Disk herniation is often seen in individuals who have had previous episodes of back problems; however, a herniation may occur without such a history. Repeated episodes are thought to weaken the annulus fibrosus. Heavy physical labor, including repetitive bending, twisting, and lifting, is a risk factor for herniated disk, especially if combined with weak abdominal and back

416 Herniated Disk muscles or poor body mechanics. Advancing age produces desiccations of the disk and friability of the annulus, which can increase the likelihood of injury.

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