Tarlov Cyst, Perineural Cyst & Synovial Cyst: Causes and Considerations
Tarlov cysts, also known as perineural cysts, are fluid-filled sacs that form along the nerve root sheaths in the spinal column. These cysts are most commonly found in the sacral region, particularly at the S2-S3 level, but may also appear in other spinal areas. While Tarlov cysts are generally asymptomatic, they can sometimes contribute to neurological symptoms if they enlarge significantly.
Synovial cysts, on the other hand, are more likely to influence spinal health by affecting joint function and nerve pathways. Understanding the differences between these cysts and their impact on spinal movement and stability is essential for individuals experiencing neck discomfort, upper back discomfort, lower back, upper extremity, lower extremity, or pelvic symptoms.
Recognizing Common Spinal and Neural Cysts
A Tarlov cyst (perineural cyst) forms near spinal nerves and is often detected incidentally during imaging scans. Research suggests that up to 98% of Tarlov cysts remain asymptomatic and do not directly cause discomfort. However, in cases where they expand and exert pressure on surrounding structures, they may contribute to neurological symptoms such as:
- Numbness or tingling in the lower body
- Discomfort that worsens with prolonged sitting or standing
- Weakness in the legs or pelvic region
Synovial cysts develop in spinal facet joints, where they may contribute to restricted movement and changes in spinal flexibility. These cysts form due to joint degeneration and may be associated with:
- Lower back stiffness
- Changes in posture and weight distribution
- Limited spinal mobility
Understanding the role of spinal cysts and their potential impact on movement efficiency can help guide non-invasive management strategies.
Characteristics of Tarlov Cysts
Tarlov cysts are distinct in their formation and structure:
- They typically do not communicate freely with the spinal subarachnoid space.
- They are commonly positioned near the dorsal root ganglion, particularly in the sacral region.
- In cases where one cyst is present, multiple cysts are often detected upon further examination.
Although most Tarlov cysts remain asymptomatic, larger cysts may influence nerve function, requiring evaluation of associated spinal structures to determine their role in movement limitations.
Recognizing the Differences Between Spinal Cysts
Meningeal cysts, meningeal diverticula, and arachnoid diverticula are similar in nature to Tarlov cysts but have distinguishing features:
- Meningeal cysts are typically positioned closer to the spinal cord and may communicate with the cerebrospinal fluid (CSF).
- Unlike Tarlov cysts, meningeal cysts do not contain nerve fibers and are often lined by the arachnoid membrane.
- Tarlov cysts can form multiple sacs around a nerve root, while meningeal cysts are usually isolated.
Understanding these differences helps in determining whether spinal cysts contribute to movement restrictions or neurological symptoms.
Considerations for Non-Surgical Support
For individuals experiencing spinal movement challenges, a structured approach to spinal alignment and mobility may help maintain long-term function. Non-invasive management strategies may include:
- Postural Awareness: Ensuring proper spinal alignment during daily activities.
- Chiropractic and Physiotherapy-Based Care: Targeted methods to support joint mobility and movement efficiency.
- Ergonomic Adjustments: Modifications to posture and movement patterns to enhance spinal stability.
At Chiropractic Specialty Center® (CSC), we provide structured, non-surgical care programs designed to support spinal function. Our approach integrates chiropractic techniques, physiotherapy-based interventions, and targeted movement strategies to enhance spinal health.
For personalized spinal care solutions, contact Chiropractic Specialty Center® (CSC) today.
Understanding Tarlov Cysts, Perineural Cysts & Synovial Cysts
Tarlov cysts, also known as perineural cysts, are fluid-filled sacs that develop along nerve root sheaths in the spinal column. While these cysts are often asymptomatic, they can sometimes contribute to neurological symptoms if they expand significantly. Synovial cysts, which arise from spinal joints, are more commonly associated with movement-related concerns and nerve involvement. Understanding the differences between these cysts is important when evaluating their impact on spinal mobility and function.
