Annular Tear

An annular tear is a break or tear in the surface of a cushioning disc in your spinal column. The normally resilient material that forms this surface, called the annulus fibrosus, surrounds a softer, water-rich core called the nucleus pulposus. If the nucleus pulposus leaks through an annular tear and intrudes upon your nerve roots or spinal cord, you can experience significant pain and other nerve-related problems. Tears in your annulus fibrosus never fully heal. However, your doctor can use several methods to help you get relief from their effects.

Spinal Disc Anatomy

The material of the annulus fibrosus is made from two different tissues, called fibrocartilage and type 1 collagen. These tissues form fibers, which in turn form crisscrossing, overlapping layers that give the annulus strength and the ability to resist considerable amounts of external pressure. The edges of each annulus fibrosus also contain fibers called Sharpey’s fibers, which attach the spinal disc to the associated bone in your spine. The nucleus pulposus inside of each disc gives it its ability to help cushion and protect your neck and back.

Annular Tear Causes

Annular tears typically form in spinal discs located in one of two areas: your cervical spine (neck) or your lumbar spine (lower back). Most of the time, they’re the result of normal wear and tear associated with the aging process. However, you can also develop an annular tear if you sustain any type of physical back trauma, such as the force of a motor vehicle accident, fall or a sports-related injury. The gradual spinal degeneration that comes with aging is sometimes referred to as degenerative disc disease.

Annular Tear Description

Annular tears can form in different ways. In some cases, the Sharpey’s fibers get pulled free from neighboring bone. In other cases, the individual annulus fibers are pushed out of their normal position. These fibers can also lose their internal integrity and break apart in one or more layers of the annulus. Annular tears  are similar to another spinal disc problem called a herniated disc. However, these two ailments differ in one significant respect. In an annular tear, leaking nucleus pulposus doesn’t spread past the edges of the nearby vertebrae. In some herniated discs, the nucleus pulposus leaks past the bone edges. In other herniated discs, the nucleus pulposus doesn’t break all the way through the annulus, but still alters the shape of the disc enough to spread it beyond the neighboring bones.

Annular Tear Symptoms

Symptoms commonly associated with an annular tear include pain in your neck, pain in your back, pain that affects a single leg, or pain that affects both of your legs. In most people, annular tear-related pain grows worse during certain body movements, including bending, lifting and sitting down. Your pain can also grow worse when you cough or sneeze. Conversely, your pain can lessen when you move from a sitting position to a standing position.

Annular Tear Treatment

Annular tears heal relatively poorly, and are typically only covered by small amounts of scar tissue. This poor healing means that once an annular tear occurs, you have an ongoing risk of reinjuring your back at some later time. Still, most people can significantly reduce this risk and return to a normal lifestyle by following a treatment plan that includes short-term use of a nonsteroidal anti-inflammatory drug (NSAID), such as naproxen or ibuprofen, as well as physical therapy designed to improve back health through posture improvement and exercises that stretch and strengthen the back muscles.