What symptoms are related to annular tears?

[neen41]

What are the symptoms related at annular tears?

[neen41]

Thanks for that I had a mri 6 months ago and obviously my tears haven't healed yet.can some annular tears just take a bit longer to heal? Also I have been diagnosed with a tarlov cyst 1.3cm at S2. I was wondering what pain is caused by what. My left lower back muscle and left glut muscle twinge and feel like they are going to spasm. When they do spasm the pain is quite bad but the aftermath of the spasm can take weeks to feel better.  Also can you exercise with annular tears? I was swimming but the rotation of freestyle caused another spasm. What can I do to aid my recovery of the annular tears? Does bed rest help? Thanks Janine

[dr_simran]

Hello Dear,


Annular Tears are the commonest cause of minor sciatica or brachialgia, and are usually the result of trauma to the spine. Tears can be either radial or circumferential, and their natural history is that they usually spontaneously heal after 6 months. In a small proportion of people, the tears do not heal, and go on to become chronic.
They occur most commonly at C5/6 and C6/7 in the neck, and at L4/5 and L5/S1 in the low back
Annular tears may allow the inflammatory mediator phospholipase A2 (PLA-2) to leak from the centre of the disc into the epidural space. Here PLA-2 causes an inflammatory reaction around the adjacent spinal nerve roots (chemical radiculitis). The inflammatory reaction causes referred pain (sciatica or brachialgia), along with nerve root dysfunction (numbness, tingling and minor weakness). Multiple healed annular tears over time may lead to a disc bulge and eventually a Disc Prolapse requiring decompressive Surgery.
Clinical examination reveals positive sciatic dural tension signs in the leg (slump test), or in the arm (nerve root provocation test), along with minor numbness and weakness in the territory of a single nerve root. As there is no physical compression of the spinal nerve root, annular tears are not associated with major clinical weakness in the limbs, spinal cord compression, or bladder dysfunction.
Treatment consists of a series of epidural steroid injections (caudal, lumbar or cervical), or a nerve root block. Topically applied depot steroids (triamcinolone) help to reduce nerve root inflammation, and produce pain relief usually lasting 6 - 8 weeks per injection. Epidurals can produce significant pain relief allowing earlier rehabilitation and recovery. Chronic annular tears may be helped by Intra-discal Electro Thermal Annuloplasty (IDET).
Refer http://www.painclinic.org/spinalpain-sciaticaandbrachialgia.htm#AnnularTear
Best