What Is Syringomyelia? Symptoms, Causes, and Treatment Explained (2026 Guide)

4 days ago

10 min read

Updated: 2 days ago

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026

Editorial note: This article is based exclusively on authoritative medical sources, including Mayo Clinic (pages updated July 22, 2026), NIH/NINDS, and peer-reviewed literature. It is for general education only and is not medical advice. If you have persistent pain or numbness in a capelike pattern across your shoulders and arms, see a healthcare professional.

TL;DR

Syringomyelia is a rare condition in which a fluid-filled cyst (syrinx) forms inside the spinal cord, often linked to Chiari malformation or past spinal injuries. It typically causes slowly developing pain, numbness, and weakness in a "capelike" pattern across the neck, shoulders, and arms. MRI is the most reliable diagnostic tool. Many cases can simply be monitored, while bothersome or worsening cases may need surgery, and existing nerve damage cannot be reversed — which makes early diagnosis important.

Quick Answer: What is syringomyelia and how is it treated?

Syringomyelia is a rare spinal cord disorder in which cerebrospinal fluid collects inside the spinal cord, forming a cyst called a syrinx. It most often causes pain and loss of pain/temperature sensation in a capelike pattern across the neck, shoulders, and arms, and is frequently linked to Chiari malformation. Treatment depends on severity: quiet cases are monitored with MRI, while symptomatic cases may be treated with medication, therapy, or surgery to restore normal fluid flow [1] [2].

What is syringomyelia?

Cerebrospinal fluid (CSF) normally flows around the outside of the brain and spinal cord, cushioning and protecting them. In syringomyelia, that fluid collects inside the spinal cord and forms a fluid-filled cyst called a syrinx [1].

The syrinx can grow larger over time. When it does, it can damage the spinal cord and cause pain, weakness, stiffness, or loss of feeling. The condition is most common in young adults — symptoms tend to begin between ages 25 and 40, though both adults and children can develop it [1].

Syringomyelia is rare. Estimates put the prevalence at roughly 8.4 cases per 100,000 people, meaning fewer than 50,000 people in the United States are affected, with most cases beginning in young adulthood [8] [9].

What does a syrinx feel like? The symptoms

Symptoms of syringomyelia usually develop slowly over time. A distinctive feature is that they are often felt in a capelike pattern across the neck, back, shoulders, arms, and hands. If the syrinx extends lower in the spine, symptoms appear in the lower body; if it extends upward toward the brain, symptoms can affect the face [1].

In some people, coughing or straining can trigger symptoms — although neither causes the condition itself [1].

Symptom category	What it looks like
Pain and sensation	Pain in the neck, arms, and back; loss of sensitivity to pain and temperature; headache
Muscles, joints, and movement	Loss of reflexes; stiffness in the back, shoulders, arms, and legs; muscle weakness and wasting; loss of grip strength; loss of feeling or movement in the face
Body functions	Trouble breathing (especially during sleep); changes in bladder, bowel, or sexual function
Spine structure	Scoliosis — a sideways curve of the spine

Infographic showing syringomyelia's capelike symptom pattern across the neck, shoulders, and arms

What causes syringomyelia?

It is not fully understood how or why syringomyelia develops. Most studies point to a problem with how cerebrospinal fluid pulses and flows around the brain and spinal cord. When CSF flow is blocked in any way, fluid can build up within the spinal cord itself and form a syrinx [1].

Researchers describe four main types, each linked to a different underlying cause:

Type	Also called	Underlying cause
Chiari-related	Congenital or communicating syringomyelia	Brain tissue pushes into the spinal canal (Chiari malformation), blocking normal CSF flow — the most common form
Primary spinal	Acquired or noncommunicating syringomyelia	An issue within the spinal cord itself: tethered cord, trauma, tumors, or swelling/scarring of the arachnoid membrane (arachnoid adhesions)
Posttraumatic	—	Severe injury to the spine or spinal cord
Idiopathic	—	Cause unknown; tests show no clear signs affecting CSF flow

A syrinx can also form around spinal cord tumors or cysts, and the swelling or scarring that follows spinal surgery or meningitis can disrupt fluid flow as well [1].

Who is at higher risk?

Certain conditions and histories raise the likelihood of developing syringomyelia [1]:

Risk factor	Why it matters
Chiari malformation	Brain tissue pushes into the spinal canal and blocks regular CSF flow
Meningitis	Swelling of the membranes surrounding the brain and spinal cord
Growths on or in the spine	Tumors, cysts, arachnoid adhesions, or bone spurs that disrupt CSF flow
Conditions present at birth	Spina bifida or a tethered spinal cord
Spinal cord injury	Symptoms may appear months or years after the injury, and can worsen with age
Complications after surgery	Swelling or scarring of the spine; radiation or chemotherapy near the spine
Family health history	Genetics may play a role
Aging	Wear and tear on the spine raises risk, especially after past trauma

What happens if it's left untreated?

