The spine is an amazing construction that is designed to absorb shock and enable movement and flexibility. It consists of vertebrae, discs, nerves, cartilage and ligaments. The ligaments are important tissues that protect the soft inner gel-like disc nucleus and connect the discs to the vertebrae. An annular tear is a tear in the ligament ring that forms the hard disc exterior. It can cause considerable pain that may be managed through physical therapy and/or exercises.
Each disc in the spine is located between two vertebrae and serves as a shock absorber. The outer part of the disc is made of a strong ring of ligament fibers called the annulus fibrosus. It protects the soft center of the disc called the nucleus pulposus.
The two main elements of the spinal disc create a well-balanced shock absorber. However, discs can be damaged or deteriorate for a number of reasons that include trauma, repetitive movements that cause undue exertion, aging, disease, and high impact activities, to name a few. An annular tear is a ligament tear that may or may not be accompanied by a ruptured disc. If the disc ruptures and the disc nucleus tissue pushes through the ligament tear, it is called a herniated disc. If just the ligament is torn, it is called an annular tear.
Annular tears can occur anywhere on the spine, but they occur most often in the neck and lumbar (lower) spine. The ligaments are supplied with nerves, so pain associated with an annular tear can range from mild to severe. Other symptoms include weakness or numbness in a leg or arm and flexibility or movement limitations. The severity of the annular tear and resulting inflammation determine the degree of pain.
Most annular tears heal on their own over time. In these situations, the treatments are designed to help you manage the pain while it heals in order to maintain mobility. The annular tear treatment options usually include a couple of days of rest, working with a physical therapist, taking over the counter or prescription pain medications, and doing non-impact exercises at home.
If the annular tear is more serious and pain is severe, a physician may recommend a steroid injection to reduce inflammation or surgery.
Physical therapy combined with self-managed exercises can shorten annular tear recovery time and may eliminate a need for a surgical treatment. In fact, the physical therapist will prescribe the appropriate exercises and will show you how to properly do stretches and exercises.
Exercises are intended to build muscle strength, increase flexibility and reduce pain. Dynamic lumbar stabilization exercises, in particular, will focus on the muscles that work the back and abdominal muscles to improve posture, strength and flexibility.
Some of the appropriate annular tear exercises include:
It is important to avoid doing certain exercises that put more pressure on spinal discs or are of high impact. They include the following:
It is important to keep moving when you have an annular tear. Though painful, only a few days of rest is advised. It takes some patience to allow enough time for the annular tear to heal too. Healing may take as long as 18 months to two years. In the meantime, being faithful about following the physician’s and physical therapist’s treatment plans is critical to avoiding surgery.
