If you are one of the millions of people who have experienced an annular tear, healing of the damaged intervertebral disc can likely occur with conservative, non-operative treatments. In fact, the vast majority of people who develop a fissure or tear in the outer disc wall – the annulus fibrosus – will never need any type of surgery.
How does an annular tear occur?
The cartilaginous discs that cushion adjacent vertebrae desiccate, thin and weaken with age. This makes them extremely susceptible to developing tears. These tears are usually asymptomatic. Localized pain develops when the tear becomes inflamed. When the tear is big enough to allow the inner gel-like disc material – nucleus pulposus – to leak into the spinal canal, disc herniation occurs. Herniated material can press on nearby spinal nerves or the spinal cord itself. This could lead to symptoms of pain, tingling, numbness and weakness. A herniated disc can also be referred to as a prolapsed disc, ruptured disc or slipped disc.
The process of resorption
Annular tear healing can require a period of several weeks or months. Even an annular tear that results in disc herniation can, in some cases, heal through a process called disc resorption. The complete physiological mechanism by which absorption occurs is not clear. Inflammation results from an annular tear when the nucleus pulposus leaks into the spinal canal. Inflammation draws cells known as phagocytes. These cells can engulf and dissolve herniated material. In most cases, the breakdown of the herniated nucleus pulposus continues until the extruded material is completely resorbed by the body. Why some herniated discs do not undergo this process completely is not known.
The process of annular tear healing may be aided by conservative treatments such as prescription or over-the-counter analgesics, non-steroidal anti-inflammatory drugs, hot/cold therapy, intermittent rest, low-impact exercise or massage. If weeks or months of these treatments do not provide relief from pain and an MRI shows no reduction in the size of your annular tear, surgery could be necessary. If this is the case, contact Laser Spine Institute. We offer minimally invasive surgical procedures that address the cause of symptoms and help our patients find relief from neck and back pain.