An annular tear, or rupture of the outer wall of an intervertebral disc, is most common in the lower back, or lumbar spine. The reason for this is the five lumbar vertebrae (abbreviated as L1-L5) are subjected to wear and tear brought on by a wide range of movement, including bending, twisting and flexion. In addition, the lumbar vertebrae support much of the body’s weight. These two factors, combined with the discs’ natural loss of water content over the years, can weaken the outer wall and produce fissures that normally start small and grow larger as more stress is placed on the damaged disc. This is called a herniated disc, and it usually is asymptomatic. However, if a portion of the damaged outer wall or extruded disc nucleus material comes into contact with the spinal cord or an adjacent nerve, symptoms such as localized pain, radiating pain, tingling, numbness or muscular weakness can occur.
Breaking it down by lumbar disc segment
The body parts that are affected by symptoms depend on the location of the annular tear within the lumbar spine. The largest nerve in the body, the sciatic nerve, originates within the lumbar spine, and nerve compression in the lower back typically results in the set of symptoms known as sciatica. A physician’s preliminary diagnosis of the cause of sciatica will be based, in part, on the location of the symptoms. The following is a loose guideline of where symptoms might occur if the nerve roots at each level are compressed:
- L1 – pain, numbness or loss of sensation in the thigh or groin area.
- L2 – diminished strength in the hip flexor; pain, numbness or loss of sensation in the thighs.
- L3 – diminished patellar reflex; pain or numbness in the thighs; quadriceps weakness.
- L4 – numbness or loss of feeling in the feet; diminished patellar tendon reflex; quadriceps weakness; pain in the legs.
- L5 – numbness or loss of sensation in the feet or toes; weakness in the hips and legs.
Treatment for an annular tear in the lumbar spine
While the tear in the outer wall will never completely “heal,” symptoms can be managed using conservative treatments such as pain medication, physical therapy, stretching or exercise. However, if chronic sciatica persists after weeks or months of conservative treatment, contact Laser Spine Institute to learn about minimally invasive, outpatient procedures that can help you find relief from lower back pain.