Treatment Options for Annular Tears

BY MARK WANG, MD

 

Dr. Mark Wang is a fellowship-trained and board-certified orthopedic spine surgeon. He dedicates his full attention to working together with his patients to identify their pain source and find the least invasive treatment that works for them.

 

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An annular tear is a discogenic condition that impacts the spine, causing lower back pain. Natural wear and tear, sports injuries, improper lifting and repetitive motions are the most common causes of annular tears, as the injury results from the fibers that make up the intervertebral disc breaking or separating. 

While these tears can occur anywhere on the spine, they happen most often in the neck and lower spine, with pain ranging from mild to severe. Other symptoms can include weakness or numbness in the arms or legs and limited flexibility. 

Annular tears are very common and often associated with low back pain, experienced by up to 84% of adults in the United States throughout their lifetime. Fortunately, there are many things you can do to manage pain if you have an annular tear. From physical therapy and exercise to minimally invasive procedures, here are a few ways you can find relief. 

Nonsurgical Treatment Options

Your physician will begin by examining your spinal condition through an X-ray and/or magnetic resonance imaging (MRI). They will also ask you a series of questions about your health history, points of pain and specific concerns to determine the best course of action. 

While larger annular tears will require treatment, a smaller one might heal on its own. However, keep in mind that once the area is torn, it’s more likely to tear again in the future. That’s why the best form of treatment is prevention — take care to avoid anything that could cause significant trauma along the spine, and work on strength-building exercises that target the upper and lower body and the core.

The first lines of treatment to manage pain and maintain mobility while a tear heals include:

• Anti-inflammatory medication: You might get an over-the-counter pain medication or a prescription. If the tear or your pain is more severe, your provider might suggest a steroid injection to reduce pain and inflammation. 
• Ice or heat therapy: A cold or hot compress can increase blood flow to the damaged area and relieve pain. 
• Physical therapy: Physical therapy treatment for annular tear includes exercise, traction and other therapies with the potential to prevent the need for surgery. 
• Home exercises: It’s also crucial to rest for a few days and do non-impact annular tear exercises at home while the injury heals. Fixing poor posture and maintaining a healthy weight can also help you prevent and manage annular tears. 

The following annular tear exercises can help you build muscle strength, increase mobility and reduce pain:

• Annular tear stretching exercises like leg extensions, pelvic lifts and shoulder blade squeezes
• Upper back extensions while lying on the stomach with arms placed along the body 
• Bicycling, swimming and walking
• Various pilates or yoga exercises 
• Water walking laps 
• Lunges targeting the glutes and quadriceps
• Elbow-based planks 

While regular exercise can help reduce pain and aid in healing, you’ll want to avoid running, barbell squats, deadlifts and twisting exercises, as these carry a risk of aggravating your injury. A physical therapist will create a tailored exercise routine to help you heal and alleviate your pain as the tear mends. 

Surgical Treatment Options

If conservative treatment methods fail to address your pain, you might explore surgical annular treatment options. Your provider will help you choose the best surgery type for your condition and preferences. Options typically include: 

• Endoscopic discectomy: This minimally invasive procedure safely removes disc fragments from the annular tear — without removing any bone or muscle. The surgery aims to relieve pressure, aiding in a fast and effective recovery.
• Artificial disc replacement: Those with severe tears might require artificial disc replacement to replace the damaged disc with an artificial one. Health providers will use imaging tests like an MRI to locate the source of your back pain and determine if you are the right candidate for disc replacement surgery.
• Endoscopic annuloplasty surgery: Surgeons can also use a laser to debride the tear, and bipolar radiofrequency to shrink and seal the tear, helping to manage pain while preventing the injury from worsening. Unlike traditional spinal fusions, endoscopic annuloplasty surgery does not damage bone and surrounding tissues during the procedure, reducing the risk of postoperative complications and pain.
• Spinal fusion: This surgery is also often used for more severe tears, fusing two or more vertebrae together to eliminate painful motion. While the procedure may take away some spinal flexibility, most patients will not notice a decrease in the range of motion from a spinal fusion. 

Minimally invasive surgeries mean smaller incisions, shorter recovery times and reduced risk of complications. It’s important to discuss treatment options with licensed orthopedic surgeons, as they can determine whether you are the right candidate for an endoscopic discectomy.

The Future of Annular Tear Treatments

It’s vital that you consult with experienced healthcare professionals to determine the right course of treatment for an annular tear. At DISC, our orthopedic surgeons offer various innovative treatments and always recommend the least invasive options first based on your specific condition and symptoms. Most clients can improve with conservative treatments like regular exercise, proper posture and physical therapy. 

We can help you find the right lifestyle changes to minimize further tears and allow healing. We can also provide guidance on pain management medications, working with you to assist with healing and providing the best possible care. If conservative treatments don’t alleviate your pain within six to eight weeks, we can recommend minimally invasive surgery. Our team specializes in endoscopic spine surgery and can walk you through the surgery process to ensure you can make a fully informed decision.

Our innovative treatment options for disc tears include:

• Endoscopic Discectomy/Annuloplasty — lumbar only
• Minimally Invasive Microdiscectomy
• Anterior Cervical Discectomy and Fusion (ACDF) 
• Minimally Invasive Spinal Fusion
• Artificial Disc Replacement (for Cervical and select Lumbar cases)

Experience the future of spinal care with Desert Institute for Spine Care’s revolutionary approach to treating disc tears. We use innovative technology and techniques to target disc tears with precision, minimizing discomfort and recovery time. 

Get Compassionate and Experienced Care at DISC

If you are dealing with low back pain, you’ll find various annular tear treatment options that can help you get relief. From regular exercise and physical therapy to minimally invasive procedures, managing pain and inflammation associated with annular tears is possible. Whether you require a surgical or nonsurgical option depends on the tear’s severity and your overall needs. 

At DISC, we understand that spinal issues can be daunting, which is why we prioritize your well-being above all else. Our compassionate team of experts specializes in minimally invasive procedures designed to alleviate your pain and help restore your lifestyle. Our commitment to your comfort and safety ensures you receive the best care possible. 

Look forward to a faster, less painful recovery and a brighter, pain-free future and request an appointment today. From minimally invasive procedures to the most complex spine surgery, we provide compassionate, innovative and effective treatments to improve your quality of life.