Identifying Key Characteristics of Tarlov Cysts
Tarlov cysts have distinct features that differentiate them from other spinal cysts:
- Communication with the Subarachnoid Space: These cysts may interact with cerebrospinal fluid flow.
- Location: Tarlov cysts are typically positioned beyond the posterior nerve root and dorsal root ganglion, most often in the sacral region.
- Neural Components: Unlike other spinal cysts, Tarlov cysts contain nerve fibers within their walls.
- Multiple Occurrences: When one cyst is present, additional cysts may often be found nearby.
Although most Tarlov cysts do not contribute to discomfort, larger cysts may influence nerve function and require further assessment.
Differentiating Tarlov Cysts from Other Spinal Cysts
Several types of cysts can form along the spinal column, each with unique characteristics:
Meningeal Cysts
- Meningeal cysts are communicating cysts, meaning they directly interact with cerebrospinal fluid.
- These cysts are typically located near the dorsal root ganglion, whereas Tarlov cysts develop beyond this area.
- Unlike Tarlov cysts, meningeal cysts do not contain neural components within their walls.
Synovial Cysts
Synovial cysts differ significantly from Tarlov cysts in their development and impact on spinal function:
- Originate from Spinal Joints: Synovial cysts form within the facet joints and contain synovial fluid, which helps lubricate spinal movements.
- More Likely to Cause Symptoms: While Tarlov cysts are often asymptomatic, synovial cysts can directly contribute to movement restrictions or nerve compression.
- Common in Degenerative Changes: These cysts are associated with spinal joint adaptations, posture variations, and changes in spinal mobility.
Understanding these differences is essential when evaluating cyst-related spinal variations.
Recognizing the Role of Synovial Cysts in Spinal Mobility
Synovial cysts are often associated with:
- Postural Adjustments: Variations in movement mechanics can influence joint function.
- Repetitive Stress on Spinal Joints: Increased demand on weight-bearing structures may contribute to cyst formation.
- Changes in Spinal Alignment: Structural variations may develop in response to mobility adaptations.
For individuals experiencing spinal movement concerns, a structured approach to spinal alignment and postural efficiency may help maintain long-term function.
Diagnostic Considerations for Spinal Cysts
MRI (Magnetic Resonance Imaging) is the preferred method for evaluating spinal cysts, including:
- Tarlov Cysts: These appear as fluid-filled structures along the nerve root sheaths, often best visualized on T2-weighted MRI scans.
- Synovial Cysts: MRI can detect cyst size, positioning, and potential effects on nearby nerves or spinal mobility.
Identifying the characteristics of spinal cysts and their impact on movement efficiency allows for a comprehensive evaluation of spinal function.
Non-Surgical Approaches to Spinal Cyst Considerations
At Chiropractic Specialty Center® (CSC), we provide structured, non-surgical care programs designed to support spinal function and movement balance. Our approach integrates:
- Chiropractic Techniques: Targeted methods designed to support joint mobility and movement efficiency.
- Physiotherapy-Based Interventions: Focused strategies that promote postural balance and flexibility.
- Postural Awareness Recommendations: Movement strategies that enhance spinal positioning.
For individuals seeking structured spinal care solutions, CSC offers non-invasive approaches to maintain spinal health. Contact Chiropractic Specialty Center® today for personalized spinal care recommendations.
Understanding Tarlov Cysts, Perineural Cysts & Synovial Cysts
Tarlov cysts, also known as perineural cysts, are fluid-filled sacs that develop along nerve root sheaths in the spinal column. While these cysts are often asymptomatic, they can sometimes contribute to neurological symptoms if they expand significantly. Synovial cysts, which arise from spinal joints, are more commonly associated with movement-related concerns and nerve involvement. Understanding the differences between these cysts is important when evaluating their impact on spinal mobility and function.
