How To Heal A Painful Annular Tear | The Spine Pro

Most people might think of the spine as a boney, cohesive structure. The spine, however, is actually a joint held together by the spinal disc tissues and ligaments. We can think of a spinal disc as a jelly donut, wherein it consists of a solid outer shell and a soft, semi-liquid center. Within the center of a spinal disc is a jelly-like material known as the nucleus pulposus and it is contained by a tough wrapping of ligaments called the annulus fibrosus. These tissues together work as a shock absorber for the spine, keeping the bony vertebrae from rubbing or fusing together. In this video, we discuss what happens when the annulus fibrosus tears, otherwise known as an annular tear, and what treatments can help heal the injury.
While there are many effective conservative treatments to consider when recovering from an annular tear, sometimes surgery is necessary when therapies fail to provide relief from pain. A Top US Spine Doctor, Dr. Hooman Melamed has himself suffered an annular tear and recovered. Having this first-hand experience, Dr. Melamed knows the pain patients may be going through and how to best help their situation. Dr. Melamed and his caring staff are available for phone and virtual consultations at [phone].
#SpinalDisc #JellyDoughnut #AnnulusFibrosus
ABOUT DR. MELAMED
Hooman M. Melamed, MD, FAAOS is widely recognized as one of the top board-certified orthopedic spine surgeons in the U.S. Dr. Melamed concentrates on disorders of the spine for children and adults. Dr. Melamed’s specialties include minimally invasive and out-patient spinal surgery, complex cervical spine disorders, degenerative disc disease, microsurgery, revision spine surgeries, spine trauma, pediatric and adult deformities - spondylolisthesis, scoliosis, tumor, and kyphosis - artificial disc replacements, nonfusion technology, XLIF, stem cell therapy, pediatric and adult deformities including spondylolisthesis, tumor, kyphosis, and scoliosis. Dr. Melamed currently serves as Co-Director of Spinal Surgery at DISC Sports and Spine Center, as well as Director of Scoliosis at Marina Del Rey Hospital.
Dr. Melamed appears regularly on The Doctors, Dr. Oz, Steve Harvey, Fox and Friends and KTLA, CBS, KCAL and ABC in Los Angeles. He has also been selected by his peers to be inducted in the leading physicians of the world, is a “Los Angeles Super Doctor” year after year and was chosen as a top doctor for two consecutive years by the prestigious Castle Connolly.
To learn more about Dr. Hooman Melamed, visit his website at www.thespinepro....
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[@bfhwhataboutthecavesdude6162]

One problem is finding a Dr. who knows how to work with people as humans not just send you on your way after 10 min. Saw one renowed specialist who told me i had spinal stenosis and was willing to operate... but I had to move away . The 2nd one , also renowed , told me I didn't have stenosis and didn't need surgery. Unfortunately , there was no space to discuss much and it was basically "get lost " after 10 min. Now , I'm confused and need to get THIRD opinion ...hopefully with someone with more people skills . But that's the problem with these Doctors and specialists ...they get courses in Med School to deal with people but most see these courses as "Mickey Mouse" courses and don't take them seriously...with the ensuing problems in their medical practice later in life.

[@jreverie7018]

Thanks so much for the video! Very motivating/reassuring. I have a annular tear and man is it frustrating - can barely stand up, used to be really active. trying to be safe and just do moderate walks. 11 months in so far and haven't improved, here's hoping I make a comeback. Screw surgery! Subscribed :) it's great to see a doctor who prefers to try non-opiate and non-envasive alternatives! Good on you!

[@mk3ferret]

