Is Annular Tear the Culprit of your Chronic Neck and Back Pain?

Did you encounter a motor vehicle accident like a rear-end impact or a T-bone accident? As a result, do you have neck or back pain? Consult a physician immediately. You might have sustained an annular tear, possibly in the neck or back. Neglecting it will make you regret it forever.

Before analyzing what an annular tear is and how it occurs, we should be familiar with our spine and spinal cord structure. The spine, the backbone of our body, is made of 33 small bones (vertebrae) stacked up on one the other. It is the junction of our muscular and skeletal systems. Our spine protects the spinal cord or the nerves going through the spinal canal to the brain from various body parts. The spine ensures the flexible movement of our body. To move smoothly and friction-free, cushion-like spinal discs between the vertebral fragments help.

The intervertebral disks or spinal discs are soft and gel-like to act as shock absorbers when our body moves or sways. These discs have a ring-like outer structure called annulus fibrosus with a soft inner part known as nucleus pulposus. When the multi-layered annulus fibrosus undergoes wear and tear or trauma, an annular tear occurs.

Let’s plunge into the causes and symptoms of annulus fibrosus tears and assay how they can be cured. We’ll also see what to do if you sustain annular torsion in auto accidents.

Annular Tear and Annular Fissure

An annular tear is also called an annular fissure in general. However, the two terms have slight differences. Old age or repetitive stress wears out the annular fibrosus and results in the annular fissure. Whereas annular tears can occur due to repetitive motion, aging as well as trauma to the spine.

What Makes Annular Fibrosus Tear?

When human beings are young, the spine will be flexible, and the discs will be filled with gel-like fluid. Once the years pass, Degenerative Disc Disease occurs. The drying out or dehydration of discs, called disc desiccation, could make the disc’s outer ring fragile. Due to the wear and tear, there arises cracks in the outer ring. Bone spurs forming at the endplate of our bones may turn out to be dangerous. When they extend to the spinal space, they may cause damage to the annular fibrosus.

When heavy impacts like occupational accidents, slips, and falls occur, they could weaken or rupture the spinal discs. Traumatic truck accidents or fatal car accidents could disposition the vertebral fragments and intervertebral discs and emanate annular tears.

Repetitive stress like lifting heavy objects or twisting or turning, sitting for a long time in improper postures while doing desk work, improper movements of the body, and excessive body weight also could rupture the annulus fibrosus.

One can get annular tears in the cervical spine, thoracic spine, or lumbar spine. An annular tear in the lower back can spawn severe lower back pain and lower limb weakness if the tears lead to disc herniations and nerve compressions.

Types of Annular Tears                                  

Based on the location of the tear, annular tear types are classified into three as listed below.

• Radial annular tear: The annulus fibrosus consists of numerous layers of nerve fibers. When the annulus fibrosus starts cracking from the inner linings and moving toward the outer layers, it is known as a radial tear. Mainly this is due to aging. When the nucleus pulposus seeps out through the annular tear, the nerve fibers in the annular fibrosus react with the nucleus and ensue in chronic pain.
• Peripheral annular tear: When the tough outer layers of the annulus fibrosus rip towards the inside, that’s called a peripheral tear. It’s also known as a transverse tear. Trauma initiates peripheral tears. There won’t be any pain or symptoms until the tear reaches the inner layer letting out the nucleus.
• Concentric annular tear: Concentric tear or central annular tear occurs when the annulus fibrosus develops fissures in the central part. Improper twisting and turning could cause partial or complete torsion in the middle layers. These central annular fissures (tears) make the outer ring brittle and fragile. This may make the discs more prone to severe injuries.

Annular Tear Symptoms

Annular tears can appear anywhere in the spine. However, they are more common in the lumbar and cervical spine, as our neck and back are more flexible and efficiently manage weight-bearing and balancing. Therefore, a tear in the cervical and lumbar discs could cause severe annular tear pain in the neck and lower back.

Is an annular tear serious? Not all annular torsions produce chronic pains. When the nucleus pulposus passes through the annular lesion, it can inflame the nerve fibers and irritate them. The pain would be mild to severe, depending on the type and severity of the tear.

