Do annular tears require surgery?

Annular tears are a common cause of chronic low back pain. While some annular tears heal on their own, others require surgery to repair the damage. At St. Louis Pain Consultants, our pain management doctors diagnose and treat many types of pain, including annular tears.

We offer various nonsurgical and surgical treatments to help patients find relief from the pain associated with this condition. Here are the determining factors considering whether or not surgery is necessary to treat annular tears:

Size of the Tear

Nonsurgical methods such as pain medication, injections, and physical therapy can effectively treat smaller tears. Smaller tears may heal on their own, making surgery unnecessary.

Large tears typically require surgery to repair the damage and prevent further pain and other complications. The large tears often cause the annulus (the disc’s outer layer) to bulge or rupture, placing pressure on nearby nerves and causing pain. Doctors use surgery to remove the damaged disc to relieve this pressure and pain.

Location of the Tear

Tears in the outer layer of the annulus are more accessible to treat non-surgically than those in the inner layers. The outer layer can have a better blood supply, promoting healing. Nonsurgical treatments may include pain medication, injections, and physical therapy.

Tears in the inner layers can be more difficult to treat as they have a limited blood supply. They may be larger and cause more pain. These tears usually require surgery to repair the damage.

Treatment for annular tears in the neck differ from that for the lower back. Degenerative changes that cause tears in the neck may not require surgery to heal. Conservative treatments can often relieve the pain. Trauma or injury which causes tears in the lower back may need surgery to repair the damage if the pain is persistent. At St. Louis Pain Management Consultants, we use the latest imaging technology to determine the exact location of the tear to recommend the best treatment option.

Type of Tear

There are three types of annular tears, and the treatment of each kind is different. They include:

• Transverse Tears
  They are typically treated with pain medication, injections, and physical therapy. If these methods do not provide relief, surgery may be necessary. Transverse tears occur when the disc’s outer layer is interrupted horizontally.  Many people experience prolonged lower back pain with this type of tear.

• Radial Tears
  These tears are often treated with pain medication and physical therapy. Radial tears can be less painful than transverse tears, and they occur when the disc’s outer layer is interrupted in a radial, or spoke-like, fashion.

• Concentric Tears
  Concentric tears require surgery to repair the damage and prevent further pain and other complications as the tear gets larger over time. These are the most severe type of annular tears, and they occur when the inner layer of the disc is disrupted.

The Severity of the Symptoms

Severe pain that does not improve with pain medication and other nonsurgical treatments is oftentimes repaired by surgery.  Other symptoms of annular tears include:

• Numbness or weakness in the arms or legs
• Loss of sensation
• Difficulty walking or standing
• Loss of bladder or bowel control

If these symptoms are severe, our pain management doctor recommends surgery to repair the damage and prevent further pain.

Age and Overall Health

Older adults and those with chronic health conditions, such as diabetes or heart disease, may not be candidates for surgery. They can be at a higher risk of complications after surgery as their bodies heal more slowly.  Nonsurgical treatments are offered to help the patient find pain relief without serious complications.

Visit a Pain Management Doctor for Relief From Annular Tears

Annular tears cause pain in the lower back that radiates to the legs. The pain occurs when a tear disrupts the disc’s outer layer due to injury or age. To determine whether the best treatment options for an annular tear, schedule a consultation at St. Louis Pain Consultants. Our pain management physicians will develop a personalized treatment plan to help you find pain relief.