the spine to extend and flex as part of a normal range of motion.

DDD is common among older adults, though disc degeneration can start in the 30s and 40s. Other factors that may increase the risk include:

● Obesity
● Smoking
● Acute injuries to the spine
● Being female
● Heavy lifting
● Poor posture

Not everyone with a degenerated disc experiences symptoms like pain, stiffness, and decreased mobility. But according to a 2018 study, over 400 million people worldwide have symptomatic disc degeneration. (1)

Collagen and degenerative disc disease: What’s the link?

Spinal discs serve to bear the load from the torso and allow flexible movement of the spine.

They comprise two critical components, a fibrous outer disc wall, and a gel-like centre:

  1. Annulus fibrosus (AF). AF is the tough fibrous outer layer of the disc, which contains the contents of the disc or its nucleus. It is made primarily of type I collagen.
  2. Nucleus pulposus (NP). This gel-like structure is contained inside the disc. It is made primarily of water and type II collagen to form the disc’s water-loving (hydrophilic) core. (2). Type II collagen accounts for 25% of the dry weight of the NP.

Type II collagen is crucial for the integrity of the intervertebral disc and, thus, its function.

The amount of type II collagen determines how much water the nucleus pulposus can hold.

Low levels of type II collagen limit the disc’s ability to hold water. The water creates (hydrostatic) pressure, rather like the air in a bicycle tyre.

A loss of water reduces the pressure inside the disc and its capacity to bear the load, increasing pressure on the disc wall (AF). Furthermore, water loss reduces the height of the disc separating two vertebrae, which can affect the nerves exiting the spinal column.
This can cause nerve pain such as sciatica from nerve compression, impingement, or irritation.

As hydration falls, the outer disc wall may begin to degrade and weaken, reducing its ability to contain the nucleus material that may bulge outwards.

Lastly, as the disc begins to degrade, low collagen levels can accompany the death of cells inside the nucleus pulposus, leading to further reduction of type II collagen.

How reduced type II collagen affects DDD

Type II collagen loss in the NP severely impacts the ability of the disc to withstand forces that occur when we use our spine. This can cause the discs to become more vulnerable to damage and degeneration.

Moreover, as DDD progresses, type I collagen gradually replaces type II collagen. Since type I collagen is less elastic, more of it means the discs can slowly lose their strength and flexibility. (3)

How can type II collagen supplementation help DDD?

As we age, the body makes less collagen. Evidence suggests that type II collagen supplementation can support the intervertebral disc.

Type II collagen supplements promote the synthesis of new extracellular matrix proteins in the disc. This increases the amount of type II collagen and other extracellular matrix proteins, which may lead to improved disc health and function.

According to a test tube study, taking a type II collagen supplement may help protect the nucleus pulposus by: (4)

  1. Stimulating its synthesis
  2. Preventing its breakdown and destruction
  3. Activating other cells essential for healthy nucleus pulposus

Furthermore, type II collagen releases anti-inflammatory substances that can relieve symptoms of DDD. (5)

Are oral collagen II supplements beneficial?

Oral collagen supplementation has been shown to benefit joint pain (6). Type II collagen is an essential protein in the nucleus pulposus cell matrix of the intervertebral disc.

Further research is needed to determine the extent to which type II collagen plays a role in supporting the intervertebral disc.

However, nutritional support for the intervertebral disc nucleus, combined with physical therapies and improved lifestyle habits such as drinking adequate water, having a healthier diet and exercising regularly, may contribute to a more holistic approach to supporting intervertebral disc health and the conservative management of degenerative disc disease.

Polly Clarke
Clinic Nutrition Ltd


  1. Ravindra, Vijay M et al. “Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume.” Global spine journal vol. 8,8 (2018): 784-794. doi:10.1177/2192568218770769.
  2. Costăchescu, Bogdan et al. “Recent Advances in Managing Spinal Intervertebral Discs Degeneration.” International journal of molecular sciences vol. 23,12 6460. 9 Jun. 2022, doi:10.3390/ijms23126460.
  3. Dou, Yiming et al. “Intervertebral Disk Degeneration: The Microenvironment and Tissue Engineering Strategies.” Frontiers in bioengineering and biotechnology vol. 9 592118. 20 Jul. 2021, doi:10.3389/fbioe.2021.592118.
  4. Lian, Chengjie et al. “Collagen type II is downregulated in the degenerative nucleus pulposus and contributes to the degeneration and apoptosis of human nucleus pulposus cells.” Molecular medicine reports vol. 16,4 (2017): 4730-4736. doi:10.3892/mmr.2017.7178.
  5. Lugo, James P et al. “Undenatured type II collagen (UC-II®) for joint support: a randomized, double-blind, placebo-controlled study in healthy volunteers.” Journal of the International Society of Sports Nutrition vol. 10,1 48. 24 Oct. 2013, doi:10.1186/1550-2783-10-48
  6. Woo T, Lau L, Cheung N, Chan P, Tan K, et al. (2017) Efficacy of Oral Collagen in Joint Pain – Osteoarthritis and Rheumatoid Arthritis. J Arthritis 6: 233.