What is an Annular Tear?
An annular tear is a tear in the ligament that connects your vertebra to your disc. This ligament surrounds the nucleus of your disc with a strong ring of cartilage fibers called the annulus fibrosus. The nucleus of your disc is a soft, jelly like substance that acts as a shock absorber for your body. It is made to degenerate slowly over time as it endures daily impact and stress.
A tear occurs if the disc ruptures and this ligament tears. When the jelly-like nucleus of the disc pushes through the annular tear it’s called a herniated disc. When no disc material is ruptured it is referred to as just an annular tear.
Because the outer annular fibrosus ring contains many nerve fibers, tears can be extremely painful. Although an annular tear will normally heal itself over time, it is susceptible to future weakness and tears causing some sufferers to seek the help of doctors or surgeons.
Types of Annular Tears
- RADIAL TEAR: Radial Annular tears begin at the center and extend out through the other layers surrounding the disc. Typically caused by the natural aging process, these tears can cause disc herniation where the inner, gel-like layer seeps through the tear outside the disc.
- PERIPHERAL TEAR: Peripheral Annular tears are tears that begin on the tough outside layers of the ligament surrounding the disc. These are often caused by traumatic injury and are sometimes referred to as transverse tears.
- CONCENTRIC TEAR: Peripheral Annular tears are tears that begin on the tough outside layers of the ligament surrounding the disc. These are often caused by traumatic injury and are sometimes referred to as transverse tears.
What are the symptoms of an Annular Tear?
Pain is the number one symptom, but the degree of pain depends on severity of the tear. Patients may only feel pain when they bend or move in a certain direction. Others complain the pain is so excruciating they are bedridden. On the contrary, some patients feel no pain at all. Below is a list of common symptoms associated with annular tears:
- Back Pain
- Neck Pain
- Radiating Pain
- Sciatic Pain
- A burning sensation along spine or sciatic nerve
- Muscle weakness in neck, back, arms or legs
- Limited flexibility
- Tingling and numbness in arms or legs
What Causes an Annular Tear?
As we age, the discs in our spine start to feel the toll of supporting our weight and movement of our bodies. Although there are many causes of annular tears, the most common cause is the natural aging process. As we age, our discs become less hydrated and more brittle making them prone to tears.
Along with aging, a tear can also be caused by:
- Traumatic event such as car accident or sports injury
- Improper lifting or movement
- Repetitive motions such as lifting or twisting
- Sitting for extended periods of time such as working at a desk
- Carrying excess body weight
A tear may be associated with other spine conditions such as:
- Degenerative Disc Disease
- Herniated Disc
- Spinal Stenosis
- Neck Pain
- Back Pain
How are Annular Tears diagnosed?
After a full clinical exam and personal health history evaluation, patients who come in complaining of symptoms associated with annular tears are often sent for imaging to determine the cause of the pain. An MRI or CT scan can be ordered to identify the problem. MRIs are generally painless but in some cases can miss the tear. The CT discography scan uses dye to identify tears, but is often painful and may not be tolerated well by patients.