lumbar disk herniation model

Where lumbar disk herniation comes from

Patients with lumbosacral radicular pain due to lumbar disk herniation (LDH) often attribute their symptoms to specific events they believe caused their condition. This recognition of potential triggers is an important aspect of understanding and managing their pain. The traditional model suggests that cumulative damage resulting from excessive forces or repeated loading leads to disk degeneration. 

According to this model, the wear and tear on the spinal discs over time contribute to the development of symptoms. However, recent studies have challenged this viewpoint by highlighting the significant role of hereditary factors in disk degeneration. These studies indicate that physical activities, although a factor, only explain a small portion of the variance in the development of symptoms.

Studying the frequency of inciting events

To get a better view of this discrepancy between traditional beliefs and newer findings, a study was conducted. The objective was to examine the frequency of these events and their association with symptom severity. The findings of the study provided interesting insights. 

Researchers discovered that 62% of LDH cases did not have a specific inciting event associated with the onset of symptoms. This challenges the notion that there is always a clear cause-effect relationship between an event and the development of lumbosacral radicular pain.

When examining the identified inciting events in the remaining cases, non-lifting physical activities accounted for the largest proportion (26%). This suggests that a wide range of everyday activities, such as bending, twisting, or even sitting for extended periods, may contribute to the onset of symptoms. 

On the other hand, heavy lifting (6.5%) and light lifting (2%) accounted for smaller proportions of the inciting events. These findings emphasize the importance of considering a broad range of physical activities and not solely focusing on lifting-related events when assessing the potential causes of lumbosacral radicular pain.

The study also revealed that patients with spontaneous LDH, where no specific inciting event was identified, were significantly older and had higher disability scores compared to those with identifiable triggers. 

More complex than heavy lifting alone

This suggests that spontaneous LDH may be associated with more severe symptoms and functional limitations. The study’s findings support the notion that lumbosacral radicular pain can manifest through different mechanisms and that the absence of an identifiable inciting event does not necessarily indicate a milder presentation.

In contrast to common beliefs, the study did not find a significant association between the occurrence of a lifting-related event and increased severity of the clinical presentation. This suggests that heavy lifting, often considered a potential risk factor, may not be a primary contributor to the severity of lumbosacral radicular pain. These findings challenge the conventional assumptions regarding the impact of lifting-related activities on symptom severity. This highlights the need for a more comprehensive understanding of the condition.

More hereditary than anything

In conclusion, patients with lumbosacral radicular pain often link their symptoms to specific events they believe have contributed to their condition. However, recent studies have shown that hereditary factors play a significant role in disk degeneration. In contrast, physical activities only explain a small portion of the variance. 

The frequency of patient-identified inciting events in lumbar disk herniation was examined in a study. This reveals that a majority of cases did not have a specific event associated with symptom onset. Non-lifting physical activities accounted for the largest proportion of inciting events, challenging the emphasis on heavy lifting. 

Patients with spontaneous LDH were usually older, with higher disability scores, suggesting a more severe presentation. Surprisingly, no significant association was found between lifting-related events and increased symptom severity. These findings highlight the complexity of lumbosacral radicular pain and call for further research to better understand its multifactorial nature.

Addressing lumbosacral radicular pain

In your effort to help people with LDH, getting a clear view is the first step towards success. Our lumbar models help you identify pain and discomfort more precisely, creating a better way to work with your patients.