Recognizing Signs & Structural Considerations of Tarlov Cysts
Tarlov cysts may remain asymptomatic for extended periods; however, structural influences may contribute to movement-related concerns over time. Changes in cerebrospinal fluid pressure, spinal alignment, or movement mechanics may influence the cyst’s impact on spinal function.
Structural Influences of Tarlov Cysts:
- Cerebrospinal Fluid Pressure Changes: Increased spinal fluid flow may contribute to cyst variations.
- Postural Influences: Variations in movement patterns may affect the surrounding structures.
- Neural Considerations: Larger cysts may contribute to nerve-related influences on spinal function.
- Movement Adjustments: Spinal positioning or movement variations may influence symptoms.
Understanding how spinal movement balance and fluid pressure variations contribute to function may help individuals take proactive steps toward long-term spinal support.
Recognizing Structural Factors Influencing Tarlov Cyst Variations
Tarlov cysts may develop due to postural adaptations, structural influences, or movement-based adjustments. Some of the most common contributing factors include:
- Spinal Movement Adjustments: Changes in spinal positioning may influence nerve root structures.
- Repetitive Stress on the Spine: Variations in spinal loading may affect cyst size.
- Weight Distribution Adjustments: Structural influences may contribute to postural balance concerns.
- Trauma or Injury Considerations: Spinal movement variations following physical stress may influence cyst development.
A structured approach to spinal movement efficiency and postural balance may help support long-term function.
Evaluating the Relationship Between Epidural Injections & Tarlov Cysts
Epidural injections are known to alter cerebrospinal fluid pressure, which may influence cyst variations. Changes in fluid dynamics, spinal alignment, or nerve root involvement may contribute to movement-based adaptations following an injection.
Structural Influences of Epidural Injections on Spinal Function:
- Postural Adjustments: Variations in spinal positioning may impact cyst-related movement mechanics.
- Spinal Fluid Flow Considerations: Cerebrospinal fluid pressure changes may influence cyst structure.
- Movement Variations: Altered movement mechanics following an injection may affect spinal balance.
Understanding the relationship between fluid dynamics and spinal alignment considerations may help individuals make informed decisions regarding spinal care.
Non-Invasive Approaches to Spinal Cyst Considerations
At Chiropractic Specialty Center® (CSC), we provide structured, non-surgical care programs designed to support spinal function and movement balance. Our approach integrates:
- Chiropractic Techniques: Targeted methods designed to support joint mobility and movement efficiency.
- Physiotherapy-Based Interventions: Focused strategies that promote postural balance and flexibility.
- Postural Awareness Recommendations: Movement strategies that enhance spinal positioning.
For individuals seeking structured spinal care solutions, CSC offers non-invasive approaches to maintain spinal health. Contact Chiropractic Specialty Center® today for personalized spinal care recommendations.
Non-Surgical Support for Spinal Cyst Considerations
Spinal cysts, including Tarlov cysts, perineural cysts, and synovial cysts, may contribute to variations in movement patterns, postural stability, and spinal mobility. These cysts develop in different spinal regions and may influence surrounding structures depending on their size and positioning. Addressing structural influences through a targeted, non-invasive approach may help maintain long-term spinal function.
At Chiropractic Specialty Center® (CSC), we provide structured, non-surgical care programs designed to support spinal movement and postural efficiency. By integrating chiropractic techniques and physiotherapy-based interventions, CSC offers personalized solutions tailored to spinal stability and function.
Recognizing Structural Influences on Spinal Cyst Variations
Tarlov cysts, perineural cysts, and synovial cysts may remain asymptomatic for extended periods. However, structural adaptations over time may contribute to variations in spinal movement and function. Some of the most common contributing factors include:
- Spinal Fluid Pressure Adjustments: Increased cerebrospinal fluid (CSF) pressure may influence cyst development.
- Postural Influences: Variations in movement patterns and spinal alignment may contribute to structural changes.
- Nerve Considerations: Larger cysts may influence neural function, affecting mobility and spinal positioning.
- Movement Adjustments: Structural adaptations in spinal mechanics may develop in response to sustained postural variations.
