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Annular Tears Overview

The annuli are the toughest, outermost layer of intervertebral discs, and they contain collagen fibers that act like a web to keep the gel-like material in the center contained. As we age, this collagen fiber may weaken or even rupture due to physical trauma, resulting in annular tears. Annular tears can be caused by age-related degeneration or excessive physical strain. They can occur in any part of the spine, from the neck to the lower back. There are three types of annular tears:

  • Concentric tears: Concentric tears occur when tears cause the membrane layers that protect the disc to separate. Such tears are typically caused by injuries, such as falls or heavy lifting. 
  • Peripheral tears: Peripheral tears are tears that occur outside of the disc. Such tears often contribute to the degeneration of the disc.
  • Radial tears: Radial tears occur when the tear spans the height of the disc and extends outward from the center. Such tears are usually caused by age-related degeneration and often contribute to disc herniation.

Symptoms Of An Annular Tear

When an annular tear occurs, the gel-like material inside the disc can leak out, leading to pain and inflammation. Additionally, the nerve root in close proximity to the affected disc may become pinched or compressed, leading to further pain and numbness. Common symptoms of annular tears include: 

  • Pain around the affected area, which worsens with movement
  • A feeling of numbness or tingling in the affected area
  • Inability to move certain body parts due to muscle weakness
  • Loss of sensory perception in the affected area
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Conventional Treatment Options 

A doctor can diagnose an annular tear by ordering an MRI or CT scan and evaluating the results. Once diagnosed, the doctor may recommend one or more of the following conventional treatments, based on the severity of the tear and the symptoms that you’re experiencing:

Corticosteroid Injections

Corticosteroid injections are a standard form of treatment for annular tears. These injections contain anti-inflammatory medications that help reduce inflammation and pain in the affected area. Injections can be performed directly into the tear site or into the epidural space, which is located around the spine. However, there are several possible complications to be aware of, including nerve damage and infection.


Non-steroidal anti-inflammatory drugs (NSAIDs) are also commonly recommended by conventional doctors to treat pain and inflammation caused by annular tears. However, they can also have serious long-term side effects, such as ulcers, liver damage, and kidney failure. In addition, NSAIDs are a temporary solution to mask the symptoms and won’t actually address the underlying cause of the tear.


Although rarely used, some people may undergo a discectomy to resolve their annular tear. This procedure involves surgically removing part or all of an intervertebral disc to relieve pressure on the spinal nerves. However, as with any surgery, significant risks are involved, and recovery time can be lengthy.

Disc Replacement

Disc replacement is a discectomy alternative. The surgery involves inserting a synthetic disc into the spine. Successful disc replacement can reduce pain and improve the range of motion. However, recovery time can be long, and there are still risks associated with surgery.

Spinal Fusion

For more severe cases, surgeons may recommend spinal fusion, which involves fusing two vertebrae together with metal rods. This procedure reduces pain by preventing the disc from shifting out of place, but it can limit mobility and cause other side effects.


What Is Platelet-Rich Plasma, Or PRP? 

The problem with most conventional treatment solutions is that they either don’t provide long-term relief or they pose potential health risks. PRP is a non-invasive, non-surgical, and drug-free treatment alternative. 

PRP therapy is a revolutionary technology that utilizes the body’s own healing capabilities. It involves extracting a person’s own platelets and injecting them into the affected area. Platelets are blood cells that contain special proteins called growth factors, which can aid in cellular regeneration and tissue repair. By introducing these powerful healing agents to the site of an annular tear, PRP can help reduce inflammation while stimulating the natural healing response of the body.

Unlike conventional treatment options, PRP has been shown to be both safe and effective. Because the patient’s own platelets are used, there is little to no risk of infection or side effects. What’s more, PRP has been shown to provide long-term relief from chronic pain and help people regain normal function to perform various physical activities and live active lives.


PRP For Annular Tears

PRP is a viable treatment option for annular tears. Research has shown that PRP therapy can help reduce pain and improve function in people with mild to moderate annular tears. The goal of PRP therapy for annular tears is to reduce inflammation, stimulate the body’s natural healing response, and help people get back to their normal activities without relying on medications or invasive treatments. 

When using PRP for annular tears, a doctor will usually inject the platelets directly into the tear site. Doing so helps reduce inflammation by improving circulation near the tear, which can speed up healing and help relieve pressure on the nerve root in cases where the tear is causing a disc herniation. As a result, PRP can help relieve any symptoms caused by annular tears, from chronic pain to numbness and tingling sensations.

Why Are Orthagenex PRP Injections Superior?

