Hold That Disc! Two Ways to Keep a Bad Disc from Getting WorseMany studies have tried to identify what causes low back pain--especially disc problems. Once risk factors for disc herniation have been found, steps can be taken to prevent this problem.
A number of causes have been suggested. These include inactivity on the job, accidental back injury, motor vehicle accidents, and smoking. Certain types of work seem to cause disc problems, such as frequent exposure to vibration, heavy lifting, and twisting and bending. Work stress and mental stress have been added to the list. More recently, genetic factors have been found to cause low back pain.
A recent study looked at 41 people who had mild to moderate disc degeneration but no symptoms. An MRI (magnetic resonance imaging) was done and repeated five years later. Within those five years, almost half of the patients showed a worsening of the disc. The disc protruded outside its normal space.
What made the disc get worse? Instead of the classic risk factors already mentioned, researchers found something new and different. Lack of sports activity, or less physical activity during leisure time, was a major risk factor for these people. Evening or night-shift work was another risk factor, with more absences from work as the disc got worse. There was also a link between the amount of disc herniation at first and how bad the problem got over time.
According to this study, disc problems can get worse based on three factors: lack of physical activity, evening or night work, and the amount of disc herniation at the time of injury. These three risk factors are new and different from what previous studies have shown. This study suggests that the classic occupational risk factors of heavy lifting, twisting and bending, and exposure to vibration have been given too much credit for making bad backs worse.
Disc problems probably have more to do with genetic and environmental factors than anything else. Though we can't escape genetics, more exercise and different work hours may keep disc problems in check.
Achim Elfering, Dipl. Psych., PhD, et al. Young Investigator Award 2001 Winner: Risk Factors for Lumbar Disc Degeneration. A 5-Year Prospective MRI Study in Asymptomatic Individuals. In Spine. January 15, 2002. Vol. 27. No. 2. Pp. 125-134.
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