Do Tarlov Cysts cause Pain?

What is a sacral Tarlov cyst?
  • A cyst is basically a bag of fluid.
  • A cyst is like a water balloon.
  • Sometimes at the sacral spine (the large bone at the back of the pelvis) there is a fluid collection known as a sacral Tarlov cyst.
  • I explain sacral Tarlov cysts by comparing the sacral spinal canal to a garden hose.
  • Have you ever seen a garden hose that gets worn down to the point where there is a bulge or out-pouching, where the wall of the hose has become worn and weak enough that the hose develops a bulge?
  • Now imagine that instead of a bulge filled with water from the garden hose, at the sacrum there is a bulge filled with spinal fluid from the spinal canal.
Do sacral Tarlov cysts cause pain or other symptoms?
  • Sacral Tarlov cysts are usually not symptomatic, but they can be.
  • Some dogmatic doctors will say that sacral Tarlov cysts are NEVER symptomatic, but I do not believe that is true.
  • Although they are USUALLY just an “incidental” finding that is noticed on MRI or CT scans, in some cases pressure from a Tarlov cyst may indeed cause symptoms.
Where do patients feel the symptoms from a sacral Tarlov cyst:
  1. Sacral pain (pain at the back of the pelvis)
  2. Pain down your leg or legs: If the Tarlov cyst causes pressure onto the upper sacral nerve roots, this may cause pain that down into one or both of your legs.
  3. Pain into your pelvis: If the Tarlov cyst causes pressure onto the lower sacral nerve roots, this may cause pain that travels into your pelvis.
    • If the sacral nerve roots that are involved include sacral nerves 2, 3, and 4, then the symptoms may travel in the distribution of the pudendal nerve, causing pain in the distribution of that nerve (pudendal neuropathy, or pudendal neuralgia).
    • Pudendal nerve pain is usually a burning pain into your genital region.
    • Pudendal nerve problems sometimes include genital numbness, instead of pain.
  4. Tailbone pain? There is one study of 9 patients in 2020 that reported that Tarlov cyst surgery gave partial relief of coccyx pain. See:
Patrick Foye, M.D.
Founder and Director at The Tailbone Pain Center
Tarlov Cyst info, Coccyx Pain, Tailbone Pain, Coccydynia, Patrick Foye MD
Tarlov Cyst info, Coccyx Pain, Tailbone Pain, Coccydynia, Patrick Foye MD
Patrick Foye, M.D.
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8 comments to Do Tarlov Cysts cause Pain?

  • Jennifer

    Thank you so much for this blog and for understanding and believing tarlov cysts can in fact cause symptoms. To have a dr. Believe that is huge to us that have these cysts.

    • Jennifer, you are very welcome.

      I am glad that you found the blog post helpful.

      -Patrick Foye, M.D.

    • I don’t really have any hepfull suggestions. Tailbone pain is the worst. Mine aches sometimes for no reason, and even a chiropractor didn’t seem to know what the cause was (although it did feel better after). In my case, I dread exercise because I know it will usually hurt after. Usually going to the chiropractor is the only thing that helps me.I often wonder if it’s related to me falling and hitting my tailbone in high school. I have a bunch of fat (I think it’s fat, anyway I don’t know what else it would be) above my butt and I don’t know if it’s related to the pain or not, and I have no clue how to make it go away.

  • I don’t have a pillow like that and I don’t think it would help. I tghhuot maybe the Boppy pillow would help since I could put the open end under my tailbone. I need to dig it out and see. I really don’t think this was caused by childbirth since I’ve had slight pains in the area before I even had Andrew. However, I can’t help but wonder if childbirth helped make it worse. It seems to have gotten worse after having William. The dr got back to me about the x-rays this afternoon. Everything looks normal. I guess the next step is an MRI.

  • Sharon Stafford

    Thank you Dr. Foye, I ordered your book 2 days ago, hoping for some insight, suggestions, helpful hints on how to diagnose my situation. So far every dr I’ve seen has a different opinion. Lastly Pain Management wants to implant a stimulator as a last resort. My husband has dementia so I’m a full time caretaker with chronic pain, not a good combination. I’m dependent on medication which I would be so happy to be able to get along without. Hope there is some info with regard to coccyx pain and how it might be related to hip pain. They seem to go together for many of us. I don’t have arthritis per my MRI. Thank you for your help with our group.

  • Kate V.

    I have these cysts in my sacrum. An mri found them in 2012. My problem is before, during, and after my period . I ache and it feels like I have a giant hard rock in my tailbone .the pain radiates to my hips and up my back a bit . Does this make sense? I’ve been to urologists, primary, doctors and plenty of obgyns because we thought it was period related but I think it’s due to the cysts more and more . What should be my next step? I am in NJ.

    • If you are having symptoms at your tailbone (you describe it feeling like a giant hard rock there), and you are located right here in New Jersey, you may want to schedule an appointment to be seen here by me at the Tailbone Pain Center. Bring your prior imaging studies of the sacrum/coccyx region (including those showing the sacral cysts) and I would be happy to review those at the Initial Evaluation here. Please see this link…

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