Our PRP treatment has been shown to be more effective and safer than traditional PRP injections. The primary reason for this is that we use advanced technology to aid with processing our PRP solutions and delivering our PRP injections. The following describes how we do just that:

Image-Guidance To Place PRP Solutions

MSK (musculoskeletal) ultrasound is a type of imaging technology that allows doctors to view the affected area in real time. This makes it possible for them to precisely place concentrations of platelets right where they’re needed. In addition, we use fluoroscopy, which is an X-ray technology used to help guide the needle during injection. This ensures that the PRP is administered with accuracy and precision – something that cannot be achieved with blind injections.

Lab-Processed For Higher Concentrations of Platelets

Our PRP solutions are lab-processed allowing us to create customized solutions that contain higher concentrations of platelets than traditional PRP injections – as many as 10 to 30 times the quantity of platelets compared to traditional PRP solutions – which are processed in a bedside centrifuge (spinning machine). Additionally, because of this, we can create the following PRP solutions:

Amber PRP vs. Red PRP

Traditional PRP solutions processed in a bedside centrifuge are sometimes called “red PRP” solutions because they are rich in red and white blood cells. However, lab tests have shown that the presence of red and white blood cells in PRP treatment can interfere with healing because they can cause an inflammatory response.

Because we process our PRP solutions in a lab, we can remove the majority of the red and white blood cells from the blood sample before it is injected into the patient. This results in a more concentrated solution, free from red and white blood cells, making it less likely to cause an inflammatory response. We refer to this as “amber PRP.” Lab tests have shown that this type of PRP solution is more effective at facilitating cellular regeneration and tissue repair than traditional red PRP solutions.

Next-Generation Platelet Lysate

In addition to our amber PRP treatments, we also use a lab to develop a next-generation platelet lysate (PL) treatment. PL solutions are even less likely to trigger an inflammatory response than our amber PRP treatments, which is why we often recommend them when treating conditions near the spine – like annular tears. Additionally, PL injections release their growth factors into the area immediately, whereas PRP injections release their growth factors slowly over an extended period of time.

PRP Customized To Every Patient’s Need

On the surface, PRP treatment may seem relatively simple. Withdraw blood, spin it down in a centrifuge, and inject the solution back into the body. However, PRP treatment is anything but straightforward – especially when you factor in the specialized tools and techniques we use to provide superior care for our patients.

At Orthagenex, we understand that every patient’s condition is unique. That’s why we take the time to assess each patient’s needs and create a customized PRP solution that will provide the most benefit. By taking into account the individual characteristics of each case, we can maximize our results so that our patients can get back to their active lifestyles as quickly and safely as possible. The following are a few examples of how we can customize our treatments:

Solutions Are Customized Using Lab-Processed PRP Solutions 

As previously mentioned, using a  lab allows us to create customized solutions that contain higher concentrations of platelets than traditional PRP injections. However, by processing our PRP solutions in a lab, we can also remove components from the blood and concentrate specific cell types for the given condition. This allows us to tailor the solution to be as effective as possible against the individual’s condition.

Bone Marrow Concentrate Can Be Used 

In some cases, we may use bone marrow concentrate (BMC) as part of the PRP solution. Bone marrow contains mesenchymal stem cells, which are capable of becoming a variety of other cell types. By adding BMC to the PRP solution, we can increase its ability to promote healing and provide relief from pain. Whether we combine the use of BMC with our PRP injections depends on the patient’s individual needs.

Doctors Specializing In Interventional Orthopedics

At Orthagenex, we take a team approach to treating annular tears. Our physicians are board-certified and fellowship-trained in interventional orthopedics, which is an advanced form of musculoskeletal medicine. This means they have the specialized skill sets required to perform image-guided procedures with precision and accuracy. In fact, only 1% of physicians in the U.S. are fellowship-trained in interventional orthopedics.

Our orthopedic doctors take a comprehensive approach to patient care and treat each individual with respect and compassion. They work closely with the patient to develop a personalized treatment plan that meets their needs and provides the best possible outcome.

Core Competencies

Our orthopedic doctors have core competencies in the use of image guidance to place injectates and SANS (stability, articulation, neuromuscular, and symmetry) evaluations. This means they are highly skilled at identifying and treating the source of pain with precision. Additionally, our orthopedic doctors are experienced in performing PRP injections for annular tears, ensuring that the patient receives the highest quality care available.


Orthagenex – Your Alternative To Annular Tear Surgery

At Orthagenex, we understand that conventional medicine or surgery is not always the best option for treating annular tears. That’s why we offer PRP treatments as an alternative to invasive surgery. Our customized PRP solutions are tailored to each patient’s individual needs and have been shown to promote cellular regeneration and tissue repair for long-lasting relief from pain and discomfort.

We take pride in delivering the highest quality care for our patients to improve their quality of life as quickly as possible. If you are suffering from pain and other symptoms caused by an annular tear, contact us today to learn more about how our PRP treatments can help.

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