Diagnosis

Your healthcare professional asks about your medical history and does a complete physical exam. In some cases, syringomyelia might be found during a spine MRI or CT scan done for other reasons.

If your healthcare professional suspects you may have syringomyelia, you may need to undergo testing. Tests may include:

  • MRI. An MRI scan of the spine and spinal cord is the most reliable tool for diagnosing syringomyelia.

    An MRI uses radio waves and a strong magnetic field to produce detailed images of the spine and spinal cord. If a syrinx has developed within the spinal cord, it is visible on the MRI scan. You may have a special kind of MRI called a cine MRI. Cine MRIs create short videos of processes within the body by taking many pictures very quickly. These videos are useful to assess the pulse and flow of the cerebrospinal fluid.

    The MRI might be repeated over time to find out whether syringomyelia is getting worse.

  • CT scan. A CT scan uses a series of X-rays to create a detailed view of the spine and spinal cord. It can help find tumors or other spine conditions.

Treatment

Treatment for syringomyelia depends on how bad the symptoms are and the size of the syrinx.

Monitoring

If syringomyelia isn't causing symptoms, it may not need treatment. But the condition should be carefully monitored to be sure it doesn't get worse. Your healthcare professional may check it from time to time with MRI and neurological exams.

Medicines

Your healthcare team may prescribe medicines to help relieve symptoms caused by syringomyelia. Although these medicines won't cure the condition, they may help manage pain and motor function. Some medicines have shown promising results in small studies, but more research is needed to support more widespread use.

Medicines that may help relieve pain include:

  • Nonsteroidal anti-inflammatory medicines (NSAIDs). NSAIDs called COX-2 inhibitors may be used. An example is meloxicam. This type of NSAID is available by prescription only.
  • Antiseizure medicines. These include gabapentin (Neurontin, Gralise) and pregabalin (Lyrica).
  • Corticosteroids. Prednisolone or methylprednisolone may be prescribed.
  • Opioids. Methadone may be prescribed.

Medicines that may help manage motor function include:

  • Muscle relaxants such as baclofen (Gablofen, Fleqsuvy, others), tizanidine, clonidine, dantrolene and benzodiazepines.
  • OnabotulinumtoxinA (Botox).

Medicines that may help regulate cerebrospinal fluid include:

  • Diuretics, such as furosemide.
  • Proton pump inhibitors (PPIs), such as omeprazole.
  • Carbonic anhydrase inhibitors, such as acetazolamide.

Supportive therapies

Certain therapies are key to managing the symptoms of syringomyelia before or after surgery. Supportive therapies include:

  • Physical therapy. A physical therapist can create an exercise program that may help reduce pain and improve muscle function.
  • Occupational therapy. An occupational therapist can help you function better in your daily tasks.

Procedures

Less invasive procedures may be available to treat pain symptoms of syringomyelia. Less invasive means that no cuts, or only very small cuts, are made in the body. Procedures include:

  • Spinal cord stimulation (SCS). In this treatment, a small device is placed near the spinal cord. The device sends electrical pulses through thin wires into the spinal cord. These electrical pulses block pain signals. SCS may be a good option for pain that is hard to manage with medicines or other treatments.
  • Stem cell transplant. One small study showed that transplanting stem cells near a syrinx reduced pain and caused the syrinx to shrink. Although more research is needed, stem cell therapy may show promise as a nonsurgical treatment for syringomyelia.

Surgery

Surgery may be needed if syringomyelia is causing symptoms that get in the way of daily life or if symptoms suddenly get worse.

The goal of surgery is to remove the pressure the syrinx places on the spinal cord and to restore the regular flow of cerebrospinal fluid. This can help improve symptoms and nervous system function. The type of surgery needed depends on the cause of syringomyelia.

To reduce pressure on the brain and spinal cord, surgery options include:

  • Treating Chiari malformation. If syringomyelia is caused by Chiari malformation, surgery might involve removing a small section of bone at the back of the skull. This surgery is called posterior fossa decompression. It can reduce pressure on the brain and spinal cord and restore the regular flow of cerebrospinal fluid. Surgery may improve or clear syringomyelia.
  • Draining the syrinx. Your healthcare professional inserts a drainage system, called a shunt. It consists of a flexible tube that keeps fluid from the syrinx flowing in the desired direction. One end of the tubing is placed in the syrinx. The other end is placed in an open area of the spine or chest.
  • Removing a growth or blockage. Sometimes, something within the spinal cord is affecting the flow of cerebrospinal fluid. Examples include a tumor or a bone spur. Surgically removing the growth or blockage might restore CSF flow. This can allow fluid to drain from the syrinx.
  • Releasing a tethered spinal cord. A tethered spinal cord may restrict movement of the spine and affect the flow of CSF. Surgery that helps correct this condition can restore fluid flow and allow the syrinx to drain.

Surgery doesn't always get rid of the syrinx. Sometimes the syrinx remains even after efforts to drain the fluid from it.

Follow-up care

Syringomyelia can come back after surgery. It's important to have regular exams by your healthcare team to monitor the area that had the syrinx. Your care team may have you repeat an MRI to check the outcome of surgery.

The syrinx can grow over time and may require more treatment. Even after treatment, some symptoms of syringomyelia can remain. This is because a syrinx can cause lasting damage to the spinal cord and nerves.

Lifestyle and home remedies

The following steps might help you manage the symptoms of syringomyelia.

Avoid activities that can make symptoms worse

Avoid activities that involve heavy lifting, straining or putting force on the spine.

Manage chronic pain

If you have chronic pain from syringomyelia, talk with your healthcare team about treatment options. Many medical centers have doctors who specialize in pain management.

Methods and techniques to relieve pain may include:

  • Applying heat or cold.
  • Relaxation training.
  • Mindfulness and meditation techniques.
  • Music therapy.
  • Cognitive therapy.

Coping and support

Living with syringomyelia and its complications can be hard. Having someone to talk with — a friend, counselor or therapist — can be helpful. Or you might find the support and encouragement you need in a syringomyelia support group.

Ask your healthcare professional to recommend a local group or look for groups online. A support group provides a place for sharing experiences. It also can be a good source of information and help you get tips for living with syringomyelia.

Preparing for your appointment

You're likely to start by seeing your family healthcare professional. You might get a referral to a neurologist. A neurologist is a doctor trained in brain and nervous system conditions.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance. If you have past medical reports or the results of MRI or CT scans that might relate to your condition, bring them to your appointment.

Take a family member or friend to your appointment, if possible, to help you remember the information you receive.

Make a list of:

  • Symptoms. Note when they began.
  • Medical history. Include spinal or back surgeries you've had and family history of syringomyelia.
  • Medicines. List all medicines you take as well as vitamins and supplements. Include dosage information.
  • Questions. Having a list of questions can help you make the most of your time with your healthcare professional.

For syringomyelia, questions to ask your healthcare professional include:

  • What is the likely cause of my symptoms or condition?
  • Are there other possible causes?
  • Could my symptoms get better on their own?
  • What tests do I need?
  • What is the best course of action?
  • Can exercise help?
  • I have other health conditions. How can I best manage them together?
  • Are there brochures or other printed material I can take with me? What websites do you recommend?

What to expect from your doctor

Your healthcare professional is likely to ask you questions, including:

  • Have your symptoms been ongoing, or do they come and go?
  • How bad are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, seems to worsen your symptoms?

What you can do in the meantime

Avoid doing anything that worsens your symptoms. For many people with syringomyelia, heavy lifting and straining can trigger symptoms, so avoid these activities. Also avoid flexing your neck.

By Mayo Clinic Staff