The primary causes of a lumbar (low back) disc herniation are,:
- Degenerative changes to the disc over time, leading to progressive herniation
- Sudden trauma to the disc from an acute injury, such as a fall
Additionally, less common causes include certain medical conditions that affect the structural integrity of the spinal discs.
Disc Degeneration: The Most Common Cause of a Lumbar Herniated Disc
Natural degeneration of discs occurs with age and causes the spinal discs to become dehydrated and brittle. Stress and strain exerted on a disc from everyday movements also accelerate its wear and tear.,
A fragile degenerated disc is susceptible to tearing and more likely to herniate under pressure, possibly even during minor movements, such as picking up a grocery bag or turning to get into a car.See Lumbar Degenerative Disc Disease Symptoms
In This Article:
- Lumbar Herniated Disc: What You Should Know
- Lumbar Herniated Disc Symptoms
- Lumbar Herniated Disc: Causes and Risk Factors
- Diagnosing a Lumbar Herniated Disc
- Treatment for a Lumbar Herniated Disc
- Lumbar Herniated Disc Video
Acute Injury and Disc Herniation
Sudden trauma that causes abrupt and forceful compression of the lower back, such as from a fall or a motor vehicle accident, has the potential to cause a herniation in a healthy or degenerated disc.
In most cases, however, there is already some degree of disc degeneration, and it is rare for this type of injury to cause herniation in healthy spinal discs.
Less Common Causes of a Lumbar Herniated Disc
In rare cases, an underlying medical condition causes a disc to herniate. A few examples are discussed below.
Vertebral endplate junction failure
Damaged vertebral endplates may cause vertical herniation of a disc.
Between each spinal disc and vertebral body lies a structure called the vertebral endplate, which plays a role in protecting the vertebral body when the lumbar spine undergoes compressive loading.
The endplate is prone to fractures and/or detachment, which increases the risk of the soft inner core of the disc (nucleus pulposus) herniating vertically through the damaged endplate.,
Connective tissue disorders
Medical conditions associated with dysfunction or abnormalities of connective tissues have been implicated in the development of herniated discs, including:
- Rheumatoid arthritis
- Ehlers-Danlos syndrome
- Marfan syndrome
- Benign joint hypermobility syndrome
The common feature of these conditions thought to be involved in disc herniation is laxity of the joints, which causes spinal instability.
7 Known Risk Factors for Disc Herniation
Several biological, occupational, and lifestyle factors known to contribute to disc degeneration have been directly linked to the risk of herniation. These risk factors are described in the following table.
Risk Factor |
Impact on Spinal Disc Health |
|---|---|
1. Genetics |
Research suggests that genetic predisposition – the presence of specific genes or genetic variations – is one of the main risk factors for a herniated disc. Specifically, genes involved in collagen formation, disc degeneration processes, and inflammatory response have been linked to an increased risk. |
2. Age, |
The incidence of lumbar disc herniation increases with age and is more common in individuals aged 30 to 50 years. |
3. Gender, |
Painful lumbar herniated discs are more common in men compared to women. |
4. Weight |
Obesity – particularly excess body fat around the chest and abdomen – increases the load on the lower back and is thought to promote inflammation in the body, increasing the risk of developing a lumbar herniated disc. |
5. Nicotine |
Nicotine use (including but not limited to smoking, vaping, and chewing tobacco) disrupts the flow of nutrients to the intervertebral discs. Nicotine also inhibits the growth of new cells in the nucleus pulposus, and it reduces the synthesis of collagen (a type of protein). |
6. Occupation |
Physically demanding jobs exert increased pressure on the lower back through movements such as heavy lifting, carrying heavy items, and forward bending. Sedentary work increases the risk of disc degeneration through sustained compression loads on the spine during prolonged periods of sitting. Consistently working for 8 hours or longer at a time and high levels of stress have also been associated with an increased risk of disc herniation. |
7. Height |
One study demonstrated a potential link between tall individuals and increased incidence of disc herniation. According to the study, men 5’ 11” (180 cm) or taller and women 5’ 7” (170 cm) or taller had a higher risk for herniation. |
While these factors increase the likelihood of a herniated disc, simply having these risk factors does not mean that a herniated disc will definitely develop.
Lowering the Risk of a Lumbar Herniated Disc
Preventing or reducing the risk of a herniated disc involves adopting lifestyle habits that promote overall spinal and disc health, including:
- Maintaining a healthy weight through a balanced diet
- Staying well-hydrated
- Avoiding smoking and all forms of nicotine
- Engaging in regular exercise, including stretching, strengthening, and aerobic exercise
- Regularly stretching, changing positions, and going for a short walk to avoid sitting for long periods
- Using supported postures when bending, lifting, pulling, or twisting
These measures work together to protect the integrity of the spinal disc, provide support to the spine, and encourage the flow of healthy nutrients into the disc.
