PREVENTION OF INTERVERTEBRAL DISC HERNIATION: EVIDENCE-BASED STRATEGIES FOR PRIMARY AND SECONDARY PREVENTION

Intervertebral disc herniation develops against the background of degenerative disc changes and unfavorable biomechanical exposures, amplified by behavioral, metabolic, and psychosocial determinants. Despite the contribution of age and genetic susceptibility, a substantial proportion of risk is associated with modifiable factors: physical inactivity, excess body weight, smoking, repetitive lifting in flexion combined with trunk rotation, prolonged static sitting, vibration exposure, and maladaptive pain responses such as fear-avoidance and catastrophizing. Contemporary clinical practice guidelines for low back pain emphasize “active” interventions, including maintaining usual activity, therapeutic exercise, self-management education, and—when chronicity risk is present—multidisciplinary programs incorporating psychoeducational or cognitive-behavioral components.