Annular Tears

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By: James Perry, DO 

What is a Disc in the Spine?

A disc is a cushion between two bones in the spine.  The bones in the spine are called vertebrae.  The disc absorbs shock and keeps space between two vertebrae.  The outer portion (Annulus Fibrosis) of the disc is made of tough fibrous material.  The Annulus Fibrosis connects two vertebrae together.  The inner portion (Nucleus Pulposus) of the disc is a gelatinous fluid.  The Nucleus Pulposus is hydrated with water and is held in place by the outer layer or Annulus Fibrosis

Image of a man with an Annular tear

 

If you would like to learn more about the Anatomy of the Spine, please watch this Spine Anatomy Video.

 

What is an Annular Tear in Your Back?

The disc can become injured with trauma or repetitive stress.  If the outer layer of the disc tears and none of the inner gelatinous layer rupture, this is called an Annular Tear.  There are a lot of nerve receptors that detect pain in the outer portion of the disc.  An Annular Tear can activate the pain receptors and cause pain in the back.  The torn fibers of the disc typically heal as the body forms scar tissue over the injured area.  Symptoms usually go away but it may take several months.

What Causes an Annular Tear?

Image of a man lifting improperly

Most of the time, Annular Tears happen due to the normal aging process.  The wear and tear of life can cause the disc to be more prone to injury.  Usually, there are multiple factors involved.  Factors that affect the disc health may include:

• Genetics
• Diet
• Exercise habits
• Alcohol and tobacco use
• Repetitive stress
• Limited core strength
• Poor posture
• Ergonomics 
• Acute Injury

If an Annular Tear occurs due to an injury, it is usually due to a twisting movement of the spine.

What does an Annular Tear feel like?

An Annular Tear typically causes low back pain. The pain is usually in the middle of the back.  Pain may radiate across the back.  Sometimes, there is leg pain but usually leg pain occurs when the disc bulges or aherniated disc.   There is typically swelling around the injured area of the disc.  This inflammation can irritate the nerve in the area but it usually comes and goes.

If you have an Annular Tear, anything that puts pressure on the disc can aggravate the pain.  These may include:

• Slouching
• Bending
• Lifting
• Coughing
• Sneezing

How do You Know if You have an Annular Tear?

If you have symptoms of an Annular Tear, a physician may perform a physical examination with specialized tests. Special Tests help the physician know whether there is a chance of an Annular tear or other spine issue. Depending on the results of the exam, the physician may order an MRI.  An MRI is a form of imaging that can show problems with soft tissue and cartilage.  MRIs can be helpful in diagnosing Annular Tears.  However, an Annular Tear seen on MRI does not necessarily mean there will be pain or symptoms.

How do You Fix an Annular Tear?

Annular Tears usually get better with physical therapy and anti-inflammatory medications.  It is important to stay active but limit impact activity.  Avoid prolonged bed rest.  You may need to modify some of your activities and your work station.  It is important to give the disc a chance to heal.  Avoid any activity that increases your symptoms.  It is rare for patients to require surgery for an Annular Tear. Physical Therapy can play a very important role in the recovery and treatment aspect of an annular tear or other low back problems.  To schedule physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.

Dr. Perry also performs robot assisted spine surgery.  To find out more, please read robotic spine surgery.

Related Articles:

• Bones of the Back
• Herniated vs. Bulging Discs
• Do You Have Lower Back Pain While Standing?
• Imaging for Back Pain

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To make appointments with JOI Rehab, please call 904-858-7045.