Leakage and buildup of spinal fluid in the area where the cyst forms can be the result of an injury or exertion such as heavy lifting or even childbirth. Other theories are that Tarlov cysts are congenital or may be linked to connective tissue disorders.
What distinguishes a Tarlov cyst from other types of spinal cysts is that the cyst wall contains nerve fibers. Because the cyst surrounds a nerve root, it is also referred to as a perineural or sacral nerve root cyst.
Pressure Symptoms and Pain
A Tarlov cyst (TC) may produce no symptoms. However, a cyst that grows or expands will cause pressure symptoms and pain. Compressed nerve roots lead to pain in the area served by the affected nerves, most commonly lower backache or sciatica pain that goes through the buttocks and down one leg. A TC may also cause symptoms consistent with interstitial cystitis (painful bladder syndrome) or other urogenital conditions. Urological tests and radiological imaging are needed to make a differential diagnosis of a TC.
Draining the cyst may give quick but temporary relief of the pressure and pain, but fluid buildup in the cyst usually recurs. If the TC causes debilitating pain or there is deterioration of surrounding bone, surgery may be needed. TC surgery is complicated because the cyst is part of the nerves. Surgery involves opening the cyst, draining the spinal fluid, freeing the nerves from the cyst wall, then sealing the source of the spinal fluid. Even with meticulous, minimally invasive surgery there may be delay or complications in healing for nerves, so pain relief may not be immediate.
More often, TC treatment centers on managing symptoms and pain nonsurgically. Oral or injected corticosteroids are prescribed for short-term pain relief. To avoid unwanted side effects of steroids, which can be very serious, medical-grade cannabis may be considered a safer pain-relieving treatment.
Marijuana for TC Pain Management
There have been small trials comparing placebo to different potencies of medical-grade tetrahydrocannabinol (THC) herbal cannabis for helping with chronic nerve pain. Researchers have found that even at low doses, inhaled cannabis, delivered by smoking or a vaporizer, is effective at improving neuropathy, or peripheral nerve pain, in general.
However, since there is limited knowledge about Tarlov cysts as a rare disease condition, there is also little clinical data on cannabis use in treating the specific type of radiculopathic pain that occurs at or near the root of the nerve along the spine. In Illinois, TC patients must consult with an Illinois cannabis dispensary and their physician to identify the specific cannabis strain and the best delivery method to treat the symptoms of their complex or chronic radiculopathy as caused by Tarlov cysts.