The cervical annular lesion causes

• Neck pain
• Radiating pain in the shoulders and arms
• Tingling and numbness in the neck and arms
• Limited flexibility in the neck and arms
• Muscle spasms in the neck, shoulders, and arms
• Weakness in the neck down to the arm and fingers

The toxic annular tear in the lumbar disc or posterior annular fissure causes

• Low back pain
• Sciatica- low back pain radiating through the sciatic nerve to one or both legs with a burning sensation
• Tingling or numbness in the lower back and legs
• Limitations in the lower back and lower limb movements
• Muscle spasms in the lower extremities
• Weakness in the lower back down to the feet

Sitting or standing for a prolonged period, improper weight distribution to the body, activities, or work could worsen the pain and make it chronic and unbearable.

In severe annular tears, the nucleus pulposus protrudes into the spinal space. This is called disc herniation. A disc herniation will compress the nerves and kick-start prominent pain. Annular tear causes can range from aging and wear-and-tear to traumatic injuries, leading to varying degrees of back pain and discomfort.

When the disc completely ruptures, the disc nucleus will spill out into the spinal canal and pinch nerves. The posterior annular tear will be painful since the nucleus inflames the spinal cord. This will steer severe radiating pain to various body parts, depending on the nerves pinched.

How to Diagnose Disc Tear

Physicians palpate the area of pain with their fingers and check if palpation elicits pain in the patient. Palpation helps to locate the area of pain. The clinician will then need an MRI or CT scan to identify the cause of the pain. Most of the time, MRIs fail to project minor lesions in the annular fibrosus.

CT discography is a painful but efficient study in diagnosing annular tears. In CT discography, a contrast dye is injected with the help of an X-ray into the desired disc space. The dye will temporarily stimulate the pain in the affected area, and the contrast dye will highlight the damaged disc in the CT, however minor it may be.

Annular Tear Recovery Time

Do Annular Tears Heal by Themselves? Minor annular fibrosus tears heal on their own with appropriate rest and annular tear exercises. However, annular tear recovery time extends to a prolonged period as the annular fibrosus has a limited blood supply. The annular tear healing time will be weeks, months, or even years. Mostly, annular fibral wall tears are treated conservatively by physical therapy, chiropractic therapy, or stretching and strengthening home exercises. The annular fissure healing time changes depending on the severity, rest, activities, and treatment.

Annular tears may never fully heal due to a combination of factors such as ongoing physical stress on the affected disc, poor blood supply to the disc area, and the body’s limited capacity to regenerate cartilage, contributing to the reality that an annular tear never heals completely in some cases.

Best Treatment for Annular Tears

To manage annular tears, try to sleep on your back to help spine in proper position. Your annular tear sleeping position can have great impact in reducing the pain you undergo. following the below steps will help you manage your pain.

• Over-the-counter medications (NSAIDs) like naproxen, ibuprofen, aspirin, or anti-inflammatory drugs will mitigate inflammation and alleviate most mild pain.
• Physical therapy is the best conservative therapy to cure annular tears. Muscle-strengthening exercises to the neck or back will suppress the pain. Core strengthening exercises can also prevent further lesions.
• Chiropractic or acupuncture therapies or spinal traction are also the other conservative methods to relieve the unnerving agony.
• Corticosteroid injections will be prescribed to those who did not get any relief from chronic pain through therapies. Cortisone steroids will be administered to the spine to lessen the inflammation.
• When the conservative methods fail to provide relief, the next option will be annular fissure surgery. In the present scenario, minimally invasive procedures are applied to prevent more damage to the muscles, tendons, or nerves during the surgery. Most of the annular tears can be closed using laser therapy. Endoscopic Discectomy (Microdiscectomy) will be apt in curing the fissure. More severe damages will need Artificial Disk Replacement Surgery or Spinal Fusion Surgery. These less invasive surgeries save you from long hospitalization, recuperation time, and being away from work for a long time.

How to Stay Away from Annular Tears

No one can be full-proof from being injured or disease-free. However, prevention is better than cure. Even some simple measures would be of great help in preventing some impending harm. Let’s see how you can safeguard yourself from a possible tear in the annular fibrosus.