17 months herniated t6-t7 "small" L4-l5, l5- S1 bulges and "annular fissures" key word "fissures" plural and some other issues but all are considered minimal meaning not totally destroyed... Medical history and mri, xrays show a badass biomechanical machine for 42 with 22 years heavy construction ZERO issues, zero claims, zero unemployment, and clean medical history Injured doing a lift hanging over the edge of a dock when leverage bar gave way Basically just folded me in half, dock weights 2,500 3,000 so about 250 300 pounds dead load right to the spine Been going round and round with doctors mainly over the phone cause corona virus Have been told everything.. the same answers as a standard google search Me requiring more than just 1 opinion, i got 5 at this point with 5 different opinions,first doc your damaged, done go home sending you to a specialist, 2 specialist say multilevel discectomy, and eat the herniation at t6-t7 something about the lungs are in the way? So i ask myself whats the one thing all had in common, answer = lack of testing that nobody mentioned that apparently there can be "free floating" material up in there and can hinder healing, so the question is there free floating material up in these fissures, how many fissures exactly if mri dosen't necessarily show everything, what IS the test CT discogram? The 2 symptoms that lead me to the "floating disk material toxic fissure" theory was physical therapy MADE IT WORSE and it was ABSOLUTELY nothing physical about it, it shouldn't make it worse and #2 Driving, sitting, laying down I went from 5hr commute with my 8 hr day construction with production bonus To not being able to drive more than 30 minutes, if that "material, fissure" theory is true, im gonna start swinging hammers

[@jreverie7018]

@@mk3ferret how are you doing now? I ended up on this video again after getting worse too! It sure is frustrating! I found physical therapy made it way worse also

[@mk3ferret]

@@jreverie7018 Well ive stopped trying to push through it and that helped, stopped driving that helped and no more construction with the hope the fissures close up Ive hit a wall with my doctors so no more money for them and its on me to heal at this point Stay positive, it can take some time Oh, it turned out one of those bulges blew out and a piece of disk is hitting the nerve hence my leg issue they didn't catch that tell like last month

[@TheDirthound]

@ JM: How is the progress? I hope it's getting better.

[@hollowskull4666]

@@mk3ferret I read a story about a guy in a similar situation to you. Prolapsed l4/l5 S1 weight lifting, numb leg that dragged when he walked. He said he healed it by making himself walk for 2 hours every single day for a year.

[@artninjapr8310]

Dr Melamed is an honest person

[@mmueller1473]

Can an annual tear cause burning, numbness and leg pain? This has a been a total nightmare! I was bedridden for 2 months… Thank you for your help and your time. I really appreciate it.

[@salmonesque]

I have an annular fissure and haven't had numbness or leg pain. It sounds more like sciatica but I'm no expert. Find a good chiropractor .. one that's well recommended and perhaps get an MRI to see exactly what's going on. Annular fissures can take 18-24 months to heal. Anti- inflammatory diet, the right physio and gentle exercise are the ways forward. Best of luck. You're not alone. Millions of us are looking for answers but diet and physio and anti-inflammatory supplements help. Circumen is good and vitamin D mouth sprays.

[@salmonesque]

And stay away from sugar! It's the worst thing for your pain. Also, alcohol, red meat, caffeine, white bread. Cut these out and you'll notice a difference.

[@longstoryshortdog8549]

Late response here but just in case useful: there does seem to be some evidence out there that tears leaking disc fluid can lead to inflammation, which then causes sciatica pain etc. Probably worth discussing with your spine/neuro expert if your scans aren't showing major herniation or something super obvious

[@aonoymousandy7467]

You're a wonderful doctor!

[@TomOsgood]

Do you have videos on what PT, diet changes etc..I can do to heal? I don’t live anywhere near you. Thanks

[@BugMateo]

Thank you good sir...

[@thespoiledtexan3904]

Thank you for this. I didn’t understand it when they called me with my report and said they wanted to get me in to discuss en epidural. I don’t know if that’s the right option, but this sounds like hope. I’m in so much pain and we are going on vacation to Mexico in a few weeks with a lot of walking and scuba diving and I’m worried I may not get to participate 😢

[@TheSpinePro]

doesn't hurt to try the epidural

[@reginaldinoenchillada3513]

This is gold.

[@reginaldinoenchillada3513]

Feeling much better. Lots of spinal decompression, stretching, pt and going slow for jogging and progressing to the next stage, take it slow.

[@laurastevensonslife6774]

Both of my precious mother’s legs went numb at once. She fell down just before it happened and kept getting worse. She hasn’t been able to walk in 3 months. Devastated. Can’t believe the doctors are putting her off this long. They said she has a bulging disc in her lower back and something about nerves being wrapped around her spinal cord and needing surgery? I don’t get clear answers. What do you think? Surgery? She is elderly and this is kinda scary

[@arsh4dkhan]

If it's messing with her nerves let her have surgery so her nerves wouldn't get damaged permanently btw how is she doing now? :)

[@samh-smith2931]

How long is the healing time expected?

