Welcome to the Pain Mangement Forum. Please excuse my tardy response.
Annular tears can cause the disc to leak fluid. Much depends on the location of the tear and the degree of the tear. Annular tears of lumbar intervertebral disks are found in both symptomatic and asymptomatic persons. For some they can be extremely painful, for others they are an imaging finding of no significant consequence.They can be the precursor of disc herniation.
The real question is how is your pain level? It may be difficult to determine what is the source of your pain, the disc bulge, the tear or are both contributing. Did you have a Discogram?
Initially your physician will most likely take the conservative route. PT, NSAID and/or other medications and take a wait and see approach. The last resort will be or at least in my personal opinion should be surgery. The least you "mess" with the structure of the spine the better, of course unless absolutely necessary.
How do you feel? If you pain levels are low it may very well be that in time they will be even better. I had a disc bulge once which was treated conservatively that after several months subsided.
I was diagnosed with an annular at L4/L5 tear by MRI and back specialist (MD) 2 years ago - did PT, 3 injections, acupuncture, chiropractor, laid off the exercise, lots of exercise, vicodin, lyrica, another MRI 2 years later showed the same thing. The pain in buttocks, pelvic floor, down leg and in foot got worse and worse. The MRI showed very mild stenosis at the same spot, but all or the experts I consulted thought it was only the herniation causing the pain. I saw a very well regarded surgeon and he concurred with the diagnosis that the main problem was the herniated disc and thought I'd have a 80-90% chance of being pain free. I scheduled surgery ASAP. I had surgery 3 weeks ago. When they got it in there - it was mainly stenosis causing the pain. Stenosis is only going to get worse and surgery is the only thing that will fix it. The Dr says the surgery was a success. I still have quite a lot of pain, but it is getting better. He says that it may take several months. My advice is to see a surgeon - and get more tests - I wish I had not waited! I have spent the last 2 years totally suffering! My recovery is slower because it was bone pressing on my nerve. Everyone is so anti-surgery. it can help. Now I've been on pain meds for 2 years and built up a tolerance to the point that I am having a hard time managing the post op pain. The anesthesiologist said that my heart rate went down (while I was under general anesthesia) when they removed the removed the bone that was compressing my spine. They thought they were giving me good news - that the surgery was going to help me. I am wondering what damage have I done to my body suffering in pain (and taking meds) that could have been alleviated by surgery a long time ago? Please get more tests and consider surgery after a couple of months if you don't get relief.
I have had an mri every month for one year straight, and each one showed something different. The most recent mri I had was ordered by a neurosurgeon who ordered the cervical, lumbar, and thoracic with contrast which did not hurt at all was so worried. I don't have the mri paperwork in front of me right now but will look Saturday. Since then I moved to another state back and forth am waiting for permission to transfer insurance. I have good doctors but presently am not receiving injections just taking pain meds, pt won't see me anymore because they say insurance won't cover me if after 16 wks of pt and there is not big change. PT reduced my pain meds and gave me great relief..Shots also helped me. Not seeing a neurosurgeon right now however four orthopedic and spine specialists said if surgery is performed on one level my entire spine will have to be done, and to get used to taking pain meds when I begged to differ. I have spinal stenosis with nerve impingement cervical, bulges, spurs, and two tears one at the cervical level and one at the lower lumbar level both disks losing fluid, and tremendous pain unable to move without medication. One surgeon two yrs ago was about to perform cervical surgery but I backed out too afraid of this surgery so close to the spinal cord. I'm living somewhere I can afford to recover and not work right now. Once I begin to work again my desire and am in dire pain after hard work or even sitting for long periods have to get up stretch. I have a primary and pain management doctor who have been working with me but nobody seems to care about surgery or my life right now. Alot of people say don't do the surgery I have disk herniation, bulges, spurs, tears at every level of my spine and nobody knows why..It came on suddently a year or so ago after recovery from knee surgery after I stopped taking pain meds. PT helps me, and income is very difficult am starting over from surgery awhile ago. My work and life is going nowhere if I can't move or it worsens
suddently and I need emergency surgery. I am going to get some new referrals and advise. Pain free is what I pray for healing my wounds. Thanks for sharing oh wanted to know how long they gave you for recovery? and what meds you take? and how much mg of lyrica? and i can take steroids but not insaids allergic ended up in icu . Prednisosne I can take and it helps but makes me feel like I'm on speed ya know.
Thanks so much again Sarah
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