Conservative treatment that may include a combination of nerve decompression and noninvasive pain management techniques is used to treat small annular tears with disc bulges at L4 or L5, as stated by Laser Spine Institute. The appropriate treatment for an annular tear depends largely on the cause and severity of the damaged disc.
Spinal degeneration due to annular tears at the L4 or L5 vertebral level causes inflammation accompanied by chronic lower back pain. While traumatic injuries commonly cause annular tears, they are more often the result of age-related degeneration, obesity or any chronic condition that places pressure on the spine. The outer walls of the intervertebral discs that cushion the spine weaken as they lose protein and water, causing them to bulge, rupture or tear easily. Tears in the outer annulus leads to disc leaks that can spread through the spinal canal, leading to severe inflammation and pain, states Laser Spine Institute.
A low dosage pain medication eases pain till mild annular tears heal themselves. Moderate tears are treated with massage therapies, hot and cold therapies, stretching techniques or alternative therapies such as acupuncture, quotes BackPainRelief.net. Minimally invasive surgical procedures are used when pain persists through many weeks of conservative treatment. Magnetic resonance imaging aids in diagnosing the severity of L4 or L5 bulges and annular tears and in choosing the right treatment options.