How Serious Is An Annular Tear?

If you have been diagnosed with an annular tear, you most likely have undergone a range of tests at your doctor’s office, including a thorough physical, an X-ray, and an MRI. These tests are intended to pinpoint the exact location of the tear as well as to help determine the severity. The location of the tear and type of damage are the main determiners of the kinds of symptoms you may be experiencing. Annular tears are usually not serious, but they sometimes can be.

How serious is an Annular Tear
Dr. Jonathan Hall

Dr. Jonathan Hall

Dr. Hall is a Board Certified Neurosurgeon that specializes in treating patients that suffer from neck pain or back pain. He is able to perform minimally invasive spine surgery and the most complex procedures.

What Is An Annular Tear?

An annular tear is a spine injury that develops in the spinal discs. These disks are shock-absorbing cushions found between each vertebra in your spine. Each disk has two main components. One component is the outer ligament that connects a vertebra to your disc. This ligament consists of a series of outer rings made up of strong cartilage fibers. The medical name for this ligament is annulus fibrosus.

The annulus fibrosus is designed to protect the inside of the disc, also referred to as its nucleus. It is made up of a soft, gel-like substance called the nucleus pulposus.

Annular tears typically begin to form on the inside of the disc where there are little or no nerve fibers present. They are a common result of the aging process and are bound to occur with the degenerative nature of a body’s ā€œwear and tearā€. Most people over 60 years old will have at least one mild annular tear and will not know it because there are no symptoms.

Annular Tears Can Get Worse

Repeated pressure on a torn or damaged disc can cause a more severe tear. An annular tear is often the precursor to a herniated or bulging disc. These conditions are much more likely to be painful and debilitating. Beginning treatment as quickly as possible is necessary in order for it to heal properly and prevent further injury.

An annular tear can also be a result of a minor traumatic injury. This could be a bad fall or whiplash from an automobile accident. These tears usually start producing symptoms shortly after the incident. Again, treating it as quickly as possible is crucial.

What Causes The Pain?

The outer portion of the annulus fibrosus contains many nerve fibers. Once those nerve fibers are irritated, an annular tear can be very painful. This pain can cause immobility and be restrictive, disrupting your quality of life.

An annular tear most commonly occurs in the cervical spine (neck) or the lumbar region (lower back). These regions of the spine are the most flexible and are essential for most of your body movements, so these disks are more susceptible.

What Are The Symptoms Of An Annular Tear?

More often than not, an annular tear exhibits at least some symptoms. These symptoms will depend on the severity and location of the tear. If there is damage to the disc or if a spinal nerve becomes pinched, the following symptoms may occur:

  • Localized or discogenic pain
  • Radiating pain to the arms, legs hands, or feet
  • Muscle weakness
  • Limited mobility, activity due to acute pain
  • Tingling or numbness
  • Pain or discomfort while sitting or resting

What Are The Main Causes Of An Annular Tear?

Annular tears often result from sudden traumatic injury or gradual wear and tear. The main causes for an annular tear are as follows:

Degenerative Disk Disease (DDD)

This occurs when the spinal discs begin to degenerate from excess wear and tear. This often accompanies a loss of fluid inside the disc and is a normal outcome of the aging process. Less liquid means the discs begin to dry out and lit will lose some flexibility. A rigid disc is more prone to tearing.

Traumatic Injury

Car accidents and bad falls are the most common. They can cause sudden damage to a spinal disc.

Overuse

Repeating the same motions over and over while working. Occupations that place a heavy strain on the neck or back are especially at risk.

Genetics

Your genes always play a big role in your life and health. Genes determine the strength and quality of your collagen. This is the substance that makes up the annulus fibrosus. Deficient cartilage production or weak collagen can make annular tears more likely.

Bone Spurs

Bone spurs are bony projections that form along the edges of our bones in response to inflammation. Bone spurs are not harmful unless they form in the disc space where they could cause a tear.

What Are The Types Of Annular Tears?

Tears will occur in different patterns and the characteristics of the tear will reveal a lot about what to expect as far as symptoms. The 3 most common annular tears are:

Radial Tears

A radial tear starts in the inner layers of the annulus fibrosus and extends outward. They can continue until they reach the outermost layer. There are no significant pain receptors in the inner part of the disc, so they do not always cause pain.

