Annular Tear

Annular Tear Overview

What is Annular Tear?

The annulus is the external ligament surrounding the disc. When the annular ligament is torn there may be leakage of inflammatory enzymes and even the internal jelly (nucleus pulposus) . The annulus is heavily innervated with nerve fibers that are very sensitive to pain.

Definition Annular Tear

Due to injury and a number of degenerative conditions, the tough exterior ligaments of the disc may tear causing pain and other symptoms. The tear may be partial thickness or through and through causing some difference in symptoms.

Symptoms of Annular Tear

Annular Tear Symptoms Include:

  • Annular tear symptoms occur when the annular ligament tough exterior rips allowing the internal jelly (nucleus pulposus) to leak out. The annulus is filled with nerve fibers that are very sensitive to pain. The nerves respond strongly to the seepage of the internal nucleus jelly. This typically causes chronic back pain.
  • If the internal jelly spills outside the disc it is a disc herniation and can be especially painful.  Other symptoms of a herniated disc include Numbness, Tingling, and Weakness of arm or leg.

What Causes Annular Tear?

Causes of Annular Tear Include:

  • Most annular tears are caused by natural aging of the disc. The discs are susceptible to wear and tear over time. Traumatic injury also may cause annular tears from sports, strenuous occupations, or accidental.
  • If suffering from annular tear symptoms, several treatment options are available.

Types of Annular Tears

There may be peripheral, central and radial types of annular tears. If you are diagnosed with an annular tear, treatment usually is non-surgical that may work very well in managing the symptoms of the annular tear and even symptoms of nerve compression.

Cervical Annular Tear

  • A cervical annular tear occurs with a disc herniation. The annular tear is a tearing of the disc external surface that may occur with the aging process or with injury. The annulus may thin or bulge or weaken to the point that disc material may extrude into the spinal canal.
  • Annular tear in the neck may cause chronic pain, and with a disc herniation or disc protrusion there may be nerve symptoms of Weakness, Numbness, Tingling and pain radiating into the arm.
  • The annular tear may heal on its own with conservative treatments. Non-surgical conservative treatment should always be tried first. These may include physical therapy epidural steroid injections and medications for pain and inflammation.
  • If conservative treatment fails, there are a number of minimally invasive procedures that are alternative to traditional surgical procedures.

Lumbar Annular Tear

  • A lumbar annular tear occurs usually with a disc herniation. The annular tear is a tearing of the disc external surface that may occur with the aging process or with injury. The L4-5 and L5-S1 discs are the most commonly affected.  The annulus may thin or bulge or weaken to the point that disc material may extrude into the spinal canal.
  • Annular tear in the back may cause chronic pain, and with a disc herniation or disc protrusion there may be nerve symptoms of Weakness, Numbness, Tingling and pain radiating into the leg.
  • The annular tear may heal on its own with conservative treatments. Non-surgical conservative treatment should always be tried first. These may include physical therapy epidural steroid injections, hot/cold therapy, and medications for pain and inflammation.
  • If conservative treatment fails, there are a number of minimally invasive procedures that are alternative to traditional surgical procedures.

Small Annular Tear

  • When a small tear opens in the annular ligament it may allow gel-like nucleus pulposus to contact the outer ligament causing pain and even nerve symptoms. The annular tear by itself will not cause pain but the leakage of the internal gel causes the pain.
  • A small annular tear may heal on its own and conservative measures may speed it along.
  • If you cannot get comfortable then there are safe endoscopic techniques as minimally invasive alternatives to open back surgery that may make you pain free.

Diagnosis and Treatments for Annular Tears

Your physician may diagnose an annular tear by MRI or discogram. The tear may be visible as a high intensity zone on the MRI and dye may leak through an annular tear on the discogram.

Treatment of Annular Tear

Annular Tear Treatment

The annular tear may heal on its own with conservative treatments. In fact most annular tears will never need surgery. Non-surgical conservative treatment should always be tried first. These may include:

  • Physical therapy
  • Epidural steroid injections
  • Hot/cold therapy
  • Medications for pain and inflammation

If conservative treatment fails, there are a number of minimally invasive procedures that are alternative to traditional surgical procedures.

Alternative Treatment

  • The annular tear may heal on its own with conservative treatments. Non-surgical conservative treatment should always be tried first. These may include physical therapy epidural steroid injections, hot/cold therapy, and medications for pain and inflammation.

Annular Tear Repair

  • Annular Tear repair is likely. If you are suffering back and leg pain from an annular tear the tear may heal itself without surgery.
  • The process of resorption of a disc herniation can occur weeks or months after annular tear. The larger the tear the more likely resorption will occur.

Surgery

  • If you cannot get comfortable then there are safe endoscopic techniques as minimally invasive alternatives to open back surgery that may make you pain-free.

How To Prevent Annular Tears and Risks

Annular Tear Prevention

There does not seem to be any means of prevention of annular tear. Most annular tears are of a degenerative origin and are not traumatic. The truth is most annular tears are not symptomatic and even the large tears may heal with resorption.

The best prevention is to simply maintain good spinal health. A few tips are to quit smoking, exercise regularly, lose weight, and maintain your flexibility with stretches.

Risk Factors of Annular Tear

Many wonder if annular tears are inherited or if a loved one may develop an annular tear. The primary risks factors known are aging and body weight. As a person ages past thirty years, the disc is prone to degeneration as the disc dehydrates and loses elasticity.

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