[@josephmullin5845]

Hi Dr. My friend recently got diagnosed with tears to their outer spine. Their inner spine is OK. I'm wondering is the same as an annular tear?

[@LJ77777]

Dr. Melamed, I have been experiencing lower back pain due to annular fissures for the past 3 weeks. But prior to 3 weeks ago, I was working out regularly-alternating PiYo and rebounding on the JumpSport (bungee chords). Both workouts are low impact. The rebounding healed my Achilles’ tendon from an injury two years ago and I would especially like to resume that one. Would you recommend that I resume those workouts and how soon? Thank You in advance!

[@TheSpinePro]

i would start slowly and listen to your body and let your body be the guide on how much you push yourself

[@ponchopelayo77]

thanks for the information

[@abolfazl7144]

hi doctor please help me I beg you I have annular tear in my neck and I'm really sad and worry what should I do what treatment should I do what nutrients should I eat , I should do physiotherapy or chiropractic, please do me an advice, and if it heal how long does it take, thanks 🙏🙏🙏

[@abolfazl7144]

hi doctor please tell me that is annular tear get heal completely and become like the same or not, thanks 🙏

[@amberpaige5035]

i have been dealing with this plus two bulging discs for 6 months. i have tried steroids, PT, injections, rest, everything. nothing has helped. i cannot make a living. it’s too painful. i cannot get SS benefits or unemployment. i’m at a loss.

[@SupaT3]

Same here. It’s been 2 years for me I haven’t been able to sit in a chair or lift anything heavy… I’ve done so much physical therapy and had all the injections I can get. What can we do 😭

[@arsh4dkhan]

How are you now?

[@ronaldvega7874]

Look into PRP (platelets rich plasma) and prolozone therapy

[@ronaldvega7874]

@@SupaT3Look into PRP and Prolozone

[@gaiseric9518]

How long did it take you to heal?

[@TheSpinePro]

about one yr. 1st 3 months bad then started getting better and better

[@prathanashrestha897]

Dr I m facing it with since the last of December,2022 and the pain is enormous,couldn't let me stand 4 more than 5 minutes .....have to take a rest frequently with a cushions n pillow at the back ......how long it lasts Dr.....do I lead a normal life afterwards???kindly advice pls 🙏

[@loveandfunandmotivationala4254]

Can epidural placed in wrong spot cause this?

[@stoner2055]

What about free floating fragments inside the disc ? How does one heal if there are fragments inside the disc aggravating the nerves ? I know all don’t have pain from an annular tear but for the ones who do , what can we do ? Tia

[@roscoeroscoe8695]

this is my question too..I see many youtube videos of surgeons (Dr. Mork and Dr. Kim) using a dye to highlight/locate the dead tissue/fragments (discogram) and then removing that tissue. my problem is that I cannot find a surgeon near me that does this procedure. they all want to replace the disc. The Surgeons on youtube are cash only - no insurance taken - so that eliminates me. Otherwise I would fly out to California and have this done..

[@stoner2055]

@@roscoeroscoe8695 what you said is EXACTLY what I’m trying to do !!! I’ve gotta sell my home but at this point I don’t care , can’t live like this anymore!!! Good luck to you , I’ll let you know my progress when this happens

[@AliBabaZumba]

@@stoner2055lookup Discseel

[@theboringgamer74]

Hey Dr, I have an annular tear in my c6 c7 and have tried everything to get it to heal, I seem to get on top of it but it always fights back and is really frustrating and the pain sucks, I have been like this for almost 10 years now

[@TheSpinePro]

i would consider trying PRP injection to see if that would help the pain and allow your body to heal itself

[@TheDirthound]

Does having an annular fissure guarantee you'll have a disk herniation? I have one (annular tear) but do't have any pain, luckily. It was found on my recent MRI. I am very active, ideal body weight etc however I'm having anxiety and paranoia about herniating that disk. I understand the value rest and good spinal hygiene and am willing to take a full year off from cycling and will modify my exercise. But the thought of that disk blowing out during the slightest movement is very concerning. Also what activities need to be permanently avoided to decrease risk of reoccurrence? Is hiking with a pack or biking for extended periods out of the question? What about lifting weights?