Peripheral (Transverse) Tears

Peripheral (sometimes referred to as transverse) tears begin in the outermost layer of the disc. From there, they can extend all the way to the nucleus of the disc. These tears are normally caused by trauma, like a fall or an automobile accident.

Concentric Tears

Concentric tears develop between layers (or rings) of the annulus fibrosus that encircle the nucleus of the disc. They are often the result of twisting the wrong way.

Diagnosing An Annular Disc Tear

Patients will need to undergo a thorough examination. This includes a full review of their medical history and an evaluation of their pain and symptoms. Imaging tests like x-ray and MRIs are used to assess a patient’s spinal anatomy and look for any irregularities.Ā 

The imaging test of choice to check for an annular tear is a magnetic resonance imaging test (MRI). This test evaluates the soft tissue structures around the vertebrae. However, sometimes annular tears are not visible on an MRI which is why the patient’s history and a thorough examination are so crucial.

Tips on How to Treat or Prevent an Annular Tea

Lessen the Load – Take the Pressure Off Your Spine

A torn disc can only heal correctly if you lessen the load on the disc for a prolonged period of time. If you overtax the fragile strength of the newly forming capillaries or interrupt scar tissue development, you will re-tear the healing area and you may have to start all over from the beginning.

Strain on your disc must be avoided while your disc is healing. You should avoid certain movements, postures, and lifting. Repetitive or excessive movements will hinder the healing process and could cause further damage.

Adopt Good Posture Habits

While lying down is the best way to unload pressure on the discs (because there is no vertical compression), sitting, especially slouching, maximally loads the discs. Standing up straight is proven to unload pressure on discs by 150-300% when compared to the load pressure associated with slouching.

Get Rest, But Keep Moving

Although lots of rest is necessary, it is important to keep moving when you have an annular tear. Some movements can be painful but maintaining muscle strength and healthy blood circulation are crucial for the healing process.

Have Patience

Allowing an annular tear to heal fully will take time. It often takes more than a year. Stick with your plan and follow the directions and advice from your physician and physical therapist. This is your best chance at avoiding surgical options.

Physical Therapy

A good physical therapist will show you how to properly do stretches and exercises to create a well-designed exercise program for you to perform on your own. This can shorten your recovery time and may eliminate a need for surgical treatment.

Correct Exercise

There are many exercises designed to build muscle strength, increase flexibility and reduce pain. Some will focus on the muscles that work the back and abdominal muscles to improve posture, strength, and flexibility.

Well-Balanced Diet

Establish a healthy diet. A healthy, well-balanced diet is important for your physical and emotional health. When you are healthy, thereā€™s less pressure on your entire body, discs included. Your diet will be a huge determiner while healing or repairing your body.

Many foods full of vitamins, minerals, and nutrients will contribute in a big way to your ongoing spinal health. Your everyday eating program should always include nutrient-rich foods and, if possible, anti-inflammatory foods.

Emphasize healthy fats, lean meats, fruits, vegetables, and unrefined carbohydrates for spinal health or healing.

Schedule A Consultation

Most annular tears will resolve themselves over time or improve dramatically if you take the stick to a conservative healing program.

However, if you have an annular tear that is not getting better with conservative treatments and if interventional pain management procedures are not helping, you should look into your surgery options. By consulting with a highly experienced spine professional, you can learn about the various routes you can take to getting back your pain-free, mobile lifestyle.

The experts at Florida Surgery Consultants have years of experience with a variety of minimally invasive procedures. Get in touch with us for a consultation and we can go over them together.

Are these Spine Surgeries Minimally Invasive?

Yes, all these spine surgeries are.

What Health Insurances are Accepted at Florida Surgery Consultants?

Currently we are in-network with Blue Cross Blue Shield, Aetna, Medicare, Bright Health, and Cigna Health Springs plans. If you have health insurance that is not listed, please contact our office, many times we can accept patients that have plans with out of network benefits. If you were involved in a motor vehicle accident or a personal injury case we can also see you. We can also help patients with workersā€™ compensation injuries.
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