Annular Fissure Causes and Treatment

Wear-and-tear to the supportive fibers near the spine

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An annular fissure is a discogenic condition that affects the spine and can cause lower back pain. It usually happens when the fibers that make up the annulus—the tough outer covering of the intervertebral disc—either break or separate. 

While an annular fissure is also called an annular tear, it's usually a wear-and-tear condition that happens over time rather than a condition caused by trauma. There are some things you can do to improve your quality of life if you have an annular fissure.

This article will go over what causes an annual fissure and how to manage the lower back pain it can cause. 

Activities to Help Prevent Annular Fissures
Verywell / Jessica Olah

Annular Fissure Symptoms

Lower back pain may be a sign of an annular fissure, or there may be no symptoms at all. When present, symptoms may include:

  • Pain
  • Numbness
  • Weakness
  • Electrical sensations that travel down one leg or arm

Numbness and weakness may be caused by the nerves getting irritated or compressed near an annular tear.

These symptoms can also be similar to a herniated disc (a possible complication of an annular fissure). However, studies have shown that annular tears and herniated discs often go unnoticed because they have few (if any) obvious symptoms.

Annulus Fiber Function 

The annulus is made of several concentric layers of tough fibers (fibrocartilage) that surround, contain, and protect the soft, liquid nucleus inside the disc.

The nucleus is a shock absorber that buffers the weight of the body on your spinal joints when you sit, stand, or move. It also helps maintain the integrity of the intervertebral joint by supporting the space between the two vertebrae that it’s made of.

The layers of the annulus fibrosus crisscross each other to provide a “scaffolding” of support.

The design makes the covering of the disc strong enough to hold the liquid nucleus material inside it. Its strength also allows the disc to buffer the jolts and jars it gets exposed to whenever you move your spine.

When an annular fissure happens, the fibers either separate or are severed from their place of insertion on the nearby spinal bone. An annular fissure can also be a break in the fibers of one or more layers.

Annular Fissure Causes

"Annular tear" is not the standard phrase that providers use to describe or diagnose an annular fissure.

The reason is that the word "tear" suggests that trauma has led to the separation or break in the fibers. While an annular fissure can be caused by a one-off injury, it’s more often caused by long-term wear and tear.

In fact, most of the time, the tears are caused by age-related degenerative changes in the disc. These changes can lead to degeneration in other areas of the spine as well.

Wear and tear as a cause of annular fissure is down to your daily habits of living—the way you sit, stand, walk, climb stairs, and do other routine movements. You may have stopped paying attention to and are likely to perform these activities without thinking much about them. 

Annular Fissure Treatment

While a big annular fissure is not likely to get better without treatment, a small annular fissure might heal on its own. However, once an area has been torn it does become more likely to tear again in the future.

Conservative treatment for an annular fissure is usually enough to control pain and symptoms, if any.

Anti-inflammatory medication and physical therapy are the first lines of treatment. Pain medication can be either over-the-counter or prescription.

Physical therapy treatment for annular fissures includes exercises, traction, and other therapies. 

If these treatments do not help with the symptoms, your provider may suggest a steroid injection to reduce inflammation and pain.

In severe cases, surgery may be explored, including disc replacement surgery. On its own, having an annular tear is not a reason to have disc replacement surgery. It is only when there are degenerative changes in the vertebral disc that surgery might be necessary.

How Long Does It Take to Recover from Lower Back Problems?

It can take three to six months to recover from degenerative disc problems if you’re doing a standard treatment plan that includes rest, low-impact therapy exercises, and anti-inflammatory treatments.

However, you may have lower back pain that keeps coming back (recurring). Strengthening your core and back could help reduce future problems.

How to Heal From Annular Fissure

Not really being aware of how you do your everyday activities can, over time, set the stage for an annular fissure. 

If fixing your daily movement and posture habits to try to prevent an annular fissure feels like a lot, know that it can actually be pretty simple. 

For example, strengthening your core and back muscles can reduce pressure on the spine and help prevent annular fissures.

Practicing proper posture, maintaining a weight that supports your health, lifting heavy objects correctly, and quitting smoking are also important for protecting your spine.

It will take some time and effort, but fixing poor posture and body mechanics can be done. The idea is to improve joint and overall body alignment, which in turn helps you prevent and/or manage an annular fissure. 

Activities you might try include: 

  • Walking
  • Yoga
  • Tai chi
  • Pilates classes
  • Strength training
  • Somatic exercises like Feldenkrais Method or Alexander Technique

These activities help with muscle balance and joint alignment—key prevention strategies that physical therapists use when they work with people who need help with spinal problems. 


An annular fissure is caused by age-related changes to your spine. It often does not cause symptoms but can sometimes cause back pain. 

To manage it, you might need to make some lifestyle changes, start doing exercises that help make your back stronger, or seek medical care from your provider if you have pain and other symptoms that need to be managed.

One of the best ways to reduce your risk for an annular fissure is to become aware of how you go about your daily activities and take steps to fix problems like poor posture.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Stadnik TW, Lee RR, Coen HL, Neirynck EC, Buisseret TS, Osteaux MJ. Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciaticaRadiology. 1998;206(1):49-55. doi:10.1148/radiology.206.1.9423651

  2. Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA. Three-year incidence of low back pain in an initially asymptomatic cohort. Spine. 2005;30(13):1541-1548. doi:10.1097/01.brs.0000167536.60002.87

  3. Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA. Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine (Phila Pa 1976). 2005 Jul 1;30(13):1541-8; discussion 1549. doi:10.1097/01.brs.0000167536.60002.87

  4. Guterl CC, See EY, Blanquer SB, Pandit A, Ferguson SJ, Benneker LM, Grijpma DW, Sakai D, Eglin D, Alini M, Iatridis JC, Grad S. Challenges and strategies in the repair of ruptured annulus fibrosus. Eur Cell Mater. 2013;25:1-21. doi:10.22203/ecm.v025a01

  5. Virginia Spine Institute. Annular disc tear.

  6. Cheng J, Santiago KA, Nguyen JT, Solomon JL, Lutz GE. Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5–9 years. Regenerative Medicine. 2019;14(9):831-840. doi:10.2217%2Frme-2019-0040

  7. Yue JJ, Telles C, Schlösser TP, Hermenau S, Ramachandran R, Long WD. Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study. Int J Spine Surg. 2012;6:13-7. doi:10.1016/j.ijsp.2011.09.001

  8. Camp CL, Conti MS, Sgroi T, Cammisa FP, Dines JS. Epidemiology, treatment, and prevention of lumbar spine injuries in major league baseball players. Am J Orthop. 2016;45(3):137-143.

Additional Reading

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.