Annular Tearing – How Does It Happen? What Are Treatment Options?

An intervertebral disc is a type of ligament that connects one vertebra to the next adjacent vertebral bone. These intervertebral discs act as shock-absorbing cushions between the vertebrae of the spinal column. Each intervertebral disc has two parts. The outer ring-like structure is called as annulus fibrosis and the inner soft jelly-like part is known as nucleus pulposus. The outer ring, i.e. annulus is the strongest part of the disc. The outer one-third part of the annular ring is richly supplied with the pain nerve fibers. Thus, if a tear occurs in the outer one-third of the annular ring, it is a very painful situation. Although this tear is liable to heal with the passage of time having scar tissue on it predisposes to future tears and injuries. It is also proven from researches that annular tears and injuries predispose to degenerative disc disease as well as the degeneration of facet joints and endplates. Annular tears are also known as annular fissures.

Pathology

Annular tears may be transverse, radial or concentric in nature. Some type of tears involve all the layers of discs but some less severe tears involve only one or some layers.

Types of Annular Tear

There are two types of the annular tear.

  • A partial annular tear is a tear in some part of the outer ring of the intervertebral disc. It may happen due to incorrect posture for long time or trauma.
  • A complete annular tear is the type of fissure which involves the whole of the annular ring. It penetrates the outside and inside of the intervertebral disc. The disc is compressed and pressure is exerted to the nerve roots present in the affected region of the vertebral column. Usually, this type of tear occurs due to a herniated disc.

Causes of Annular Tear

  • An annular tear can be due to an acute injury to the vertebral column when the force directly hits the affected vertebrae
  • Age-related wear and tear changes lead to the degenerative changes in the disc. If the annulus is severely subjected to degeneration, it results in an annular tear. If such pathology has occurred in any person, the proper intervention must be undertaken because such degenerative tears can also happen in the other parts of the vertebral column.
  • Spinal stenosis is also a leading cause of disc tearing. In this condition, the central canal of the spinal column is narrowed down. The tissues of the annular ring are stretched and then torn out. This condition mainly affects the cervical and thoracic region of the spinal column. Spinal nerve roots are also compressed by stenosis.
  • Wrong weight lifting techniques can also lead to annular tears. The persons who do heavy weight lifting job should adopt proper lifting techniques otherwise they will end up with any vertebral column injury including annular tear.
  • Extra body weight can also cause the weakening of the annular fibers and the risk of annular tearing is enhanced. This happens because the spinal column has to support extra body weight and more stress is exerted to the discs.
  • Various researches show that genetics play a significant role in the development of herniated disc. There are some genes that cause the development of weak spinal cord and they run in the families. Both of these factors play an important role in the development of annular tearing.
  • Daily activities like twisting, bending and swaying from side to side can also cause annular tearing. But such types of tears are very small.

Symptoms of Annular Tear

The symptoms of the annular tear are dependant upon its location in the affected person’s vertebral column and the severity of the fissure. Commonly, the first symptom is severe back pain. If the annular fissure is in the lower part of the vertebral column, the pain will radiate to one or both legs. Usually, the pain is aggravated with sneezing, coughing and lifting heavy objects. If the tear is in the lower part of the back, it is difficult for the patient to sit down because the pain is enhanced on sitting.

In case of a full annular tear, numbness, weakness, tingling and burning sensations are also felt in the localized region of the back and in the upper and lower extremities. Such sensations are felt because the roots of nerves supplying this area are pressed.

Simple tasks of routine life cause the worsening of the annular tear. The pain is also aggravated with routine life simple tasks because the patients use their back in almost every activity for example sitting, standing, walking and changing position.

How Tear is Diagnosed?

An annular tear is diagnosed by the doctor after taking a good history and performing a proper physical examination. During the physical examination, the doctor watches the back, neck, supporting muscles and joints of the patient thoroughly. The patient must carefully describe the symptoms to the doctor. The patient should also be prepared to tell briefly all the daily routine activities.

During the physical examination, the doctor gives extra attention to the alignment of the spinal column, posture and way of sitting and lying. The doctor also palpates the back of the patient by pressing hands against the back and neck.

Treatment Options for Annular Tearing

Following are the treatment modalities for annular tearing:

Conservative Options

Invasive treatment should be avoided at the start of the treatment. Non-invasive conservative treatment options are steroid injections and nerve root block. These remedies provide temporary relief (approximately up to one year) and then you have to repeat the procedure again and again. Another conservative treatment option is to put a spinal cord stimulator (STM). It causes the reduction of severe pain associated with the condition. It does not correct the underlying pathology.

Spinal Decompression Therapy

Spinal decompression is an effective way to reduce pressure from the nerve roots of the affected region. Pressure may be due to a bulging or herniated disc or central canal stenosis. Spinal column can be decompressed either through surgical procedure (which we do not recommend) or through spinal decompression therapy. Here at Spinal Backrack, we provide you an innovative spinal decompression device that helps you decompress your spine safely at home.

This unique device is called Backrack™. It is designed to treat almost all spinal disorders through simple exercises. Anybody who suffers from annular tear or back pain can use Backrack™ to treat the cause of pain. Backrack™ works on the whole spine from neck to lower back and hips. Please click here to find more details about the Backrack™ device.