[@TheSpinePro]

While an annular tear may lead to more serious disc issues and pain, every patient is different which impacts recovery. Conservative treatments, such as supervised physical therapy, have been shown to help heal an annular tear without surgery, but of course you should consult your doctor first. There is also more information here: www.thespinepro.com/what-is-an-annular-tear/

[@TheDirthound]

@@TheSpinePro Thank You for taking time to reply. Is the accepted timeline for healing 1-2 yrs for scar tissue formation and remodelling? Understandably everyone uses their body different and healing will vary. Also in your experience are people able to return to pre-injury activities ?

[@arsh4dkhan]

@@TheDirthound hey man how are you :)

[@TheDirthound]

@@arsh4dkhan I'm good, thank you. How are you?

[@abolfazl7144]

@@TheSpinePro hi I have neck annular tear in me Mri but I have little pain but I'm so sad and worry about Mri reply, please tell me annular tear can heal completely and if so how long does it take to heal, thanks 🙏

[@audiominer2070]

I am over the 1yr anniversary of my painful annular tear/fissure injury. I have followed all conservative treatments nothing has helped still to this day. I have gotten 3 opinions and they all keep saying give it more time. At what point will everyone in the medical community be convinced my tear/fissure isn’t gonna heal? And what is the last option for treatment? Thanks for any information.

[@TheSpinePro]

One year is a reasonable time. Have you also committed to an anti-inflammatory diet and gut health? Are you taking your vitamin D3 with K2 and other supplements, such as ginger, turmeric, cayenne pepper among others? Have you done adequate core and trunk stability exercises?

[@audiominer2070]

@@TheSpinePro I have been taking vitamins and I try to eat healthy as I can. I have gained 35lbs since my injury because I cannot do cardio as I use to run and be very fit. I don’t like anti- inflammatory or muscle relaxers I have been doing core PT for a year I’m stronger but still have pain. I was told to try aquatic therapy exercises to help lose some weight. Any information is gratefully appreciated. I know a lot of people with this injury but have yet met any that has fully recovered. Thanks for all you are doing for us.

[@TheSpinePro]

@@audiominer2070 I have seen many patients recover successfully. I was talking about anti-inflammatory diet NOT pills. Are you familiar with that? Frankly, biggest misconception, is you have to exercise not to gain weight or lose weight. 85% or so of your weight has to do with your nutrition not exercise. Exercise of course important but is not as important as proper nutrition. Of course, the extra weight is absolutely not contributing to your healing, and it increases the overall inflammation in the body which causes the annular tear not to heal.

[@audiominer2070]

I live in Alabama and there isn’t any dr. Here that do PRP or stem cell stuff for disc issues. Update I have lost 12lbs by following your advice on total focus on diet. Thanks for your advice!

[@TheSpinePro]

@@audiominer2070 by optimizing your lifestyle, including nutrition, ergonomics, and proper form of exercising there’s a very good chance your body will heal the annual tear and you’re going to be fine

[@dsamshandil641]

Hi sir

[@roscoeroscoe8695]

Dr. do they not heal because of the loose fragments stuck in the annulus?

[@TheSpinePro]

Not necessarily. Sometimes it just doesn’t heal. And sometimes it could be because of a disc fragments pushing on it but most of the time the reason it doesn’t heal is because it just doesn’t heal. Most important is to give your body. The ability to heal itself. By following a strict anti-inflammatory diet incorporating lifestyle that includes consistent core and trunk stability exercises.

[@roscoeroscoe8695]

@@TheSpinePro how does a Dr. know if there are trapped nucleus fragments trapped in the annulus - that need to come out?

[@TheSpinePro]

@@roscoeroscoe8695 that is extremely extremely rare. But that’s a very good question. You don’t know unless you actually go into surgery or you can do discogram and then get a postop CT after which I do not recommend as it has lots of radiation, and the discogram is very toxic to the disc itself

[@TLCtashi]

Hi doctor I'm suffering from mild L4-l5 diffuse disc bulge with annular fissure. Is it curable?

