Most people have heard of a herniated disc and know that it can be an extremely painful condition to live with. However, there is another common spinal issue that can greatly contribute to the development of a herniated disc known as an annular tear.
An annular tear causes symptoms that can be similar to a herniated disc, but may not be quite as severe. Let’s take a closer look at annular tear causes and symptoms, and the steps we can take to prevent them.
What Is an Annular Tear?
An annular tear is a condition where a crack or fissure develops in the tough outer layer of a disc in the spine. This weakens the structural integrity of an intervertebral disc and can cause the soft, gel-like contents within a disc to rupture, creating a herniated disc.
While you may think an annular tear can only happen one way, there are actually three different types of annular tears. Does the type of annular tear even matter? Actually, it does. The type of annular tear suffered can help determine what symptoms are likely to develop.
Transverse Tears
A transverse tear is usually the most noticeable type of annular tear. This happens when the tear begins at the outermost rim of the disc and can continue all the way to the nucleus. Because there are a large number of pain receptors that exist around the outer rim of a dis, this type of tear is most likely to cause noticeable pain.
Radial Tears
Radial tears occur in the opposite direction of a transverse tear. With a radial tear, the tear begins in the nucleus of the disc and can extend out towards the outer rim of the disc. Fortunately, these types of annular tears are not as painful because of the small amount of pain receptors existing in the innermost area of a disc.
Concentric Tears
A concentric tear is a type of annular tear most associated with torsional injuries to the spine, such as twisting the wrong way. A concentric tear causes a crack to develop around the nucleus of a disc.
Concerned that you may have an annular tear? Contact one of our experts at Florida Surgery Consultants. Our Board certified neurosurgeons are experienced at diagnosing and treating annular tears.
Symptoms of an Annular Tear
The symptoms of an annular tear can be very similar to those of a herniated disc. Although annular tear symptoms are often not as severe which is why many people may not be aware that they have an annular tear.
An annular tear causes symptoms, such as:
- Pain in the back, neck, arms, or legs
- Numbness
- Muscle weakness
- Tingling sensations in the back or neck
Fortunately, with annular tears, symptoms are usually only noticeable when a transverse tear occurs. These tears originate at the outer rim of an intervertebral disc, where a large number of pain receptors exist compared to the rest of the disc. Patients may also experience symptoms if a pinched nerve develops due to an annular tear.
Common Annular Tear Causes
One of the most common annular tear causes is aging. As you get older, the intervertebral discs that provide a cushion between the bones of your spine begin to deteriorate and dry out. As these discs dry out, they become more susceptible to cracks and fissures, similar to dry skin.
Other factors that can contribute to an annular tear include:
- Wear and Tear: An annular tear can often be the result of overuse. Overuse commonly occurs when people do lots of heavy lifting, such as weight lifters, or in professions that place chronic strain on the back, such as construction, sports, or nurses.
- Degenerative Disc Disease (DDD): This condition is often associated with aging and occurs when discs begin to lose the fluid within them, causing them to degenerate. This causes the disc to dry out and lose flexibility, making a crack or tear more likely.
- Genetics: The annulus fibrosus, or circular exterior of a disc, is made up of collagen. The strength and quality of this collagen is often determined by your genes. This means your genes can play a role in your susceptibility to an annular tear.
- Bone Spurs: A bone spur is a knobby growth that can develop on the end plates of bones due to inflammation. They can often be harmless, but if a bone spur extends into the disc space, it can lead to an annular tear.
- Traumatic Injuries: High impact injuries can wreak havoc on the spine, causing a disc to tear from the force. This is common in sports injuries, car accidents, and hard falls.
Treatment Options for an Annular Tear
In instances where an annular tear causes significant pain and discomfort, you may decide it is time to diagnose and treat the issue. Non-surgical treatment options should always be considered and attempted first. If non-surgical options have proven to be ineffective or symptoms of an annular tear are only getting worse, it may be time to consider surgical procedures.
Non-surgical Treatment Options
There are several different non-surgical treatment options to consider for addressing annular tear symptoms. These include:
- Physical Therapy: Physical therapy involves working with a trained physical therapist to develop exercises and stretches to help alleviate your pain and improve your spine’s health. This can often require several sessions, but progress should become noticeable within the first few sessions.
- Pain Medication: In most cases, treatment using over-the-counter anti-inflammatory medications or analgesic medications can help improve pain symptoms. However, your doctor will work with you to develop a medication plan that is safe and works for you which may involve short-term prescription narcotic use in severe cases.
- Activity Modification: If you are suffering acute and severe pain from an annular tear, it may be best to reduce your daily activity and avoid any physically strenuous activities temporarily. Overall, though staying active in a healthy way is usually best and disc conditions have been shown to worsen after too much bed rest.
- Steroid Injections: Another effective pain treatment can be an epidural steroid injection. Several different methods and types of injection can be used depending on the individual needs of the patient. After an initial injection, the patient’s reaction will be monitored and the doctor can determine if future injections may be needed.
Surgical Options
If you have exhausted your non-surgical treatment options for an annular tear and pain symptoms still persist, surgery may be your best choice. The type of surgery performed will depend on a number of different factors. However, these surgeries are usually minimally invasive surgeries. This allows for a speedier recovery and less post-surgical pain.
