Annular Fissure — What is it and What Should You Do About It?

A good view of the annulus fibrosus of the disc.
A good view of the annulus fibrosus of the disc. BSIP/UIG/Universal Images Group/Getty Images

Annular fissure is a type of discogenic condition that affects the spine. It usually occurs when the fibers that make up the tough, outer covering of the intervertebral disc either break or separate. Collectively, these fibers are known as the annulus fibrosus.

Annular fissure is also called annular tear, although there are differences between the two terms. (This is discussed in more detail below.)

Annular Fissure or Annular Tear — What's in a Name?

Note that, "annular tear" is not a standard term doctors use to describe or diagnose this condition. The reason is that the word "tear" suggests that some type of trauma has lead to the separation or break in the fibers. 

While an annular tear can be due to a one-off injury, more often long term wear and tear is the culprit. In fact, most of the time, tears are a result of age-related degenerative changes that take place in the disc. These types of changes can and do lead to further degeneration in other areas of the spine, as well.

This means that wear and tear as a cause of annular fissure is, to a great extent, about those day in and day out habits of living — the way you sit, stand, walk, climb stairs, and  do other routine movements — that you may have stopped paying attention to, and that you likely perform auto-pilot (so to speak.)

A lack of attention to the way in which we perform our everyday movements may, over time, set the stage for an annular tear. 

If correcting your daily movement and posture habits for the prevention of annular tear seems like a mountain to climb, there's good news.

With a bit of effort, the poor posture and less than ideal body mechanics that may have led to the tear in the first place can, in many circumstances, be reversed. But it takes effort and is not a quick fix, as surgery might be. Instead, the idea is to improve joint and overall body alignment, which may, in turn, help you prevent and/or manage an annular tear.

What activities could help you do this? You might try yoga, Tai Chi or Pilates classes, strength training using good form, Feldenkrais Method, Alexander Technique and/or somatics. Each of these systems in some way works towards muscle balance and joint alignment, key prevention strategies employed by many physical therapists when they work with their spine patients.

How an Annular Tear Happens

The annulus consists of several concentric layers of tough fibers (the material they are made of is called fibrocartilage) that surround, contain and protect the soft, liquid nucleus located inside the disc. The nucleus is a shock absorber; it buffers the weight of the body as it impacts the 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 vertebra that comprise it.

The layers of the annulus fibrosus  are oriented obliquely to one another; in other words, they criss-cross each another and in this way, provide scaffolding and support.

This design makes the covering of the disc is very strong, strong enough to contain the liquid nucleus material within. Such strength allows the disc to buffer the jolts and jars that tend to arise when you move your spine.

When an annular tear or an annular fissure occurs, the fibers either separate from one another or are severed from their place of insertion on the nearby spinal bone. A tear may also be seen as break through the fibers of one or more of the layers.

Symptoms of an annular fissure or tear range from no symptoms at all, to those similar to a herniated disc. The latter may include pain, numbness, weakness and/or electrical sensations that travel down one leg or arm.

Treatment for an Annular Tear or Annular Fissure

Conservative treatment for an annular tear or fissure is generally sufficient to keep the pain and other symptoms at bay. These may include pain medication, either over the counter or by prescription, and/or physical therapy. Physical therapy treatment may include exercises, traction and more.

Should these measures fail to relieve your pain, your doctor may suggest a steroid or other type of injection, or possibly minimally invasive spine surgery.

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