Risk Factors for a Herniated Disk

• Natural aging process-ongoing loss of water and proteins from the disk
• Genetic (inherited) predisposition-an accelerated degeneration of disk materials
• Obesity — excessive body weight places added stress on the spine
• Lack of exercise — results in a loss of trunk muscle strength and diminished spine support
• Work activities — long periods of sitting, lifting or pulling heavy objects, frequent bending or twisting, heavy physical exertion, repetitive motions or exposure to constant vibration
• Smoking — deprives blood flow and nutrients needed for disk repairs
• History of back injury, previous herniated disk or prior back surgery

• A moderate injury causes immediate numbness or weakness in one or both legs
• You have shooting leg pains with coughing, sneezing or straining
• Leg pain is accompanied by persistent weakness, tingling or numbness
• Back pain persists or builds in intensity over a few weeks' duration
• Back pain is accompanied by pain during urination
• You experience severe deep back muscle pain and muscle spasms
• You have loss of bowel or bladder control

Diagnosis is based on a complete medical history accompanied by a thorough physical examination performed by your doctor. Tests involving imaging of the spine are sometimes done. Treatments can include oral medications, drug injections and physical therapy. Most back and leg pain will resolve with these simple measures. For persons who have chronic pain and disability, surgical options may be considered.

For More Information

• American Academy of Family Physicians
  http://familydoctor.org/341.xml

• American Association of Orthopaedic Surgeons
  www.aaos.org

• American Association of Neurological Surgeons
  www.neurosurgerytoday.org/what/patient_e/herniated.asp

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at www.jama.com. Many are available in English and Spanish.

Sources: American Academy of Family Physicians, American Association of Orthopaedic Surgeons, American Association of Neurological Surgeons

John L. Zeller, M.D., Ph.D., Writer
Alison E. Burke, M.A., Illustrator
Richard M. Glass, M.D., Editor

(JAMA. 2006; 296: 2512)
Published in JAMA: November 22/29, 2006