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What is an Annular Tear?
An annular tear develops in the annulus of an intervertebral disc. They develop gradually as we age. Tiny tears and fissures can develop and spread through the soft tissue of the nucleus pulposus. Eventually, the tears will irritate the outer third of the disc which contains several nerves. The pain may at first be acute and gradually become chronic, and quite irritating. An annular tear can be concentric, transverse, or radial and can involve all layers of the annulus.
Your vertebral discs serve as shock absorbers, cushioning the spinal column. Not surprisingly, losing the structural support of a disc will cause pain which will intensify with movement. Occasionally, the annular tear will stimulate the transversing nerve and cause a form of pain called radiculopathy which is felt in your arms and legs.
At times, a fissure can cause an extrusion or herniation of the annulus fibrosus, a sturdy ring of fibers that contains the soft center. A herniation can place significant pressure on the nerves adjacent to the vertebrae. If herniation has occurred, you can be sure that an annular tear or an annular fissure was present.
Many annular tears will not cause any pain and will heal on their own, but some tears can be quite painful especially if they are located in the outer third of the disc’s annular ring. For patients over sixty, annular tears can also be an early sign of degenerative disc disease caused by osteoarthritis.
How is an annular tear evaluated?
An MRI is often the best choice for identifying an annular tear. It allows your spinal doctor to assess the size of a tear and whether it is concentric, transverse or radial in its orientation.
A CT scan will identify nerve roots or spinal cord compression, but it may not identify edema in the disc and the tell-tale signs of fissures or tears that have not yet caused herniations which is why an MRI is most often used.
How is an annular tear treated?
Doctor Melamed has a wide range of non-invasive, non-opioid pain relief strategies that can bring welcome relief to the pain caused by annular tears.
An annular tear is an indicator that degenerative disc disease may be starting. There are several integrative medical techniques that reduce acute and chronic pain and slow disc degeneration.
Pain is real, but Dr. Melamed has developed a way to control it by taking a holistic approach that includes non-surgical therapies based on Integrative Medicine techniques, lifestyle optimization, and starting an anti-inflammatory diet program.
Most patients respond well to these holistic solutions, but some patients may not. If surgery is your best choice, Dr. Melamed may request additional imaging tests. He will review the most appropriate surgical options and discuss the therapeutic benefits of his Opiate-Free Surgery and Pain Management System which has helped hundreds of patients recover from back pain and avoid potential addiction problems during the recovery phase.
Insurance
and Billing
We provide a very high level of individualized and concierge care. Therefore, we are out-of-network with almost all insurances, but as long as you have out-of-network benefits, we are happy to work with you, bill on your behalf, and verify your benefits.
