The bottom two portions of the spine, the sacrum and coccyx (tailbone), do not feature discs. In the more flexible upper two-thirds of the spine (cervical, thoracic, lumbar), spinal discs provide the flexibility and shock absorption necessary for the range of body movement.
Spinal discs can be thought of almost as flat jelly donuts. Each “donut” has two parts. The gelatinous nucleus pulposus makes up the inner portion of the ring and is the more flexible of the two parts. The annulus fibrosus, as its name implies, forms a fibrous ring around the nucleus pulposus that allows the gelatin-like inner layer to serve as a stretchy protective layer between each vertebra. Without the annulus fibrosus, the pressures exerted by the spine would cause the “jelly” to stick out of each intervertebral space, much like a herniated disc.
An annular tear, therefore, occurs when a crack develops within the fibrous ring layer of the spinal disc. Owing to its purpose in the spinal anatomy, the annulus fibrosus is the toughest part of the intervertebral disc. But regular wear and tear, combined with additional stresses that come from repetitive movement or athletic activity, can cause this firmer feature of the disc to weaken.
These tears take three distinct shapes:
- Radial Tears are the most common kind of annular tear. They begin from within the center of the ring, where the nucleus meets the annulus. These tears usually stem from normal wear and tear. As vertebrae push down on discs over time, the nucleus is continually pressed up against the ring that contains it, a condition that will sometimes result in the emergence of a tear.
- Concentric Tears take the shape of the annulus itself, the form of a ring. These can occur due to stress brought about by a sudden and severe twisting of the spine.
- Peripheral Tears start at the outer layer of the disc, the part that is visible to a spinal surgeon when they perform spinal surgery. This type typically happens as a result of a direct blow to the spine, such as a hard fall or a particularly aggressive contact during athletic competition.
One annular tear on its own may not amount to much, and it’s possible that a small tear can develop without leading to other complications. But because the annulus fibrosus’s primary task is to envelop the nucleus pulposus, a small crack can cause the nucleus to penetrate the annulus (a bulging disc) and even precipitate a more serious herniated disc, when the exterior of the annulus fails to contain the nucleus altogether.
This is not to say that every single annular tear will cause a snowball effect that leads to complete disc failure – far from it. However, spinal discs naturally decrease in efficacy as human beings age, meaning that it’s important to address potential sources of further injury before they emerge.
What are the Symptoms of an Annular Tear?
So, when might you start to detect an annular tear? Usually, it won’t be at the moment of the tear itself. It’s possible to go on living for quite some time without experiencing any symptoms at all, especially with small tears. Moreover, spinal discs are capable of healing themselves, and a small tear could simply come and go. Of the three types of tears, radial tears are the ones most likely not to provoke any symptoms, as the core of the spinal disc has fewer pain receptors than the outer portions.
Those who experience a symptomatic case of spinal tears will most likely experience pain directly at the site of the tear itself. This pain will be more pronounced in instances where the spine is in an active or weight-bearing position, which includes sitting with upright posture.
Nerve issues might come into play should the tear expand or the disc weaken as a whole. Nerve-related symptoms include radiating pain beyond the site of the tear itself, muscle weakness, tingling, numbness, and/or the “hitting the funny bone” feeling.
When to See a Doctor for an Annular Tear
It would be prudent to reach out to your spinal specialist once any of those nerve-related symptoms appear. The spine exists not just for skeletal structure but also protection, as the spine shields the central nervous system that dictates our ability to move around. Presentation of nerve symptoms is a signal that what may have begun as a single tear in a disc now threatens to affect the nervous system.
Along with the kind of pain, the level of the pain matters for patients assessing whether a doctor visit is necessary. The annulus fibrosus contains many more pain receptors than other parts of the spinal disc, so a tear of some size can cause severe pain, which should, of course, be answered with a quick call to the doctor.
This doesn’t mean, though, that one must wait until things look dire to consult with a spinal specialist. The first flush of back pain shouldn’t be a cause of terror either, as small tears can heal themselves, especially if assisted with gentle stretching, rest, and applying heat to the affected area. Avoiding strenuous activity, athletic or otherwise, can also help back pain dissipate.
But if your back pain lingers despite the standard home remedies, you should make an appointment as soon as you can with a spinal specialist. This holds particularly true for those who have a genetic predisposition to spinal problems.