An intervertebral disc or spinal disc is a type of connective structure that connects two vertebrae. These intervertebral discs act as shock-absorbing cushions between each vertebra.
Each disc has two parts. The outer ring-like structure is called as annulus fibrosus and the inner soft jelly-like part is known as nucleus pulposus.
The outer ring is the strongest part of the disc and is richly supplied with pain nerve fibers.
Thus, if an annular disc tear occurs in the outer one-third of the annular ring, it is a very painful situation. Although this tear can heal with the passage of time, having scar tissue on it predisposes it to future tears and injuries.
Annular tears are also known as annular fissures.
Annular tears may be transverse, radial or concentric in nature. Some type of tears involve all the layers of a disc 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, which involves injury only to a portion of the annular ring
- A complete annular tear is tear which involves the entire annular ring, which usually occurs due to a disc herniation or bulging disc. This can involve severe annular tears.
Causes of Annular Tear
- An acute or even traumatic 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.
- 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.
- Wrong weight lifting techniques can also lead to annular tears. People who do heavy weight lifting as part of their job should adopt proper lifting techniques.
- 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.
- Genetics can also play a significant role in the development of herniated disc.
- Daily activities like twisting, bending and swaying from side to side can also cause annular tearing.
Symptoms of Annular Tear
The symptoms of annular tear are dependent upon its location in the affected person’s vertebral column, as well as the severity of the fissure. However, symptoms typically include:
- Severe back pain/annular tear pain.
- Pain that may radiate down both legs, if the annular fissure is in the lower part of the vertebral column, the pain will radiate to one or both legs. The cervical and thoracic spine may also be affected.
- The pain can be aggravated when sneezing, coughing and lifting heavy objects, as well as while sitting down, or even while performing everyday tasks such as standing or walking.
- Numbness, tingling weakness, and burning sensations in the case of a full tear.
How Annular Tear is Diagnosed?
Diagnosing an annular tear starts with a physical examination conducted by a doctor, who will also ask for the medical history of the patient. During the physical examination, the doctor thoroughly examines the back, neck, supporting muscles and joints of the patient.
Annular Tear Treatment Options
Minimally-invasive conservative treatment options are physical therapy, steroid injections, nerve root block and anti inflammatory medications. These remedies provide temporary pain relief (approximately up to one year) and then you have to repeat the procedure again and again.
Spine surgery, such as disc replacement or spinal fusion should be avoided as much as possible for annular fissure treatment, due to the complications they can cause post-surgery.
Spinal Decompression Therapy
Author: Spinal Backrack