Tarlov cysts are cysts that typically form around the nerves of the sacrum at the base of the spine. These cysts usually manifest as small sacs filled with cerebrospinal fluid. They most often form at the roots of the sacral nerves, and can lead to compression of these nerves. Not all Tarlov cysts cause symptoms, but when symptoms appear they can include pain in the lumbar spine, sciatica, constipation, and headaches. Dietary changes, steroid medications, and surgery can help relieve the symptoms of Tarlov cysts in some patients.
Women are considered far more likely than men to develop Tarlov cysts. Many people with Tarlov cysts display no symptoms at all. While these cysts can cause compression of the sacral nerve roots, they must generally reach a considerable size before nerve compression begins.
The nerve compression associated with Tarlov cysts can be quite painful. Sciatica, which normally causes burning pains to shoot down the legs from the buttocks or lumbar spine, can occur when Tarlov cysts begin to compress sacral nerves. Other symptoms of nerve pressure in the lower spine can include sexual dysfunction, constipation, urinary incontinence, and partial numbness or paralysis in the legs or feet. Lower back pain is considered common, and may result from damage to the spinal bones caused by nerve compression. These cysts can lead to imbalances in cerebrospinal fluid pressure, causing headaches.
Treatment may be surgical or nonsurgical. Draining the cerebrospinal fluid from the cysts can temporarily relieve nerve compression, but it usually doesn’t stop the cysts from recurring. Refilling the drained cyst with fibrin glue, or another filler material, can help keep the cyst from growing back. Complete removal of the cyst and associated nerve root may be an option for some patients. In some cases, however, such surgery does not relieve Tarlov cyst symptoms.
Dietary changes and use of steroid anti-inflammatory drugs can help relieve the symptoms of Tarlov cysts without surgery. Corticosteroids may be injected into the area to relieve pain and inflammation. Dietary changes typically aim to create a more acidic environment inside the body, since this is believed to mitigate the development of Tarlov cysts. Specialized nutritional supplements may be administered to help support the effects of dietary changes.