Hi Thank you for your question to HCM. Scoliosis of the cervical spine was certainly preexistent and not caused by recent car accident. The treatment for annular tears causing back pain is 1 Antiinflammatory medications like ibuprofen, meloxican or naproxen 2 Analgesics like tramadol and sometimes even stronger ones like oxycodone under the supervision of a doctor 3 Physical therapy once the acute pain is resolved Your wife s treatment will depend on symptoms. Treatment for pure back pain would be as described above. In the presence of radiating leg pain if it is right sided L4-5 foramen narrowing on right side may be the cause. In that scenario after trying above mentioned medications and physical therapy, epidural injections can be done by a spine surgeon or pain specialist. These are mostly helpful and can be repeated if necessary. If the injections cease to help a discussion with spine surgeon about surgical decompression is recommended. Hope this is helpful. I would be happy to answer any questions you may have.