Annular tears occur when the fibrous outer layers (annulus fibrosis) of the intervertebral discs in the spinal column pull apart, leading to inflammation and potential nerve impingement. This can result in various spinal conditions, including disc herniation, osteoarthritis, facet joint syndrome, and spinal stenosis.
Under normal circumstances, healthy spinal discs can withstand tremendous amounts of force and weight placed on them. Spinal discs play a crucial role in supporting the body’s weight. As we age, discs are subject to wear and tear. Over time, they tend to weaken and lose their structural integrity making them more susceptible to tears and herniations. Tears in the annulus fibrosus can compromise the overall stability of the spine.
Causes of Annular Tear
An annular tear is more commonly caused by a combination of an acute back injury on top of a chronic spinal injury. A back injury can cause an annular tear in a disc, but it is much less likely if the spinal discs are healthy and have not deteriorated much over the years. Common contributing factors to disc tears include:
- Acute Back Injury: An acute back injury, such as lifting a heavy object or suffering trauma.
- Chronic Spinal Injury: Repetitive motions or positions in certain jobs, such as heavy lifting or prolonged sitting.
- Heredity: Some individuals may have a genetic predisposition to annular tears, particularly if there is a family history of back injuries.
- General Wear and Tear: Prolonged stress on the spinal column can cause annular tears over time.
- Obesity: Obesity can place additional stress on the spinal column, making it more likely for an individual to experience an annular tear.
- Scoliosis: A condition in which the spine is abnormally curved, increases the risk of annular tear by placing weight and imbalance stress on the spinal discs.
Symptoms of Annular Tear
Annular tears can often lead to neck and back pain symptoms. When a disc tears, the disc is weakened and can lead to disc herniation and herniation-related symptoms due to the pain of the tear itself, the associated inflammation, and irritation to associated nerves. This can include symptoms including, but not limited to:
- Back Pain
- Neck Pain
- Radiating Pain
- Pain or burning sensation along the spine or sciatic nerve
- Muscle spasms or weakness in the neck, back, arms, or legs
- Back and neck stiffness or limited flexibility
- Tingling and numbness in arms or legs
Diagnosis and Treatment of Annular Tear
Diagnosis typically consists of a physical examination and a review of medical history. The doctor will look to see if the patient has any of the above symptoms, a history of accidents and repetitive strains, or a family history of back injury. The doctor will likely confirm the diagnosis with an MRI scan or a more invasive diagnostic test that may involve injections (called a discogram or discography) to accurately diagnose an annular tear that is responsible for your pain.
To treat an annular tear, a doctor may start by prescribing low-dosage pain medication. The pain associated with annular tears often resolves over time unless they are overly serious. For more moderate cases, patients may require massage therapy, hot-cold therapy, alternative therapies, or injections.
If there is no improvement after a few months of treatment, doctors may prescribe surgery. Those suffering from back pain are encouraged to contact their physician to discuss treatment options.