8 Reasons Why We Get Lumbar Disc Herniations

1/30/20244 min read

Age-Related Degeneration: Discs lose hydration and elasticity with age, increasing herniation risk. According to a review on disc aging and degeneration by Zhao et al. "disc degeneration is an aberrant, cell-mediated response to progressive structural failure due to aging and other environmental factors" (1).

Genetic Predisposition: Genetics significantly influence susceptibility to disc degeneration. Battie et al. highlighted genetic factors as major predictors in their research (2).

Improper Lifting Techniques: Inappropriate lifting can strain the lumbar spine and has a strong association with lumbar disc herniation. According to a case-controlled study by Mundt et al., lifting objects or children weighing more than 25 pounds with straight legs and bent back had the strongest association with lumbar disc herniation. Other activities that increase the risk were twisting while lifting and lifting with outstretched arms (3). Not lifting with your legs, twisting while lifting, and lifting away from your center of gravity are all common mistakes people make when lifting.

References

  1. Zhao CQ, Wang LM, Jiang LS, Dai LY. The cell biology of intervertebral disc aging and degeneration. Ageing Res Rev. 2007 Oct;6(3):247-61. doi: 10.1016/j.arr.2007.08.001. Epub 2007 Aug 10. PMID: 17870673.

  2. Battié MC, Videman T. Lumbar disc degeneration: epidemiology and genetics. J Bone Joint Surg Am. 2006 Apr;88 Suppl 2:3-9. doi: 10.2106/JBJS.E.01313. PMID: 16595435.

  3. Mundt DJ, Kelsey JL, Golden AL, Pastides H, Berg AT, Sklar J, Hosea T, Panjabi MM. An epidemiologic study of non-occupational lifting as a risk factor for herniated lumbar intervertebral disc. The Northeast Collaborative Group on Low Back Pain. Spine (Phila Pa 1976). 1993 Apr;18(5):595-602. doi: 10.1097/00007632-199304000-00012. PMID: 8484151.

  4. Lis, A.M., Black, K.M., Korn, H. et al. Association between sitting and occupational LBP. Eur Spine J 16, 283–298 (2007). https://doi.org/10.1007/s00586-006-0143-7

  5. Hashish, R., Badday, H. Frequency of acute cervical and lumbar pathology in common types of motor vehicle collisions: a retrospective record review. BMC Musculoskelet Disord 18, 437 (2017). https://doi.org/10.1186/s12891-017-1797-5

  6. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010 Jan 15;171(2):135-54. doi: 10.1093/aje/kwp356. Epub 2009 Dec 11. PMID: 20007994.

  7. Huang W, Qian Y, Zheng K, Yu L, Yu X. Is smoking a risk factor for lumbar disc herniation? Eur Spine J. 2016 Jan;25(1):168-176. doi: 10.1007/s00586-015-4103-y. Epub 2015 Jul 10. PMID: 26160690.

  8. Maurer Elke, et al. Long-term effect of physical inactivity on thoracic and lumbar disc degeneration—an MRI-based analysis of 385 individuals from the general population. The Spine Journal, 2020 20(9):1386-1396. doi: 10.1016/j.spinee.2020.04.016.

Lumbar disc herniation is a common condition that often leads to back pain and discomfort. Understanding the causes is crucial for prevention and effective management. In this post we will look at eight of the most common reasons people get lumbar disc herniations.

Prolonged Sitting: Sitting for long periods of time, particularly with poor posture, can elevate herniation risk. A systematic review by Lis et al. identified prolonged sitting as a factor for lower back pain when combined with whole body vibration or awkward postures (4).Sitting increases the pressure on intervertebral discs primarily due to the biomechanical and physiological changes that occur in the spine when seated. When you sit, especially if you slouch, several things happen that affect your intervertebral discs:

  • Forward Bending of the Spine: Sitting often leads to flexion of the spine. This posture shifts the body's weight and the gravitational pull forward, increasing the load on the front part of the discs.

  • Disc Compression: In a seated position, the vertical load on the spine is increased compared to standing or lying down. This increased load compresses the discs, particularly in the low back. This is in part due to imbalanced load distribution, decreased activity of the muscles that stabilize the spine, and decreased intraabdominal pressure.

  • Reduced Disc Nutrition: Movement and physical activity promote the exchange of fluids and nutrients within the discs. Sitting for prolonged periods limits this natural disc nutrition process, as the reduced spinal movement decreases the pumping action necessary for nutrient exchange.

  • Altered Disc Pressure: Studies have shown that the pressure inside the intervertebral discs is higher in a seated position compared to standing or lying down. This increased pressure can contribute to disc degeneration over time.

  • Muscle Imbalance and Tension: Prolonged sitting can lead to muscle imbalances, where certain muscle groups become tight or overstretched. This can alter the normal forces applied to the spine and further increase the stress on the discs.

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Traumatic Injury: The transfer of force to the spine can cause immediate disc herniation. One of the more common causes of disc herniation related to trauma is car accidents. A retrospective study found that of 76.5% of people that were in a car accident suffered a lumbar disc protrusion or herniation greater than 2 mm (5).

Being Overweight or Obese: Excessive body weight increases spinal load. Shiri et al. found that compared with non-overweight people, overweight people had a higher prevalence of low back pain, but a lower prevalence of low back pain compared with obese people (6).

Smoking: Smoking reduces spinal blood flow, leading to disc degeneration. A 2016 systematic review conducted by Huang et al. concluded smoking promotes the development of lumbar disc herniation (7).

Physical Inactivity: Lack of exercise can weaken spine-supporting muscles. A study by Maurer et al. found that over a 14 year period there was a correlation between physical inactivity and disc degeneration (8).

Knowing why disc herniations happen can have a major impact on both prevention and management of lumbar disc herniation.

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