What Is an Annular Tear?
An annular tear is an injury that occurs in the intervertebral discs of the spine. Spinal discs support and cushion the vertebrae, absorb shock, distribute weight across the spine and enable the spine to bend, twist and otherwise move freely and flexibly. Intervertebral discs are incredibly tough — they’re made of a fibrous outer ligament ring (called the annulus fibrosus) that protects a jelly-like inner fluid (called the nucleus pulposus).
An annular injury develops when the ligaments making up the annulus fibrosus rupture or tear. There are three types of tears:
- Transverse tears. A transverse tear begins at the outermost ring and travels all the way inward to the nucleus. These tears are usually the most painful, because the ligamentous outer ring is made up of a lot of nerve fibers and pain receptors.
- Radial tears. A radial tear begins in the nucleus and eventually travels all the way outward to the fibrous shell. These tears may not cause as much pain and symptoms, because the nucleus contains fewer pain receptors.
- Concentric tears. A concentric tear develops in the nucleus and extends in a ring around the nucleus.
With repeated stress and pressure on a damaged disc, minor tears can worsen into more significant tears and cause the spinal disc to bulge outward or herniate. Disc herniation occurs when the jelly-like inner material leaks into the spinal canal. The fluid can compress or irritate nearby nerves, causing pain and inflammation.
An annular tear may be an early sign of degenerative disc disease (DDD), a condition that develops when spinal discs begin to degenerate naturally with age. Degenerated discs are weaker and more prone to injuries like tearing.
Causes and Risk Factors
Spinal discs degenerate naturally with age. They become stiffer, drier, weaker, less flexible and less able to provide adequate cushioning and shock absorption. Natural wear and tear due to aging is the most common cause of an annular tear. Tears can also develop from years of performing repetitive movements like lifting and twisting that place the spinal discs under chronic pressure. A sudden tear may occur during a traumatic incident like a fall, car accident, or sports collision.
Age is the primary risk factor for developing an annular tear. Other risk factors include genetics, obesity, physically demanding jobs that require heavy lifting, playing sports, or living an inactive and sedentary lifestyle. Inactivity and sitting for long periods of time place excess pressure on the spinal discs.
Minor tears may not cause any symptoms at all, or only mild discomfort during movements like twisting your back or bending over. Placing repeated stress and pressure on a tear can worsen it and cause more significant symptoms. Some people experience excruciating pain and symptoms from an annular tear.
Depending on the location of the damaged disc, the primary symptom of a tear is low back or neck pain. Annular tear pain is usually localized and stems from the disc itself. If the damaged disc irritates a nearby spinal nerve, nerve compression may cause radiating pain, weakness, numbness or tingling in the legs or arms. Pain may become worse during activities or movements that place more pressure on the spinal discs, like sitting, lifting, bending or twisting.
Treatment and Prevention
Seek medical help if you’re experiencing recurrent back pain. It’s always better to identify and treat an annular tear in the early stages, before it worsens or leads to disc herniation. Your doctor will use imaging studies like a CT scan or MRI to detect a spinal disc tear.
Many annular tears heal on their own with time and conservative treatment measures. Your doctor may recommend the following treatments to reduce pain and symptoms.
- Rest and activity modification. Increased stress and pressure on the spine from high-impact activities cause more pain and may lead to a worsening tear. While you should remain as active as you can, try to avoid activities that aggravate or irritate the damaged disc. For example, you can switch out a run for a low-impact walk or swimming.
- Medications. Over-the-counter pain medications like acetaminophen or NSAIDs can help relieve pain, swelling and inflammation. If you’re experiencing significant pain or muscle spasms, your doctor may prescribe a stronger painkiller, nerve medications or a muscle relaxant.
- Physical therapy. During physical therapy, your therapist will show you exercises and stretches that relieve pressure on your spine. Additionally, a therapist will work with you to strengthen the core and back muscles that protect your spine.
- Injections. A corticosteroid injection can help reduce pain and inflammation if a damaged spinal disc is pressing against a nearby spinal nerve. Injections provide temporary pain relief that may last for several months to a year.
Even if a torn spinal disc heals completely, it’s still susceptible to future tears and weakness. At home, it’s important to maintain a healthy weight and exercise regularly to keep your back healthy and strong. A strong core and low back will help relieve pressure on the spine and lower the risk of future injuries.
Surgery is an option if pain and symptoms persist after several weeks or months of conservative treatment. Depending on the location and severity of an annular tear, you may need surgery to repair, partially remove or replace a damaged spinal disc.
Contact Integrity Spine and Orthopedics to Learn More About the Conditions We Treat
At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more.
Some of the primary benefits of minimally invasive surgery include:
- Smaller incisions
- Fewer complications and bloss loss during surgery
- Less damage to surrounding muscle and soft tissues
- Lower risk of infection
- Less post-op pain and less reliance on strong pain medications during recovery
- Faster recovery and rehabilitation
- Better cosmetic results with minimal scarring
If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love.
Call us at 904-456-0017 or contact us online to request an appointment.