An annular tear can cause a great deal of pain; when the gelatinous, interior material of an intervertebral disc makes contact with the nerve endings within the cracked exterior shell, it can trigger intense discomfort. To address this pain, a physician may recommend a number of conservative treatment options for a patient. In addition to approaches like exercise, rest and heat/cold therapy, medication is often used to mitigate symptoms.

Common medications

Some of the over-the-counter and prescription medications that have been used to address the symptoms of annular tears include:

• Non-steroidal anti-inflammatory drugs – This category of drugs can treat moderate pain by reducing the inflammation of the affected area; examples include ibuprofen, naproxen and aspirin
• Narcotic drugs – This category of drugs can address moderate to severe pain, but they can carry the risk of addiction; examples include codeine, morphine and (in particularly severe annular tear cases) oxycodone

These medications can help control pain due to inflammation of the nerve endings, but if the disc deteriorates further, the gel-like interior can cause the disc to bulge or even rupture. Often, these changes in structure can lead to pinching of the neighboring nerve roots or impinging upon the spinal cord itself, causing additional inflammation as well as radiating symptoms like pain, muscle weakness, tingling and numbness that manifest in the arms, hands, legs or feet. In these cases, more intensive medications may be used, such as:

• Selective nerve root block injections (SNRB) – This approach can be used in cases of moderate to severe pain; a steroid and anesthetic are injected into the nerve root to quell inflammation, and they are sometimes used to diagnose the exact location of impingement
• Epidural steroid injections – Similar to SNRBs, these injections consist of a mix of anesthetic and steroid and are injected into the epidural space in the spine to address severe pain

When medications are not enough

If these medications, together with other conservative approaches, aren’t enough to provide sufficient relief from your annular tear symptoms, surgery may become an option. In addition to the traditional, open spine surgical approaches, be sure to consider the minimally invasive outpatient procedures that USA Spine Care offers. You can contact us today for more information and to request a review of your most recent MRI or CT scan.