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Lumbar Annular Tear

What is a Lumbar Annular Tear?

A Lumbar Annular Tear is a defect in the outer layer of the disc, called the Annulus Fibrosus. With age and injuries, the Annulus will degenerate and weaken. This leads to small tears, which can get inflamed and painful.

What is the difference between an Annular Tear and a Disc Herniation?

In the case of an Annular Tear, the soft core of the disc (nucleus) has not broken through the Annulus, but is still in the center of the disc. In the case of a disc herniation, typically the Annulus has ruptured and allowed the material lof the nucleus to spill out.

Does an Annular Teat mean that the disc will Herniate soon?

Not necessarily. Annular tears are very common and may not indicate that the disc will herniate.

Do Annular Tears cause back pain?

Many spine specialists believe that an Annular Tear is just part of the normal degenerative process of the spine. Others believe that it is a common reason for back pain.

How do Spine Specialists diagnose a Lumbar Annular Tear?

Spine specialists usually use information from a Lumbar MRI to diagnose an Annular Tear. However, a Lumbar Discogram (injection of dye into the disc) can also help make the diagnosis.

Can Spine Specialists find out if an Annular Tear is causing pain?

Spine specialists often perform an injection called a discogram to see if a disc and specifically an annular tear is painful. Contrast dye is injected into the disc under pressure to see if it is painful. The contrast dye is seen on an X-Ray machine which can show if it is leaking through an Annular Tear.

What is the treatment for an Annular Tear?

 

  1. Non-Surgical Care

A. Alternative Health Care

Alternative Health care options can often complement conventional medical care. Massage Therapy, Acupuncture, Meditation exercises and Herbal Remedies can all help with the pain from this condition.

B. Nutrition and Weight Loss

Proper nutrition and weight loss can have a positive impact on many spine conditions. Excess weight on the spine often contributes to the symptoms of pain and spasms (Spine and Obesity).

C. Chiropractic Care

Chiropractic care including manipulation and adjustments of the spine can help with the pain and spasms from this condition.

D. Spine Exercises

Spine exercises can help with the muscle pain and tightness from this condition. Exercise also increases the amount of oxygen delivered to the spine which can help with healing. Pilates, Yoga and T’ai Chi can help maintain the spine’s flexibility.

E. Physical Therapy (PT)

PT has many modalities to offer for this condition. They can range from Manual Therapy and Exercises to Traction and Ultrasound Treatments.

F. Self Help Tools

Self Help Tools are items which can be purchased to help with back pain. They range from Back Braces to Back Mattresses and Ergonomic Devices such as chairs and computer accessories.

G. Spine Medications

Here are some of the common groups of medications which are available for this condition:

  1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
  2. Muscle Relaxants
  3. Nerve Pain Medications
  4. Pain Killers
  5. Topical Medications

 

H. Spine Injections

Here are some spine injections which can provide relief from this condition:

  1. Lumbar Interlaminal Epidural Steroid Injections
  2. Lumbar Transforaminal Epidural Steroid Injections
  3. Lumbar Nerve Root Blocks
  4. Lumbar Trigger Point Injection

 

      2. Surgical Care

Currently no specific surgery exists to predictably repair an Annular Tear. Debate exists amongst spine specialists if Annular Tears are a normal part of the aging process of if they represent a specific disease.

However, here is a minimally invasive procedure sometimes done for Annular Tears which are thought to cause pain:Lumbar Intradiscal Electrothermal Therapy (IDET)