INTERNAL DISC DISRUPTION OR ANNULAR TEARS

What is it?
Internal disc disruption is where a disc annulus is torn and can be causing pain. The annulus is the firm outer ring of the disc which surrounds the soft “jelly center” of the disc.

How does it occur?
Internal disc disruption or annular tears occur when the annular fibers are stretched and strained. The fibers will be torn. This can occur when the disc is put under a significant load. This can occur when lifting, bending twisting and combinations of several movements or positions.

What are the symptoms?
Annular tears and internal disc disruption usually produce mid line pain in the spine. This can be a sharp intense pain or a daily ache. Annular tears can be associated with disc bulges and herniations. When this occurs, there may be radicular symptoms of pain radiating down the arm or leg or weakness and numbness.

How is it evaluated?
Clinical examination is helpful. An MRI can identify if there is an annular tear. A discogram is a test which stresses the disc and can identify painful discs.

How is it treated?
Most annular tears can be treated with conservative care. This can include: non-steroidal anti-inflammatories, activity modification and physical therapy. Transdiscal/Biacuplasty or IDET can help to decrease the pain. Radiofrequency ablation, a heating of the nerves to the disc can help to control the pain and symptoms. Surgery may be required.

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