Some people never develop symptoms and never need treatment. But if a syrinx grows and damages nerves within the spinal cord, it can lead to serious and sometimes permanent complications [1]:

Complication	What it involves
Scoliosis	Spine curves sideways as nerve damage weakens spine-supporting muscles
Charcot joint	Shoulder, elbow, or hand joints change shape as their muscles weaken
Chronic pain	Ongoing burning, tingling, numbness, or electric-shock-like pain
Numbness and sensory loss	Capelike numbness along the neck, shoulders, and upper arms; face if the syrinx extends upward; lower body if it extends downward
Motor difficulties	Stiff, weak legs; walking and balance problems; slow reflexes; difficulty moving the face, mouth, or tongue
Digestive and function changes	Upset stomach, vomiting, appetite and weight loss; bladder, bowel, and sexual function changes
Paralysis	In severe cases, total loss of movement or feeling in the face or one or more limbs

How is syringomyelia diagnosed?

Sometimes syringomyelia is discovered incidentally on a spine scan done for other reasons. When a healthcare professional suspects the condition, they start with a medical history and a complete physical exam, then order imaging [2].

Test	What it does
MRI	The most reliable tool for diagnosing syringomyelia; radio waves and a strong magnetic field produce detailed images where the syrinx is clearly visible
Cine MRI	A special MRI that creates short videos of processes in the body, useful for assessing the pulse and flow of cerebrospinal fluid
CT scan	Uses a series of X-rays for a detailed view of the spine; helps find tumors or other spine conditions

The MRI may be repeated over time to determine whether the syringomyelia is getting worse [2].

Diagram comparing a normal spinal cord to one affected by syringomyelia, showing the fluid-filled syrinx

When should you see a doctor?

Contact a healthcare professional if you have any symptoms of syringomyelia. If you have had a spinal cord injury, watch carefully for symptoms — syringomyelia may develop months or even years after the injury. Make sure your healthcare professional knows about any spinal cord injury you have had [1].

How is syringomyelia treated?

Treatment depends on how bad the symptoms are and the size of the syrinx [2]. The condition is not curable in the sense of erasing the underlying damage, but it can be effectively managed, and early treatment helps prevent further nerve damage.

Situation	Treatment approach
No symptoms	Monitoring — no treatment needed; periodic MRI and neurological exams to confirm it is not worsening
Pain	NSAIDs (COX-2 inhibitors such as meloxicam), antiseizure medicines (gabapentin, pregabalin), corticosteroids, or opioids (methadone) — they relieve symptoms but do not cure the condition
Motor function problems	Muscle relaxants (baclofen, tizanidine, clonidine, dantrolene, benzodiazepines) or Botox injections
CSF regulation	Diuretics (furosemide), PPIs (omeprazole), or carbonic anhydrase inhibitors (acetazolamide)
Persistent pain unmanaged by medicines	Spinal cord stimulation (a small device sends electrical pulses that block pain signals); stem cell therapy shows promise in one small study but needs more research
Symptoms that interfere with daily life or suddenly worsen	Surgery to remove pressure on the spinal cord and restore normal CSF flow

It is worth noting that most medicines listed above have shown promising results in small studies, and more research is needed to support wider use [2].

Surgery options

Surgery is not always required, but it may be needed when symptoms get in the way of daily life or suddenly worsen. The goal is to remove the pressure the syrinx places on the spinal cord and restore the regular flow of cerebrospinal fluid [2].

Surgery type	When it is used
Posterior fossa decompression	For Chiari-related syringomyelia; removes a small section of bone at the back of the skull to relieve pressure and restore CSF flow
Draining the syrinx (shunt)	A flexible tube keeps fluid from the syrinx flowing in the desired direction — one end in the syrinx, the other in an open area of the spine or chest
Removing a growth or blockage	If a tumor or bone spur is disrupting CSF flow, removing it may let the syrinx drain
Releasing a tethered spinal cord	Corrects a tethered cord that restricts spinal movement and CSF flow, allowing the syrinx to drain

Surgery doesn't always get rid of the syrinx. Sometimes it remains even after efforts to drain the fluid from it [2].

Physical and occupational therapy

Supportive therapies are key before and after surgery. A physical therapist can build an exercise program that may reduce pain and improve muscle function, and an occupational therapist can help you function better in daily tasks [2].

Flowchart of syringomyelia treatment options, from monitoring to medication, therapy, and surgery

What can you do at home?