[@TheSpinePro]

Yes very much

[@rokees5507]

How long it takes to heal

[@TheSpinePro]

it can take up to a year to heal

[@jonkinsella6234]

Hi Doctor. I’ve had a suspected high annular tear since May 2019. It’s not until now - post MRI, which commented on the possibility - that I know what it might be - it fits all the symptoms. If I have aggravated it a few times, does that make it less likely to heal? As things stand, the pain isn’t severe (it was in May 2019, July 2019 and Feb 2020 in separate episodes). I would say it moves between mild and moderate now, without ever going away. I’m now beginning a programme of light cardio, core strengthening, anti-inflammatories and good nutrition (I wasn’t exactly unhealthy before but could definitely be much better). How long do you think it can take to heal? And will it ever fully heal, speaking generally? Thank you for any help.

[@TheSpinePro]

Thank you for sharing your personal journey with us, Jon. Healing time can vary because every patient is different. For one patient it may take several weeks to heal a back injury while another patient may need more than a year of recovery and conservative care. The important thing is that you are making lifestyle changes and pursuing a conservative treatment plan. Make sure you check with your doctor or a conservative care specialist, like a physical therapist, before attempting any new treatments. Here is also some more information on annular tears that I think might help: www.thespinepro.com/conditions/annular-tear/

[@pattillo21]

Hey Jon, are you feeling any better now? I just got an annular tear c5 c6. Pain is really bad in the back neck in the morning and it wakes me up. Then after a few hours I start feeling a little better but the pain then travels to my left arm and left side of my chest.

[@henkvanweert4192]

Hello i have this between 5 lower backbones, is there a solution for me ?

[@interested777]

Sorry to hear, thats brutal.

[@lokanayagi1293]

Losing weight can make my annular tear heal they say..But,which exercise can i follow to lose weight atleast 1 kg in one month..Its really painfull...And i feel like i am in a nightmare..

[@muthukrishnanganesan4317]

Madam, please reply. Did you find any solution. Becos i have this issue.

[@a.lachel2528]

My doctor thinks I may have this. It hurts to walk, reach, turn, move, sit, to the touch even when I put my underwear it's excruciating pain, it goes and wraps around my shins and my knees hurt! My lubar back hurts, neck, shoulder, waist, and hip hurts. I'm numb and feel burning sensations! My doctor gave me some injections in my lumbar area that helped some especially in my neck and shoulder. I took pain meds and meds from neuro pain, and lidocaine patches but I'm still in a lot of pain in on my left still more where the injections was given but not as much where I couldn't even barely walk than in my rt side where I also Sciatic nerve damage bilate! My doctor is going to R/O things and find out what's wrong. It shouldn't hurt to sit on the toilet or anywhere and put on underwear!

[@TheSpinePro]

best to get mri of thoracic and lumbar spine

[@a.lachel2528]

@@TheSpinePro Thank you.

[@mmueller1473]

How are you doing now? I hope things are getting better. I am going through this now.

[@a.lachel2528]

@@mmueller1473 The steroids helped. It was the worst two months I've ever been through. I hope you feel better soon. I continue my injections to prevent having it again. I can feel it when it's coming on again. I hope you find something that helps you. I needed both injections and oral steroids times two to start helping. Prayers for some relief ASAP!

[@a.lachel2528]

@@TheSpinePro It's bilateral sciatic nerve damage.

[@perryanderson3939]

Wasn’t really a ‘how to’ was it.

[@jerryseinfeld6971]

Terrible

[@supermushroom3175]

Annular tears do not heal.

[@piyushkmanand4994]

How r u?

[@supermushroom3175]

@@piyushkmanand4994 same. u

[@piyushkmanand4994]

@@supermushroom3175 is ur pain reduced than before.

[@piyushkmanand4994]

@@supermushroom3175 same here too. But yes little bit less pain

[@supermushroom3175]

@@piyushkmanand4994 same here. 2 yrs now. better, little less pain. r u planning to get surgery?