If you have developed an annular tear without disc herniation, surgery is rarely necessary. However, it is important to begin treating your symptoms with conservative, non-operative therapy. The goal of therapy is symptom relief and reduction of the likelihood of progression to disc herniation. Nearly all uncomplicated annular tears heal themselves with conservative treatment over a period of months or weeks.
An annular tear can progress to a herniated disc, otherwise called a prolapsed or ruptured disc. This occurs when the outer wall of an intervertebral disc develops a tear and the inner disc gelatinous material, called nucleus pulposus, leaks into the spinal canal. Symptoms result if extruded material presses on nearby spinal nerves or the spinal cord. Your body recognizes that the extrusion of this nuclear material is abnormal and releases chemicals that break down the material in an attempt of resorption, thus allowing the disc fissure to close. If your annular tear undergoes disc resorption, surgery will not be necessary.
Are annular tears always painful?
Some annular tears are completely asymptomatic. If the fissure is thin enough that no nuclear material escapes, there is virtually no risk of painful neural compression. In addition, the disc wall itself does not contain any nerve endings and does not have its own blood supply. Therefore, incidence of significant inflammation is lowered. Barring inflammation and herniation, annular tears are usually asymptomatic. However, instances in which a tear occurs very near the vertebral endplates can lead to localized pain since vertebral endplates are richly innervated.
Minimally invasive procedures
If conservative treatments like pain medication, rest, hot/cold therapy or massage do not help your annular tear, more extensive pathology requiring surgery may be necessary. Keep in mind that there are minimally invasive alternatives to traditional open spine surgery. Laser Spine Institute offers a variety of outpatient procedures that can help you find relief from neck and back pain. For more information on annular tears and to find out if you could be a candidate for one of our numerous procedures, contact Laser Spine Institute today.