Events related to Lumbar Disk Herniations
As logical creatures, humans usually want to associate an event with a cause. In our current culture, we want a reason for many of our own medical conditions. Regarding spine problems, Physicians know that being over weight, smoking, and genetics have bearing on the incidence of disk problems. People, however, want to associate a disk herniation with an event. A 2010 Spine Jounal Article by Suri, et al. examined the inciting event associated with development of a herniated disk.
154 people who had Lumbar Disk herniations confirmed by MRI and with corresponding radicular pain were polled. While the authors acknowledged the self reporting nature of the responses, never the less, it provided interesting information on the self reported Inciting event causing the MRI identified Lumbar Disk Herniation.
Each person was asked to identify the cause of the disk herniation.
Here are the category choices with percentages results:
1. Spontaneous onset at 62% with no specific identified event
2. Nonlifting physical activity at 26%
3. Heavy lifting (>35 lbs) at 6.5%
4. Light lifting (<35 lbs) at 2%
5. Nonexertional occurrence at 2%
6. Physical trauma at 1.3%.
The results show a supra majority of people not really being able to define a specific event, and most interestingly, only 1.3% identified the inciting event as being caused by trauma.
As the authors commented, the results suggest Lumbar Disk herniations may be triggered by cumulative or genetic factors. Further review of the population surveyed identified only 8% with worker’s compensation claims. While some may argue it did not sample a cross sectional population, this self reported study demonstrated that disk herniations are more often associated with non traumatic causes, rather than lifting or trauma.
This information runs counter to our common sense interpretation. Yet, as a Clinician, and Surgeon, I often find that people do struggle trying to explain why they developed a disk herniation. While patients try to relate Lumbar Disk Herniations to a specific event, it may be totally unrelated.