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Old 12-17-2003, 03:59 PM   #1
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rmurf HB User
Question New to board - experiences with annular tears?

Hello to everyone - I am new to this board and would appreciate any information/experiences with annular tears, as I have just been diagnosed with one.

I have a sports related injury from July 2003 that resulted in sciatic pain in left rear end and back of my thigh that has stayon on after the back pain resolved. I was first diagnosed with lumbar strain, then piriformis syndrome, then a herniated disc L5-S1 for which I had 2 epidurals, 3 months of PT and take Bextra anti-inflammatory. These have reduced, but not relieved the pain.

I just saw a new OSS/NS who diagnosed an annular tear as the cause of my sciatic butt/upper thigh pain (no lower back pain). He said my 3 mm herniation was not an issue because I did not have a problem with the "straight raise leg test" and my intolerance to sitting was the key.
Unfortunately, it sounds like this is not something to get over in a short time. Some people get better and others blow out their disc. Although a disc blow-out sounds bad, apparently it is "easier" to resolve than a tear.

My questions are:

1. What is the treatment for an annular tear and what options have people chosen, both surgical and non-surgical?

2. Can a person recover fully from and annular tear, if so, how long did it take, or will I have to rely on pain management for the rest of my life?

3. I stopped my PT because it was flaring me up, but are there any particular exercises or things your PT did that helped. I walk and he said that was ok.

thanks! MDM

 
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Old 12-17-2003, 06:26 PM   #2
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SusanPLIF HB User
Re: New to board - experiences with annular tears?

Hello MDM,
My particular annular tear (L4-5) occured with a rear-ender car accident in August 1998.

I was athletic before that, in great shape - however the hit did the irreparable damage. I found out after my first MRI that I had some mild DDD going on prior to my accident. I was never aware of this beforehand...didn't have pains.. It also revealed a midline herniation. You could see it indenting on the thecal sac, but it wasn't really pressing any nerves.

Sounds like our pains differ somewhat. I didn't have so much leg pains during or after the muscle strains healed. I had 3 epidural steriod injections, did PT, tried everything (apart from accupuncture).

After enduring 4 yrs of back pain - In July 2002, I had a four-level discogram to diagnose my pain once n for all. My doc found that my L4-5 had an annular tear. The gel from the nuceus irritates the surrounding tissues and causes pain.

Interesting point... back in the first year of my pain treatment.. my physical therapist KNEW it was a tear from the results of her evaluation. However, it took a painful exam like the discogram to really give the "fool-proof" evidence of the problem.

From what I know - tears do not heal. I suppose maybe if you had a really healthy disc before..it MIGHT be possible. Mine was slightly dehydrated (the mild DDD). Maybe someone else here can answer that better. My impression (and I'm no expert) is that they cannot heal once torn. Not on their own anyway. IDET supposedly can seal a torn disc..

I tried to get the IDET procedure OK'd (for my pain mgmt doc to do) through my insurance - but they said no..even on appeal. I waited another year, while my pain got worse, before finally deciding to revisit my neurosurgeon. He's a very conservative surgeon too by the way. He asked me if my pain was controlling my life. After 5 years, trying everything first.. I had to finally say yes - that it was.

August 1st, 2003, I had a posterior lumbar interbody fusion done (cages/rods/screws). I'm nearly 20 weeks out now. I imagine I'm about 90% fused if not 100. I use WAY less pain meds... and that alone so far has been worth the surgery. I was never near some people's medication usage (4mg dilaudid 2 or 3x a day - before surgery), but I just didn't want to live like that anymore. I now only use ANY meds when something flares up (weather or whatever causes it ...lol... who knows!). When I do, it's miniscule comparatively.

I'm waiting on my neuro's OK to resume some of the activities I'd like, and I have realistic views on what my surgery will allow me to do. The most important thing to me though is that I am feeling SO much better. I'm not nearly in the same pain I used to be. I can see a light at the end of this chronic pain tunnel I've lived in for the last 5 yrs.

My best advice is to reserve surgery ONLY ONLY ONLY as a last resort. On yours, it doesn't even sound like a fusion would be in order... maybe just a laminectomy to relieve pressure on your L5-S1 nerve roots? What am I saying? LOL..I'm not a doctor! HA HA

I know - this isn't a funny matter though. I really hope that your pain resolves ITSELF! Just know - if it's warranted - there are remedies in most cases if your body cannot heal itself.

Sorry for the book!!

Keep the faith,
Susan

 
Old 12-19-2003, 06:25 AM   #3
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Join Date: Jul 2002
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KrisL HB User
Re: New to board - experiences with annular tears?

Hi Amy!

Vibramycin is a penicillin. Its effects on backpain are not listed in the medicine books, I checked..
I thought this was really new but the person who got this info from her doctor was told it's been known for a while.
Of course it has it's sideeffects to have a great number of people eating penicillin (even if it's only a 10 day course), I guess that's why doctors don't tell this (I also believe many don't know this)

/Kris L.

 
Old 12-19-2003, 07:20 AM   #4
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Join Date: Nov 2003
Posts: 167
Amy R. HB User
Re: New to board - experiences with annular tears?

That's understandable!

I have to say I could care less about side effects! My stomach, my liver....who cares! I just want the back pain to go away!




[QUOTE=KrisL]Hi Amy!

Vibramycin is a penicillin. Its effects on backpain are not listed in the medicine books, I checked..
I thought this was really new but the person who got this info from her doctor was told it's been known for a while.
Of course it has it's sideeffects to have a great number of people eating penicillin (even if it's only a 10 day course), I guess that's why doctors don't tell this (I also believe many don't know this)

/Kris L.[/QUOTE]

 
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