What Are Annular Tears and How Do They Affect Back Pain?

Back pain is one of the most common conditions that adults deal with. It’s one of the most common reasons for missed days of work and one of the most prevalent causes of disability. However, annular tears, a prevailing cause of back pain, are not as well known as they should be. Considering that this condition is such a common cause of back pain, it’s important to understand how they develop, what causes them, and how they can be treated to relieve back pain. Keep reading to learn everything you need to know about annular tears, and if you’re suffering from back pain, learn more about the non-surgical options provided in our practice.

Anatomy of the Spine

To fully understand annular tears, how they affect the spine, and how this contributes to back pain, we first need to discuss the makeup of the spine.

The spinal column runs from the pelvis all the way to the skull and is made up of four sections that help provide stability for the rest of the body. These four sections are the cervical spine, thoracic spine, lumbar spine, and sacrum. 

The cervical spine is located in the neck and is made up of seven vertebrae numbered C1 through C7 from top to bottom. These seven vertebrae allow you to hold your head up and make the movement of your neck possible.

Following these seven vertebrae is the thoracic spine, located in the upper back and made up of 12 vertebrae. These vertebrae are numbered T1 through T12 from top to bottom, similar to the cervical vertebrae. This part of the spine is the least likely to develop issues like herniated discs, degenerative disc disease, or annular tears, but that doesn’t mean that it’s impossible for this part of the spine to be the source of back pain.

The thoracic spine is followed by the lumbar spine, a section made up of five vertebrae numbered L1 through L5 from top to bottom. The lumbar vertebrae are the largest in the spine and support the majority of weight and stress for the spine. This is why the lumbar spine, located in the lower back, is the most likely to develop an injury or degenerative condition. 

Finally at the base of the spine, following the lumbar spine, is the sacrum. This is a small section made up of five vertebrae that fuse together to form one section during the growth process before birth. The sacrum makes up the back of the pelvis and hip girdle, and includes the coccyx, or tailbone, at its very base.

Spinal Discs

Now that we have a better understanding of the anatomy of the spine, we can move on to the part of the spine where annular tears develop: spinal discs, also known as intervertebral discs. Spinal discs are made up of the nucleus pulposus and the annulus fibrosis. The easiest way to picture the makeup of spinal discs is to imagine them like jelly doughnuts. 

The nucleus pulposus is found inside the spinal disc and is a jelly-like substance, that allows spinal discs to function as cushions between the vertebrae. The nucleus pulposus provides the spine with flexibility and movement, allowing it to bend and twist.

The annulus fibrosus is the outer layer of the spinal disc. This portion is made of 22-25 layers of fibers that connect to the vertebrae above and below the disc. The annulus fibrosus also contains the nucleus pulposus, stopping it from leaking and causing issues in the spine.

The annulus fibrosus and nucleus pulposus work together to evenly distribute force and stress placed on the spine, prevent the vertebrae from rubbing against each other, and ensure that spinal nerves don’t become pinched or compressed. In short, the spinal disc’s main function is to prevent pain in the spine.

Annular Tears

Unfortunately, as we age or after some kind of trauma or injury, the spinal disc can develop tears. In fact, annular tears are a normal part of the aging process.

As our bodies age, the fibers of the annulus fibrosus begin to break down simply because of daily wear and tear. As these fibers break down, certain motions or injuries can increase stress on the spinal discs until they develop tears. Traumatic injuries leading to annular tears are most commonly seen in high-impact sports like gymnastics and football, but sports like weight lifting and golf are known to cause annular tears as well.

These tears are the cause of many disc issues that contribute to back pain. It’s not uncommon for annular tears to be the root of spine pain for some patients. Spinal disc tears can cause general back pain as well as disc herniation, degenerative disc disease, and disc hydration (also known as desiccation). The bottom line is that this is a common cause of back pain, which makes finding an appropriate treatment option crucial for many patients.

Symptoms of Annular Tears – How They Affect Back Pain

Annular tear pain usually manifests in one of two ways: either localized and concentrated in the area around the tears or radicular pain that affects various areas served by the affected nerve root. Localized pain is typically a deep pain that may worsen over time with certain movements that may irritate or stress the torn spinal disc. Radicular pain is radiating pain that stems from irritation of a spinal nerve and radiates toward other parts of the body served by that spinal nerve.

But what causes this annular tear pain? Tears in the annulus fibrosus compromise its ability to keep the nucleus pulposus contained. When tears become large enough, the nucleus pulposus may leak out, inflaming and irritating the nerves surrounding the area. In cases of radicular pain, this can be the cause of pain in areas like the arms or legs in addition to back pain. Annular tears allowing the nucleus pulposus to leak out can also place pressure on nerves, causing pain from compression. 

In addition to this pain, a leaking disc will also lose its height with time, limiting the affected disc’s ability to withstand compression and other forces. Other symptoms of an annular tear include:

  • Dull or achy pain in the lower back.
  • Pain that worsens after prolonged standing or sitting.
  • Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet.
  • Numbness or tingling in the legs.
  • Muscle spasms and tightness in the low back, pelvis, and hips.
  • Difficulty standing up straight, walking, or going from standing to sitting.

Keep in mind that this list is not definitive, as annular tears can cause many more symptoms that aren’t listed here. It’s important to consult a physician as soon as possible if you’re suffering from back pain.

Annular Tear and Back Pain Treatment in Glen Mills, PA

Most common treatments for back pain are unable to heal annular tears. Unfortunately, when annular tears are the source of back pain, this means that unless they’re addressed, you’ll continue to deal with the back pain they cause. Unlike other areas in the body, spinal discs can’t heal themselves. This is because spinal discs have few blood vessels, which means that this area needs help to generate new tissue and complete healing. 

Fortunately, orthobiologic options like SpineRenu and the Discseel® Procedure are available and capable of facilitating the healing process for annular tears, providing relief from back pain. These treatment options are non-surgical and non-invasive and once the healing process is complete, mobility won’t be limited as it would following spine surgery. We understand that our patients’ top priority is to successfully recover from their conditions while getting back to their lives as quickly as possible.

If you’d like to learn more about our services or contact us to schedule a consultation, please call our office in Glen Mills, Pennsylvania, at (610) 459-4200 or fill out our form. We welcome your inquiry and we look forward to helping you get back to the game of life!

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