A structured approach to movement efficiency and spinal balance may help support spinal function over time.
Recognizing Differences Between Tarlov, Perineural, and Synovial Cysts
Each type of spinal cyst has unique characteristics that influence its impact on spinal function and movement efficiency:
Tarlov Cysts (Perineural Cysts):
- Typically located in the sacral region near nerve root sheaths.
- May communicate with cerebrospinal fluid flow in the spinal canal.
- Often detected as multiple cysts rather than isolated occurrences.
- Generally asymptomatic, but larger cysts may influence nerve structures.
Synovial Cysts:
- Develop in spinal facet joints, often due to degenerative joint changes.
- More likely to contribute to movement restrictions or nerve compression.
- Commonly linked to joint instability and postural adaptations over time.
Meningeal Cysts & Arachnoid Diverticula:
- Positioned near the dorsal root ganglion and may communicate with CSF flow.
- Do not contain neural components, unlike Tarlov cysts.
- Typically occur as isolated cysts rather than in multiple formations.
Understanding structural differences between these cyst types may help guide non-invasive management strategies for spinal movement efficiency.
Non-Surgical Support for Spinal Stability & Cyst Considerations
At Chiropractic Specialty Center® (CSC), we offer structured, non-invasive care programs designed to support spinal alignment, postural balance, and movement efficiency. Our approach integrates:
- Chiropractic Techniques: Gentle, targeted methods designed to support spinal joint function.
- Physiotherapy-Based Interventions: Focused strategies that promote flexibility and mobility.
- Postural Awareness Strategies: Recommendations to enhance spinal positioning and movement efficiency.
A structured approach to spinal care may help maintain long-term spinal function and reduce movement-related influences from spinal cysts.
Postural Considerations for Spinal Function & Cyst-Related Adaptations
Adjusting daily movement strategies may help maintain spinal alignment and mobility. Consider incorporating:
- Postural Awareness: Supporting spinal positioning while sitting, standing, and lifting.
- Ergonomic Adjustments: Modifications to workstation setups and daily activities to enhance movement efficiency.
- Controlled Movements: Engaging in targeted movement-based strategies to promote flexibility.
For personalized spinal health recommendations, consulting chiropractors and physiotherapists may provide targeted strategies to support postural stability and spinal function.
Comprehensive Spinal & Movement Support at Chiropractic Specialty Center®
CSC provides structured spinal and postural care programs for individuals seeking non-surgical solutions for movement stability and alignment. By integrating chiropractic techniques, physiotherapy-based methods, and targeted movement strategies, CSC offers customized solutions for long-term spinal function and postural support.
For personalized spinal care solutions, contact Chiropractic Specialty Center® (CSC) today.
What happens if you leave these untreated? I have them in several thoracic areas. What causes them to enlarge? Can cortisone make them smaller?
Dear Tammy,
Tarlov Cyst is a common condition. As mentioned, it is often asymptomatic (painless). If you are experiencing pain, the cause may be related to a co-condition. However, severely larger cysts can become painful. But, I would not recommend steroid injections, even for the large or painful ones. Injecting steroids into cysts can dramatically worsen them! In fact, spinal injections are common causes of Tarlov Cysts in the first place. Besides, there are many side effects associated with spinal injections.
To date, the only effective treatment is surgical removal. Surgical removal is only recommended for several large and painful cysts. If you want a detailed answer, we will need to assess your spine thoroughly. Please call our main center in Kuala Lumpur at 03 2093 1000 to schedule a one-on-one consultation with one of our experts. You will need to bring in your MRI films or CD for this assessment. After reviewing your MRI, we should be able to offer you better guidance.
I hope this helped.
