This is a replay of the live broadcast with Todd Wegerski DC hosted on 1/29/2016.
Annular tears or annular fissures (this is the new medical term) fall under the category of degenerative disc disease. The intervertebral disc is made up of 2 components, the annulus fibrosus and the nucleus pulposus. A healthy disc is able to sustain the compressive loads of the spine, while a degenerative disk loses that ability. The number one risk factor for disc degeneration is poor genetics, being dealt a bad hand from the family tree.
The annulus fibrosus is made up of tough collagen fibers that encircle the inner nucleus pulposus. Its job is to contain the nucleus in the center, and be able to withstand the strong compressive forces that the spine is under. The nucleus pulposus has a gel like consistency, its job is to help distribute those compressive forces over a greater surface area of the vertebra itself. “Poor genes” results in a defect in one of the components of the disc that is responsible for attracting water, glucose, and oxygen into the disc. When this occurs, there is a decrease in cell metabolism in the disc which eventually leads to cell death, and “death” of the disc itself. This is what is degenerative disc disease.
When the disc degenerates, it loses the ability to handle the compressive forces of the spine. The layers of the annulus can begin to tear or fissure. This can occur either from the inside-out, known as a radial tear, or in between the layers, known as a concentric tear. Some annular tears are asymptomatic, while others are symptomatic. Painful tears can be the result of disc material leaking out of the disc and irritating nerves that are close by. These can and do heal. It is a slow process ranging in the 6-18 month range.