Does An Annular Tear Require Surgery?

Back pain is a frequent problem for people of all ages, but one common cause is annular tearing. Annular tears occur when the outer ring of the intervertebral disc cracks or tears. This tear or crack can be very painful and left untreated can lead to disc herniation. Consulting a pain management physician who can offer proper treatment options is an effective solution.

Physical therapy and medication can be beneficial, but in many cases, spinal injections may be recommended depending on the extent of the condition and its cause.  Severe cases can sometimes even require surgery. 

What Causes an Annular Tear?

Below are the common causes of annular fiber tears.

Advanced Aging

Daily wear and tear on your body through the years creates degeneration of spinal discs and they become worn down and are less protected.  Movements that were once normal and pain free place stress on the discs and annual tears can begin to develop. 

Activities/Improper Lifting Techniques

Increased pressure on the intervertebral discs can cause annular tears. This often occurs with activities such as lifting heavy weights without the proper form and bending activities such as gardening.  Additionally, high impact sports that include repetitive stress to the back such as golf, tennis, and soccer can increase your risk for annular tears. 

Accidents/Traumatic Injuries

Car accident victims often end up with annular tears due to the extra pressure placed on vertebral discs at the time of impact.  Annular tears also often occur with falling and slipping events.   

Other Conditions and Complications

Annular tears can also result from health complications due to

•    Bone spurs

•    Degenerative disc conditions

•    Genetics 

Different Annular Tear Types

Not all annular tears are the same, so treatment should be focused on a case-by-case basis by a pain management specialist. Here are the different annular tear types you can suffer from:


This occurs on the sensitive part of the disc’s outer rim. Transverse annular tears are extremely painful and extend towards the nucleus.


Radial annular tears occur in the inner part of the annulus. Radial tears have acute pain but can grow to hit the vertebral disc’s rim.


Concentric annular tears are rare, but they often result from excessive twisting. They form on a ring around the lumbar disc’s nucleus. 

Annular Tear Treatment Options

Annular ruptures are painful and greatly inhibit your activities.  It is important to seek the expert care of a pain management doctor as soon as possible.  There are numerous non-surgical treatment methods available for annular tears


A common symptom of annular tears is swelling, and anti-inflammatory medications are sometimes beneficial.  As with all medications, you should seek the advice of your physician before utilizing such medications.


In cases where excessive pressure on the vertebral discs causes annular tears, physical therapy is sometimes recommended to increase strength and improve form which will help in avoiding future injuries. Physical therapy experts use a range of exercises to help strengthen and stabilize the core.

Spinal Injections

Spinal injections given by a pain management physician such as epidural steroid injections have proven to be very successful to help alleviate pain associated with annular tears.   Pain management physicians often work hand in hand with physical therapy experts so once you receive relief from your pain you can go on to regain your strength. 

Visit the Pain Management Experts Today

The experts at Saint Louis Pain Consultants can diagnose if your lower back pain is the result of an annular tear and offer treatment to help with your recovery.   Managing your pain eases the recovery process and aids in helping you regain overall body strength.

Dr. Anne Christopher and Dr, Hayden Franz are leading pain management physicians in the Missouri and Illinois bi-state area.  They offer convenient locations and hours.  Oftentimes patients are scheduled for an appointment within a couple of days.  Contact us today at St Louis Pain Consultants to get started on your recovery process.

If you are living with chronic pain, seek help from St. Louis Pain Consultants.

We want to help remind you what life without pain feels like.

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