• Adapt to Exercise, away from annular tear: Adequate stretching and strengthening exercises to relieve the compression on the spine is a healthy option.
• Healthy weight, healthy spine: Since the spinal cord has the duty to make us walk around, it’s not right to add more pressure by being overweight. Extra weight adds more compression to the discs and increases the risk of wear and tear in the discs. Only when the cushion works well will our movement be comfortable.
• Good posture, great for the spine: A person with a hunched body won’t be pleasant in appearance and healthwise. Incorrect postures invite the dangers of exerting extreme pressure on the backbone. Good posture will distribute the body weight equally to the body and relieve the spine from being compressed.
• Say no to smoking: Smoking not only dilapidates the lungs but also blocks the nutrients from the body. A lack of nutrients will weaken your spine. Once you quit smoking, the flow of nutrients will re-strengthen your spine.

These simple steps will shield you from getting posterior annular tears in the near future.

Annular Tear and Personal Injury Claims

Do you think your annular tear originated from a motor vehicle accident? Are you wondering what to do to manage the sky-rocketing medical expenses? Dial a pro personal injury attorney to steer your claim to bag a weighty compensation.

Attorneys will weigh your case by analyzing the gravity of your injuries, like annular tears and disc protrusions, to decide how to proceed with your litigation. When your injuries are proven to be the result of someone else’s negligence, they will assess your degree of injuries. The impact might have produced multiple annular tears, disc herniations, and other severe injuries. You might have undergone invasive procedures and therapies and needed adaptive equipment and home care. Every penny you have spent will be calculated.

The damages you can claim include

• Medical expenses for the annular fibrosus tear and other injuries
• Modifications done at home and workplace to help your injuries
• Expenses for personal home care
• Lost wages and loss of earning capacity
• Loss of quality of life
• Loss of consortium
• Impairment and disabilities
• Emotional distress
• Pain and suffering
• Future medical expenses

How can you ensure your claim?

Compensation may not eliminate your pain but it can definitely reduce or eliminate your financial burden. To get the restitution you deserve, you need to have your medical documentation handy. Some annular tears may not surface soon after the accident. They will effectuate the symptoms slowly. Documenting your symptoms periodically in your personal notes and medical records will strengthen your personal injury claim.

The evidence of the severity of the impact, witness testimony, evidence of the defendant’s negligence, collision report, EMS report, and past and present imaging studies also could speak for your injuries. Collate all the evidence to fortify your claim.

Severe injuries assisted with proper evidence could persuade the jury to award you a hefty claim. At the same time, the absence of strong evidence could also result in lesser compensation. Let’s go through some of the cases to know how much compensation could be recovered in annular tear litigations based on the circumstances and evidence.

• In 2020, an older woman around 60 years was rear-ended. She had sustained annular tears, disc herniations, and other injuries. The other driver admitted to the allegations of the woman that he was negligent in causing her injuries. However, the defendant denied saying that her injuries were not severe. The woman was awarded compensation of more than $500,000.
• In another case, the plaintiff bagged more than $1 million for the L4-L5 annular fibrosus tear, which was not healing due to insufficient blood supply to the annular fibrosus. The testimony of an expert helped him recover his claim.
• A woman of around 35 years was rear-ended. The MRI did not reveal her cervical annular torsion. However, the CT discogram diagnosed her with cervical annular tears, being the reason for her significant pain. Though she had undergone surgery, the accident made her prone to future neck issues and possible surgeries. It is proved that her earning capacity was reduced due to the injuries. Based on the expert testimony, the jury awarded a reparation of around $600,000.

These instances stand as proof of the severity of annular tears and how strong evidence aided the plaintiffs in getting their recompense. Therefore, if the negligence of others has caused your injuries, gather all the possible evidence and proceed to claim with the abetment of an efficient personal injury lawyer.

Final Thoughts

Accidents and driving are somewhat inseparable, even if the driver is highly cautious. When the impacts cause trauma, never fail to seek medical attention. When injuries like the annular tear are neglected, your activities can exacerbate it and cause significant damage to the spine. In the initial stage of the tear, the annular lesion can be cured effortlessly. However, severe torsion to the annular fibrosus can lead to annular tear surgery.

Never ignore the warnings given by your body and aggravate the annular tear. Since the pain generated by the annular lesion could possibly be nightmares, get appropriate treatment on time. Worry not about the annular tear compensation. Experienced attorneys will try to prove that your injuries are caused by your motor accident with the expertise of accident reconstruction experts and medical experts.

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