Question
I am 39 female 5'1" 125 pounds.  8 weeks ago I woke up and couldn't move without pain in my lower back.  I have always been athletic and did nothing out of the ordinary.  I had been kayaking, exercising as normal= Cardio 6x a week weight training 3 x week, cleaning house.  Felt like my core was stronger than it has ever been.  I just got the results back from my MRI and I am very concerned that about the annular tear.  The doc said that it can never heal and that I will always have to just manage the pain.  This is very discouraging because my husband and I are going around the world on a sailboat Aug 2009.  I cannot find any good info about this issue from any good source.  Will you please tell me my options.  I had planned to be exercising until I was 105! I want to run and jump and play again.

Answer
An annular tear doesn't mean you can't stay active by any means. The discs act as shock absorbers in your spine, and they are composed of two parts - rings of cartilage that form the outer annular layer and a soft center known as the nucleus pulposis. A tear to the annulus is usually the result of cumulative wear and tear through the years. It doesn't always result from just one traumatic episode of lifting or bending incorrectly. You probably have what is known as degenerative disc disease, which predisposed the annular tear.

While it is true that once the disc has degenerated, it cannot fully repair or rehydrate itself, your painful symptoms will most likely resolve over time and you should be able to resume normal physical activities. If you have a disc protrusion or extrusion in addition to the annular tear, it may take longer to heal and for your symptoms to resolve. Surgery sometimes is necessary to manage a herniated disc, but the most recent literature and research shows that outcomes for surgically managed disc patients and those who undergo physical therapy and rehab are very similar. It may take longer, but your best route is to try to physical therapy first. I would suggest you find a good therapist that can work with you on spinal stabilization exercises and McKenzie protocols for lumbar discs.

If you get on the right exercise program and stick with it for 2-3 months, I have a good feeling your symptoms will get better and you will be back to doing all the things you enjoy with minimal pain.