A recent 2010 research study published in the prestigious Spine Journal found that most disc herniations actually don’t come from lifting (heavy or light) objects. In fact, the majority (62 per cent) have no known cause. In this study, the patients said their back and leg pain (sciatica) just came on without warning.  As many of my own patients explain, “I was totally fine and then last night I bent over to brush my teeth and my back gave out!”…or stories that are similarly less eventful.

Today, most experts agree that disc degeneration occurs over an extended period of time.  The repeated loads that we place on our spines through our daily activities of life combined with the effects of aging and possibly some genetic predisposition are probably the culprits at work here.

In addition to looking at possible causes linked with disc herniation, the researchers also compared the severity of symptoms with possible causes of symptoms.

The 154 people in the study were all adults (18 years old and older) who had back pain that radiated down the leg….we typically refer to this as sciatica.  MRIs confirmed the presence of a disc herniation and pressure from the disc on the spinal nerve root was the confirmed source of the back and leg pain.

Only a small number of patients (eight per cent) could identify a specific event that resulted in the symptoms that were caused by disc herniation. Most people started noticing symptoms while doing normal, everyday activities. Examples of non-lifting physical activities as inciting events included vacuuming, bending, reaching, leaning, misstepping, and making the bed.

Golf, skiing, and tennis were the most commonly reported sports and recreational activities believed to be associated with disc herniation. Physical trauma from falls or car accidents was listed as the inciting event in only 1.3 per cent of the people.

Basically this confirms that in many adults, discs don’t rupture.  Instead, the outer covering called the annulus slowly weakens.   And this weakening of the outer protective allows the center portion (the nucleus pulposus) to seep through.  The analogy I typically give to patients is to think of a jelly filled doughnut.  If the doughy outside portion develops a crack that extends to the centre, then that jelly can seep out of the doughnut.

It’s the classic proverbial situation of “the straw the broke the camel’s back”…the pain starts after a simple event because the disc was already to go and the coughing, sneezing, laughing, or turning one way or the other was just the final physical stress to herniate an already deteriorated disc.

Also, according to this study, the symptoms are no worse with certain inciting events.  So it doesn’t matter whether it was due to a fall, sports activity, mopping the floor or a sneeze.  There is no correlation to the pain level or severity of symptoms to the inciting event.

The authors also conclude that the symptom severity of disc herniations is not biased by race, employment status, income or age. as well.  Most of the time, a disc herniation appears to be spontaneous and occurs without any known cause.

As dire as these findings might sound, you CAN do things to help reduce your risk of lumbar disc herniation.  These include:

• exercise regularly and in particular, add core-specific exercises that work the inner and outer muscles that surround your waistline
• vary your activities (folks who work or play activities that involve the same thing over and over again or that require you to stay in one position all the time are not so good)
• learn proper ergonomics from your chiropractor/physiotherapist
• get spinal adjustments regularly to improve spinal mobility
• maintain good nutrition and get adequate rest

And remember, if you do manage to experience a lumbar disc herniation, we can help at the Laser Pain Solution.  The BIOFLEX laser is great at resolving inflammation and helping to heal the damaged disc.  In the 8 years I’ve administer laser therapy, I’ve helped plenty of happy patients lose their sciatic pain where pain-killer and anti-inflammatory medications have failed!

Reference: Pradeep Suri, MD, et al. Inciting Events Associated with Lumbar Disc Herniation. In The Spine Journal. May 2010. Vol. 10. No. 5. Pp. 388-395.