Yours in Health,
CSC Clinical Team Member
Hi, I have 6 Tarlov cysts in my sacrum, and disc bulges with L5-S1 with nerve root impingements. How would I know if the cysts are the cause of my pain instead of the disc bulges? I have sharp tingling pain in my left butt and down my left leg, mainly behind my knee area, foot, and sometimes in my calf. I have done 8 sessions of acupuncture and haven’t helped at all. I have also done 4 sessions of physiotherapy and stretches to provide little pain relief. Only lying down helps to relieve most of my pain. How much are your services, including consultation, adjustments, decompression, and is it safe to decompression with Tarlov cysts?
Dear Susanna,
Tarlov Cysts are usually not the primary source of pain. However, large cysts can be painful by themselves. Tarlov Cysts that cause pain in the legs are often located at the upper portions of the S-1 segment (first sacral segment). But, in your case, I suspect the leading cause of radicular pain (pain in the buttocks and legs) is related to the L5-S1 disc disorder. Tarlov patients with bulging, herniated, protruded, prolapsed, or extruded disc often experience a higher degree of pain. It is relatively impossible to calculate the degree of pain caused by one or the other when both a cyst and spinal disc are present. Therefore, I recommend NSD Therapy® programs to all Tarlov patients. NSD Therapy® is the best integrative method of spine care. It incorporates Chiropractic, Physiotherapy, Nutrition, Exercise, and spinal decompression therapy through the RxDecom®. NSD Therapy® is not contraindicated in patients with Tarlov Cysts. In other words, it is perfectly safe.
The goal with NSD Therapy® is to repair and fix the actual cause of your damaged disc. NSD Therapy® is superior to acupuncture, physiotherapy, or chiropractic. Over the years, we have successfully treated hundreds of Tarlov and slipped disc patients. Stretching exercises and the acupuncture you are currently getting are of little help in addressing the actual damage within your spinal disc and spinal joints. The best advice that I can provide is to visit our center to assess your condition thoroughly. We can give you better information once we have assessed your spine. The costs for consultation are RM100. Treatment costs depend on the procedures needed. Each slipped disc patients are unique, and those with Tarlov need additional attention. Our centers provide chiropractic and physiotherapy treatments. You can get more information on costs of care and our pricing when you visit one of the appropriate pages below:
Our chiropractic treatment prices in KL, Malaysia
Our physiotherapy treatment prices In KL, Malaysia
I hope this helped.
Hi, thanks for your reply. Seen another spine specialist, and he said it’s not my disc bulges causing my pain! I have foraminal stenosis caused by spurs and was given 3 options; physiotherapy (not effective), steroid injection, or Transforaminal Interbody Lumbar Fusion surgery. I am mobile and have control of bowel movements, just severe sciatic pain. I don’t understand why I need such a major surgery. Will your treatment help my condition? Thanks, and I hope to hear from you soon.
Dear Susanna,
Thanks for updating us. As we mentioned in our last reply (July 31, 2018), the cause of your pain is not a cyst. I am glad to hear that the surgeons agree with our assessment. However, we disagree with the invasive options. Steroid Injections are short-term at best. Often, they cause more harm than good. The transforaminal Interbody Lumbar Fusion surgery is a more invasive patch. In other words, spine fusions are ineffective in the long term. Besides, spinal fusion success rates performed in the United States are relatively low. Failure rates of spine fusion surgeries are said to be as high as 74%. We have a detailed article published on our site on spine surgery (fusions). Please read it.
Physiotherapy as a standalone means of care also fails. We have successfully treated thousands of similar cases. Our methods are through integrative solutions enriched with breakthrough spine technology. The care you get is targeted and collaborative through the efforts of our clinical physiotherapists and doctors of chiropractic. I am confident that we can help. Our success rate is higher than 95%. You can read more about our proven methods that repairs damaged ligaments, muscles, joints and spinal discs.
You don’t have to have surgery. We can help. I invite you to schedule an appointment for a complete assessment. We have several centers throughout the Klang Valley. However, I recommend that you call our main office for the initial assessment at 03 2093 1000. We can help.
May I know who shall I see for Tarlov’s cyst in my sacrum S2?
