Locations:
A Tarlov cyst is a fluid-filled sac that sits on spinal nerve roots. These usually occur at the base (bottom part) of your spine. While Tarlov cysts don’t always cause symptoms, you may experience pain, numbness and bladder or bowel issues. Treatment is available to relieve discomfort or remove the cyst.
A Tarlov cyst is a fluid-filled sac that sits on the nerve roots that extend out from your spinal cord. The fluid inside the cyst is usually cerebrospinal fluid (CSF). CSF is a clear fluid that surrounds your brain and spinal cord.
The cysts are most common in your lower back (sacrum) and can form after an injury. You may have multiple Tarlov cysts at one time.
Tarlov cysts vary in size. Most cysts are completely asymptomatic and are found incidentally when working up a different spinal issue. Larger cysts may cause symptoms like pain, bowel and bladder problems or numbness.
You might hear your healthcare provider refer to Tarlov cysts as meningeal cysts or perineural cysts.
It’s difficult to determine how many people experience Tarlov cysts because they don’t all cause symptoms. One study estimated that just under 4% of people in the United States experience this type of cyst.
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Symptoms of a Tarlov cyst vary based on the size and location of the cyst. Studies show that only 5% to 8% of people diagnosed with a Tarlov cyst experience symptoms. Usually, larger cysts are more likely to cause symptoms, including:
We aren’t sure exactly what causes Tarlov cysts. Research suggests they may form as a result of:
CSF pressure can change the size of a Tarlov cyst. It’s normal for CSF pressure to fluctuate. When CSF pressure increases, the size of the cyst may increase. You might notice the change in pressure when you’re performing strenuous activities like lifting weights. This is when symptoms could get worse or become noticeable.
Anyone can develop a Tarlov cyst. You may be more at risk if you:
Tarlov cyst complications are rare but may include:
You may need to make adjustments to your daily routine if you have complications, especially ones that affect your movement. Many people experience mental health challenges like depression due to how long-term (chronic) symptoms affect them.
A healthcare provider will diagnose a Tarlov cyst after a physical exam and neurological exam. They’ll take a complete medical history and ask you questions about your symptoms, like when they started and if they get worse with activity.
An imaging test, like an MRI or CT scan, confirms a diagnosis. An imaging test gives your healthcare provider a picture of the cyst and the nerves it targets.
A healthcare provider may accidentally discover a Tarlov cyst while performing an imaging test, like an MRI for lower back pain.
You don’t need treatment for a Tarlov cyst that doesn’t cause symptoms. Your healthcare provider may recommend regular exams to monitor the size of the cyst and whether or not symptoms appear as you age.
If you have a cyst that’s causing symptoms, your provider will focus on treating those symptoms. Treatment can vary from person to person and may include:
Your provider will weigh the benefits and risks of each treatment option to find one that fits your needs and is safest for your situation. None of these treatment options prevent the cyst from recurring (coming back).
Each type of treatment comes with possible side effects. Talk to your healthcare provider about the side effects of the specific medication they prescribe to you. Some medications to treat pain can cause drowsiness, nausea and physical dependence.
If your healthcare provider drains cerebrospinal fluid from a cyst, it can fill back up with fluid. This can happen within an hour after draining it in some cases. Most providers use a technique to fill the cyst with another substance that won’t cause CSF to return and won’t put pressure on your nerves.
Side effects of surgery also vary based on what procedure your surgeon needs to perform. Possible side effects may include:
Depending on what type of treatment your healthcare provider recommends, you may feel relief from your symptoms immediately or shortly after taking a medication or getting a procedure. Sometimes, symptom relief can take weeks before you notice a change. Other people may not find relief, even after cyst decompression or removal. Your provider will recommend regular checkups during treatment to make sure you don’t experience any side effects and to monitor the size and location of the cyst(s).
There’s no known way to prevent Tarlov cysts, as the cause isn’t well understood. You can take steps to protect yourself from physical injury to reduce your risk.
Tarlov cysts don’t always cause symptoms, so you might not know you have one. If you have a symptomatic cyst, treatment options are available to relieve pain and discomfort. Nonsurgical treatment options are usually the first step to treat a Tarlov cyst, like taking medications to relieve symptoms. If your symptoms don’t improve with treatment, surgical removal is an option. Over 80% of people who had their cyst surgically removed noted symptom relief one year after surgery. Cysts usually don’t grow back after surgical removal, but it’s possible.
Visit a healthcare provider if you experience symptoms of a Tarlov cyst, like:
If you’re undergoing treatment for a Tarlov cyst and you experience side effects like an infection (swelling, skin discoloration) or severe or worsening pain, let your provider know.
Most people diagnosed with a Tarlov cyst don’t have symptoms and don’t need treatment for the fluid-filled sac on their spinal nerves. For others, it can be a challenge to deal with Tarlov cyst symptoms. These cysts exist in sensitive areas of your body that regulate your movement, especially your lower body. You might not feel comfortable sitting in one place for a long time. You might have a difficult time going to the bathroom or going more frequently than what’s normal for you.
A healthcare provider can help you manage these symptoms or monitor the size of the cyst throughout your life. Asymptomatic cysts can turn into symptomatic ones, so let your provider know if you notice any changes in how you feel.
Last reviewed by a Cleveland Clinic medical professional on 11/05/2023.
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