Annular Tear

Symptoms of an Annular Tear


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Causes of an Annular Tear


Annular tears often result from gradual wear and tear or sudden, traumatic injury. The factors leading to an annular tear are usually as follows:

Degenerative Disc Disease (DDD): DDD occurs when the spinal discs begin to break down, or degenerate, from excess wear and tear. Often this coincides with a loss of fluid inside the disc, a normal facet of the aging process. As the disc begins to dry out, it also loses some of its flexible nature. This ultimately makes the disc more prone to tearing.

Bone Spurs: Bone spurs are bony knobs that form along the endplates of our bones in response to inflammation. Although not “bad” in and of themselves, bone spurs can cause annular tears if they extend into the disc space.

Traumatic Injuries: Sports collisions, car accidents, and falls… Each of these events can cause instantaneous damage to a spinal disc.

Overuse: Repetitive, heavy lifting and occupations that place chronic strain on the back (like sports, nursing, or construction) can lead to annular tears.

Genetics: Your genes often determine the strength and quality of your collagen, the substance that makes up the annulus. Poor cartilage production or inferior collagen can make annular tears more likely.

Worried that you might have an annular tear? Contact our disc experts at the Advanced Spine Center! Dr. Charles Gatto, MD specializes in annular tears, bulging discs, and disc herniations. For superior spine care that you count on, contact the Advanced Spine Center today!

Types of Annular Tears


It seems that annular tears would occur in a fairly straightforward way. The disc itself becomes weak and/or a force causes the disc to rip. And, while this may be true, annular tears can actually occur in 3 different patterns. (Although you might be asking… Who cares if an annular tear is radial vs. concentric? How the disc tears actually reveals quite a bit about the symptoms that will emerge). The 3 major types of disc tears include:

Transverse Tears: Transverse tears begin in the outermost rim of the disc and can extend all the way to the nucleus. This is significant because the outer ? of the disc is highly innervated with pain receptors. If you experience an annular tear here, it’s fairly difficult not to notice.

Radial Tears: These tears begin at the innermost portion of the annulus and can continue to crack until they reach the rim. Because these tears begin in the center of the disc where pain receptors are sparse, they do not always cause symptoms.

Concentric Tears: Concentric tears develop in a ring that encircles the nucleus of the disc. They are often the result of torsional injuries, or twisting the wrong way. (Think of throwing out your back while swinging a golf club.)

How an Annular Tear is Diagnosed


If you suspect that you might have a torn disc, then your doctor will need to perform imaging tests to confirm the presence of the tear. In particular, your doctor will need to order an MRI or CT scan to reveal soft tissues, like spinal discs. Your doctor should also perform a physical examination, which involves palpating (or touching) the spine and investigating any painful areas. Once you have received your diagnosis, your doctor will prescribe a regimen of pain relief options.

Looking for a doctor who can diagnose disc pain? Seek the advice of a board-certified spine surgeon, like Dr. Charles Gatto. Dr. Gatto has over 20 years of experience in resolving annular tears, bulging discs, and disc herniations!

Annular Tear Treatment Options

Pain Management

Often, annular tears will heal on their own when given sufficient time. In the meantime, your doctor may prescribe pain medications, such as ibuprofen, or steroid injections into the disc to relieve inflammation.

Microdiscectomy

If your torn disc does not heal after 6 months of conservative therapy, your doctor may recommend minimally invasive spine surgery. During a microdiscectomy, your doctor will remove and repair damaged portions of your disc. Read more...

Physical Therapy

Exercise is often one of the most prescribed methods for relieving a torn disc. By working with a physical therapist, you can develop a routine of stretches and weight-bearing exercises that maintain flexibility while enhancing strength.

Artificial Disc Replacement

If your disc becomes too unstable for microdiscectomy, your surgeon many suggest an artificial disc replacement. During this procedure, the damaged disc is removed and replaced with an artificial model. Read more...