Dear Gladys,
Thanks for posting your question, and please forgive us for the delay in getting back to you. A TRarlov’s cyst is an incidental finding on an MRI examination of the spine. They are rarely the cause of pain. Over 99% of them are asymptomatic. On rare occasions, cysts larger than 2cm can cause pain. You should avoid surgery to remove a cyst. A focused and comprehensive non-surgical treatment options are the best initial options.
Patients with Tarlov’s cyst experiencing back pain always have co-conditions such as disc degenerations, slipped discs (bulging or herniated discs), and spinal joint degenerations (facet syndrome or facet hypertrophy). I encourage you to visit one of our centers for a detailed assessment of your spine, and please do bring with you your MRI.
I hope this helped.
Hello,
what sources are you citing for your findings that a Tarlov cyst may increase in size due to an increase in pressure?
I have degenerative changes in my back and would normally try the injection; however, I have a 1.2 mm Tarlov cyst at my s2/3 and 2 smaller ones at s2. Is the increase in pressure and size causing my pain?
Dear Mike,
Thank you for reaching out with your questions about Tarlov cysts and their potential to increase in size due to increased pressure following certain medical procedures.
In discussing the potential for Tarlov cysts to increase in size due to increased CSF pressure, the information provided is based on general medical understanding about spinal fluid dynamics and the mechanics of CSF pressure. Specifically, procedures like epidural injections, which introduce substances into or around the spinal column, can engorge veins and consequently increase CSF pressure. While this is a recognized mechanism, direct clinical data linking such procedures to an increase in the size of Tarlov cysts is limited and often theoretical, based on isolated case reports rather than extensive clinical trials.
Regarding your condition, it’s important to consider that degenerative changes in the spine, such as disc degeneration or facet joint issues, are common causes of back pain and may be more directly related to your symptoms than the Tarlov cysts, especially given their small size (1.2 mm at S2/3 and smaller at S2). These cysts are often asymptomatic and may not necessarily cause pain unless they are pressing significantly on nerves, which is less likely with smaller cysts.
Given the degenerative changes in your back, I recommend prioritizing treatment for these conditions first, as they are more likely to be causing your pain. This can include physiotherapy (physical therapy), chiropractic, rehabilitation combined as these three provided collobratively will have better impact. Treating these primary conditions can often alleviate symptoms without directly addressing the Tarlov cysts.
If symptoms persist despite treatment and if there is evidence that the Tarlov cysts are contributing to your symptoms, then interventions that directly address the cysts are appropriate. However, any treatment, especially invasive ones like injections, should be approached with caution due to the potential to increase CSF pressure and exacerbate the cysts.
Always consult closely with your healthcare provider to assess the potential risks and benefits of any treatment. A thorough evaluation, which might include additional imaging or diagnostic tests, is crucial to accurately determining the causes of your symptoms and developing an effective treatment plan.
Please let me know if there is any further information I can provide or any other way I can assist you by WhatsApp our main center at +(60)17-269-1873
Best regards,
SIR, I HAVE A TARLOV CYST. HOW CAN I GET BETTER? HOW CAN I SEND MY MRI?
Hello,
Thank you for reaching out with your concerns about having a Tarlov cyst. It’s important to note that in most cases, Tarlov cysts themselves are not the actual cause of pain; rather, it’s often another underlying issue that needs to be addressed.
To further assess your condition and determine the appropriate course of treatment, it would be helpful to review your MRI scans. You can send your MRI images in person or through post, as emailed images may not load properly.
We recommend scheduling an appointment with one of our chiropractors, who can provide a comprehensive evaluation and recommend a conservative course of care that might include evidence-based chiropractic, clinical physiotherapy, and focused rehabilitation. These approaches address the symptoms and any underlying conditions contributing to your discomfort.
Please contact our office via WhatsApp on +(60)17-269-1873 to arrange for a consultation, or if you need further assistance on how to send your MRI images securely mail currier.
Best regards,