PREVENTION OF INTERVERTEBRAL DISC HERNIATION: EVIDENCE-BASED APPROACHES TO REDUCING THE RISK OF DISC DEGENERATION AND CLINICALLY SIGNIFICANT LOW BACK PAIN

Abstract

Intervertebral disc herniation is often the clinical endpoint of degenerative disc changes combined with adverse biomechanical, behavioral, and occupational factors. Although disc degeneration is partly driven by aging and genetic determinants, a substantial proportion of risk is associated with modifiable factors, including physical inactivity, excess body weight, smoking, poor work organization, repetitive flexion–rotation loading, vibration exposure, and prolonged static sitting. Psychosocial stressors and maladaptive pain beliefs (fear-avoidance) also contribute to symptom persistence and chronicity. Contemporary clinical practice guidelines for low back pain emphasize “active” strategies: maintaining activity, therapeutic exercise, and self-management education; when indicated, multidisciplinary programs incorporating cognitive-behavioral components.