A tear in the tough outer wall of a spinal disc. The word ‘tear’ does the work of frightening people; the finding itself is often unremarkable.
In more detail
- Each disc has a fibrous outer ring — the annulus fibrosus — surrounding a gel-like centre. An annular tear, also written as an annular fissure or a high-intensity zone, is a split in that outer ring.
- Radiologists increasingly prefer ‘fissure’ to ‘tear’ precisely because ‘tear’ implies an injury that has just happened. Many of these are age-related and have been present for years.
- They are found frequently in people with no back pain whatsoever.
What it means for you
On its own, an annular tear is not a reason for alarm and not usually a reason for surgery. It becomes clinically interesting when the pattern of your pain matches it — typically central low back pain, worse with sitting and bending forward — or when disc material has come through the tear and is irritating a nerve root.
Remember the general rule. Findings like this one are common in people with no pain at all, and become steadily more common with age. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your examination. See understanding your MRI report.
Bring your scan and report in and we will go through it with you. Call (314) 310-5577 or request an appointment.
Common questions
Is an annular tear permanent?
The fissure itself often persists, but the pain associated with it usually settles. Symptoms and imaging findings do not track each other closely here.
Does it need surgery?
Rarely. Treatment is aimed at the pain and the inflammation, not at the appearance of the disc.
Can it heal?
The outer annulus has a poor blood supply, so it heals slowly and often incompletely — which again is not the same as continuing to hurt.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.