Everyday habits can help manage symptoms. Avoid activities that involve heavy lifting, straining, or putting force on the spine, and avoid flexing your neck — these commonly trigger symptoms for people with syringomyelia [2].

For chronic pain, talk with your healthcare team about options. Pain management approaches may include applying heat or cold, relaxation training, mindfulness and meditation, music therapy, and cognitive therapy. Many medical centers have doctors who specialize in pain management [2].

Living with syringomyelia and its complications can be hard. Talking with a friend, counselor, or therapist helps many people, and syringomyelia support groups (local or online) offer a place to share experiences and exchange practical tips [2].

Preparing for your appointment

You are likely to start by seeing your family healthcare professional, who may refer you to a neurologist. Bring past medical reports or results of any MRI or CT scans. Take a family member or friend to help you remember what you're told, and prepare lists of your symptoms (including when they began), your medical history (including spinal surgeries and family history of syringomyelia), all medicines and supplements with dosages, and your questions [2].

Your healthcare professional is likely to ask whether your symptoms are ongoing or come and go, how severe they are, and what seems to improve or worsen them [2].

Why early diagnosis matters

A syrinx grows slowly, and the damage it causes to the spinal cord and nerves can be lasting. Treatment can improve symptoms and stop further damage, but some symptoms may remain even after treatment because of nerve damage that already occurred [2]. The syrinx can also grow back after surgery, so regular follow-up exams and repeat MRIs are an essential part of long-term care.

For people with persistent pain or numbness in a capelike pattern — especially those with Chiari malformation, a history of spinal injury, or family history — early evaluation with an MRI is the single most important step.

Conclusion and next steps

Syringomyelia is rare, but its signature pattern is easy to recognize once you know it: slow-onset pain and loss of pain and temperature sensation in a capelike distribution across the neck, shoulders, and arms. It is frequently linked to Chiari malformation or past spinal trauma, and MRI can detect it reliably.

Your next steps: If you notice this pattern of symptoms, see a healthcare professional and mention any history of Chiari malformation or spinal cord injury. If you've been diagnosed, work with your care team on a monitoring plan with periodic MRIs, and discuss whether medication, therapy, or surgery is right for you. If you've had surgery, keep up with regular follow-up exams — the syrinx can return or grow, and catching that early matters. And if chronic pain is affecting your daily life, ask about a referral to a pain management specialist.

Frequently Asked Questions

1. Is syringomyelia curable? Syringomyelia cannot be "cured" in the sense of erasing existing nerve damage, but it can be managed effectively. Many cases only need monitoring, and surgery can relieve pressure and restore normal fluid flow. Some symptoms may remain after treatment because the syrinx can cause lasting damage to the spinal cord and nerves [2].

2. How rare is syringomyelia? It is considered a rare condition, affecting roughly 8.4 people per 100,000 — fewer than 50,000 people in the United States. Symptoms usually begin in young adulthood, most often between ages 25 and 40 [1] [8].

3. What does syringomyelia pain feel like? It often starts as pain in the neck, arms, and back, combined with a loss of sensitivity to pain and temperature in a "capelike" pattern across the neck, shoulders, and upper arms. Some people also experience headaches, burning or electric-shock-like nerve pain, and stiffness [1].

4. What is the connection between syringomyelia and Chiari malformation? Chiari-related syringomyelia is the most common form of the condition. In Chiari malformation, brain tissue pushes into the spinal canal and blocks the regular flow of cerebrospinal fluid, which can cause fluid to collect inside the spinal cord and form a syrinx [1].

5. Can syringomyelia appear years after a spinal injury? Yes. Posttraumatic syringomyelia is caused by severe injury to the spine or spinal cord, and symptoms may develop months or even years after the original injury. As you age, symptoms connected to an old injury may become worse [1].

6. How is syringomyelia diagnosed? An MRI of the spine and spinal cord is the most reliable tool for diagnosing syringomyelia — the syrinx is visible on the scan. A cine MRI can create short videos to assess the pulse and flow of cerebrospinal fluid, and the MRI may be repeated over time to track whether the condition is worsening [2].

7. What treatments are available? Treatment depends on symptom severity and syrinx size. Quiet cases are monitored with MRI and neurological exams. Medicines can manage pain and motor function, physical and occupational therapy support daily living, and surgery (decompression, shunting, growth removal, or tethered cord release) may be needed when symptoms interfere with daily life [2].

8. Can syringomyelia come back after treatment? Yes, it can. The syrinx can grow back or regrow after surgery, which is why regular follow-up exams and repeat MRIs are important. The syrinx can grow over time and may require additional treatment [2].