annular tear and back pain annular fissure

Taking Care Of Annular Disc Tears To Reduce The Low Back Pain – The Causes And Symptoms

According to an article by WHO, if you are around 50-55, you are more susceptible to lower back pain (LBP). And mostly, women are the ones suffering low back pain as a gift of aging. On the other hand, an annular fissure is caused by the absence of the rigid outer layer of the annulus fibrosus. Here, we understand and address a common yet often overlooked source of discomfort – annular disc tears. Back pain affects many of us; within this realm, annular disc tears play a significant role.

You need to see what annular disc tears are, why they occur, and how they can contribute to lower back pain. By exploring the causes, symptoms, and various treatment approaches, we aim to highlight the importance of recognizing and caring for annular disc tears.

What Are Annular Disc Tears?

Annular disc tears, though often unheard of, are a common condition impacting the spine. Essentially, these tears involve a breakdown in one or more layers of the annulus fibrosus, which surrounds the nucleus pulposus in the intervertebral disc. These tears can result from various factors, with stress on the spine being a key contributor. The annulus fibrosus, comprising 15-20 layers, plays a crucial role in supporting the spine, and when these layers tear, it leads to what is termed an annular disc tear. The prevalence of these tears, estimated to range from a few percent to over 50%, underscores the importance of understanding their nature and implications. 1

The Causes and Symptoms of Annular Disc Tears

Annular disc tears can be attributed to various factors, and comprehending the causes and symptoms is fundamental to addressing this spinal condition.


The annulus fibrosus, consisting of type I collagen, encapsulates the nucleus pulposus in layers. Whether sudden or chronic, stress on the spine can lead to a breakdown in these layers, resulting in annular disc tears. The annulus fibrosus’ unique structure, with vertically oriented fibers more prominent in the posterolateral aspect, makes this region particularly susceptible to tears.


The tears may occur due to wear and tear over time, traumatic injuries, or repetitive strain on the spine. Understanding the causes involves recognizing the vulnerability of the annulus fibrosus to various stresses and the subsequent implications for spinal health.


Review of Lumbar Discogenic Pain Annular Disc tear
Flexion can drive the nucleus posterior and increase the symptoms with an open fissure.


Identifying the symptoms of annular disc tears is crucial, considering many cases are asymptomatic. When symptoms do occur, they often fall into two categories: localized pain or radicular symptoms.


  1. Localized Pain
  • Occurs when the tear causes discomfort within the spine.
  • Aggravated by movements that stress or irritate the focal annular tear.
  • Typically deep-seated and may vary in intensity.


  1. Radicular Symptoms
  • Arise from irritation of the passing nerve root.
  • It can include pain, paresthesia (tingling or numbness), and weakness.
  • Severity depends on the extent of nerve irritation or compromise.


How Does Annular Disc Tear Cause Lower Back Pain?

Lower back pain due to an annular disc tear is intricately linked to the disruption and vulnerability of the annulus fibrosus, the outer layer of the intervertebral disc. When this fibrous structure, comprising layers of collagen, experiences a tear, it compromises the disc’s integrity. The tear can lead to localized pain if the annular fissure irritates the spine, particularly in movements that stress the affected area. Additionally, the tear can give rise to radicular symptoms, intensifying lower back pain.

Treating Annular Disc Tears To Reduce Low Back Pain

Effectively addressing annular disc tears is crucial in alleviating low back pain, and the treatment approach varies based on the nature and severity of the condition.

Conservative Measures

Asymptomatic Cases – If the tear is identified incidentally and doesn’t cause symptoms, no specific treatment may be necessary, as these tears may resolve spontaneously over time.

Non-Steroidal Anti-Inflammatory Medications (NSAIDs) and Physical Therapy – Symptomatic cases without disc protrusion often benefit from these conservative measures. NSAIDs help manage inflammation, while physical therapy aims to strengthen core muscles and mitigate factors contributing to the tear.

Symptomatic Cases without Disc Protrusion

Local Inflammatory Reactions – Addressed with NSAIDs and low-impact physical therapy, focusing on reducing inflammation and strengthening the spine.

Transforaminal Steroid Injections – In some cases, local injections may be considered to alleviate symptoms more rapidly.

Symptomatic Cases with Disc Protrusion or Herniation

Treating Disc Protrusion – Priority is given to addressing the protruding or herniated disc material, as it is often the primary cause of clinical symptoms.

Conservative Measures – Initially include NSAIDs, physical therapy, and local injections.

Surgical Options – Considered if symptoms persist or worsen with procedures like laminotomy, laminectomy, foraminotomy, discectomy, fusion, or a combination thereof.

Long-standing Cases or Cases with Complications

Granulation Tissue Formation – Addressed similarly to symptomatic cases without disc protrusion.

Foraminotomy – Considered in cases with weakness or progression, aiming to decompress the nerve and prevent further deterioration.

Differential Diagnosis

Identifying Similar Conditions – Recognizing and differentiating conditions with similar symptoms is crucial for accurate diagnosis and targeted treatment.

Prognosis and Complications

Natural History – Mechanical back pain, including that associated with annular disc tears, often subsides.

Complications – While rare, potential complications like cauda equina syndrome or neurological deficits highlight the importance of vigilant monitoring and appropriate management.

Patient Education and Deterrence

Medication Adherence and Lifestyle Changes – Patients are advised to follow prescribed medications and make lifestyle changes to minimize further tears and facilitate healing.

Avoiding Excessive Spine Movements – Education on avoiding activities helps prevent aggravation of the condition.


To guide patients in understanding the cause of annular fissures and back pain, Dynamic Disc Designs has created realistic spine models that help medical practitioners as well as patients project the entire process so that the patient is satisfied with the treatment. Explore.