Home » Spine Conditions » Annular Tear » Annular Tear Types » Types of annular tears and their causes
An annular tear occurs when the outer layer of a spinal disc develops a tear, usually caused by age or injury. This condition is not necessarily painful, with symptoms usually developing if inner-disc material pushes out through the tear and puts pressure on a nerve in the spine. These symptoms can be extremely debilitating if they do develop, making it difficult to work around the house, run errands or get a good night’s sleep.
If you or someone you know has been diagnosed with this condition, a great first step in treatment is educating yourself. Learning more about how doctors classify the types of annular tears and how this diagnosis affects treatment can help make you more knowledgeable as you seek relief.
Types of annular tears
There are three types of annular tears, which occur in different layers of the annulus fibrosus, which is the medical term for the tough outer layer of a disc. Each type can have a different cause and a range of symptoms that varies in severity.
- Radial tear. A radial tear, also known as a radial fissure, starts in the innermost part of the annulus fibrosus and travels to the outermost part. This deep tear can sometimes allow the nucleus pulposus to leak out into the spinal column. It does not always cause symptoms, but it can irritate nerve endings in the annulus fibrosus and cause pain at the site of the tear. Disc tissue can also put pressure on spinal nerves, causing radiating pain, numbness, muscle weakness or tingling.
- Concentric tear. This is also commonly called a circumferential tear and occurs in between the layers of the annulus fibrosus. These tears usually do not occur in the inner third of the disc.
- Transverse tear. Transverse tears happen in the outermost lamellae, and are also known as rim lesions or peripheral tears. Discs that incur this type of tear are at risk for developing a more severe tear that travels further into the disc.
Causes of annular tears
Concentric tears and transverse tears are commonly caused by traumatic injury, including those incurred by playing sports that require a great deal of spinal twisting like golf or baseball. Radial tears, like a lot of spinal injuries, are caused by degeneration of the spine that can occur with aging. Over time, the spine will see degenerative changes from supporting the body’s weight and repeated use of the spine from physically demanding activities. These changes make the spine more susceptible to disc deterioration, including annular tears.
If a tear develops and begins to cause symptoms, doctors will usually recommend a course of conservative treatments upon diagnosis. This can include pain medication, physical therapy, epidural steroid injections, exercise and hot\cold compression. Surgery can become an option if weeks or months of conservative treatments don’t bring the relief needed for a return to normal, comfortable activity.
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