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Annular Tears

Painful Spine Problem Can Be Effectively Treated Annular tears can cause fluid to leak out of vertebral discs of the spine, irritating nearby nerves, causing significant pain, numbness, and tingling in the back, neck or legs.

Annular tears are most often the result of normal wear and tear associated with the aging process. Since the tears may not fully heal, the risk of reinjury is high.

Most people can reduce the possibility of reinjury and return to a normal lifestyle by following an individualized treatment plan prepared by the physicians at National Spine & Pain Centers. We specialize in this type of painful spine disorder and can offer you quick and long-las􀆟ng relief.

What are annular tears?

Annular tears are spinal conditions that affect the vertebral discs that cushion the bones of the spine. A disc’s tough exterior surrounds an inner jelly-like substance. As you move, this inner substance shifts to absorb stress from the spine and to reduce the force exerted on your back. Factors that generate the most force are sitting, standing from a sitting position and maneuvers that increase pressure inside your abdomen, such as coughing, sneezing and straining.

When an annular tear occurs in the tough outer shell of the disc, some liquid from the inner substance can leak out and irritate nearby nerves, leading to inflammation. Additionally, if the tear is large enough, a disc herniation may occur in which the inner substance pushes through the tough exterior and into the spinal canal, causing further symptoms such as weakness. Though the location and quality of the pain may be similar for annular tears and disc herniations, the pain of an annular tear is typically caused by a chemical irritation of nerves (caused by the liquid) as opposed to the structural (mechanical) irritation associated with a herniated disc.

Although most annular tears occur because of the natural aging process, they can also develop by any type of back trauma, such as the force of a car accident, a fall or a sports-related injury.

The need for an accurate diagnosis:

Your physician will ask questions about your past and recent history and conduct a physical examination to determine any specific factors that put you at higher risk of having an annular tear and to rule out other potential causes of your symptoms. If you have an annular tear, some portions of the physical examination may reproduce or increase your symptoms. Often, an MRI examination of your spine may be required to confirm the diagnosis and provide additional information regarding the precise location and extent of nerve involvement.

The importance of treatment:

The symptoms of an annular tear can be treated initially with oral an􀆟-inflammatory medications, medications that are specific for nerve-mediated pain, heat treatments, modified activity, weight reduction, physical therapy and exercise. For longer las􀆟ng, non-surgical options, your physician may recommend a series of epidural steroid injections. This involves putting inflammation-relieving medication right at the source of what is inflamed, the nerve. Although the corticosteroid medication does not change the underlying problem, it can break the cycle of irritation and pain, allowing the body to begin healing. The injection is guided by fluoroscopy (live x-ray) to ensure accurate needle placement. Pain relief usually occurs within 48 hours.

An annular tear can be extremely painful and interfere with the quality of your life. The board certified pain specialists at National Spine & Pain Centers can tailor a treatment plan that works with your lifestyle, returning you to an active routine–and keeping you there.

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