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Massage therapyRelaxing the muscles concerned can take pressure away from the affected
area.
PhysiotherapyRegularly doing targeted exercises to stretch and strengthen the muscles
around your spine can help alleviate pain. Ice and heat therapies can also be beneficial.
MedicationPain killers and relaxants provide at least some temporary relief. However, it is
essential to take these medications only under the supervision of your physician.
Weight LossIf you are overweight there is a good chance that weight loss could relieve
pressure on the affected disc. Follow a healthy diet and daily exercise regimen, but take care to
stay away from high-impact activities that could further strain your back.
Chiropractic CareMany people claim that a visit to a chiropractor is an essential part of any
back pain treatment. Chiropractors help align your back through natural methods, releasing
muscles and evening pressure by fixing your posture.
SurgeryThis method should only be used if you experience severe pain and have already tried
all other treatments. Seek multiple medical opinions before choosing an operation. This
procedure involves a spinal fusion, in which the disc is removed (and sometimes an artificial disc
is inserted) and the adjacent vertebrae are joined with screws and rods. This can be highly
successful in eliminating pain, but, again, should only be used as a last resort.
Annular fissure
Dr Ayush Goel and Dr Frank Gaillard et al.
An annular fissure (or tear) is the deficiency of one or more layers that make up the annulus
fibrosus. They may be radial, transverse or concentric in orientation. Although very common, only a
minority are identified on MRI, and are characterised by a region of high T2 signal in the otherwise low
signal annulus.
Most are asymptomatic, however some are painful. The defect allows ingrowth of nerve endings and
granulation tissue. Fissures near the dorsal root ganglion are especially likely to be painful.
The fissure may involve all layers or only some. The distinction is difficult if no disc extrusion is seen.
Discography (introduction of contrast into the nucleus pulposus) can help distinguish partial thickeness
vs full thickness annular fissure, although the clinical relevance of this is disputed.
Many authors prefer the term fissure over tear as the latter seems to imply acute injury. In the setting of
severe trauma with disruption of the disc, then the term disc rupture should be used.