Chronic lower back pain that silently affects and is more prevalent in women

According to the Spanish Society of Neurology, an estimated 57% of people with neuropathic pain are women. This condition encompasses a wide range of diseases, some of them rare, such as pudendal neuralgia , which affect the quality of life of thousands of women every day. Among these other rare or unusual diseases are Tarlov cysts , which sometimes manifest silently, but are primarily caused by chronic lower back pain.
What are Tarlov cysts?Dr. Isadore Tarlov first discovered these cysts in 1938, and his explanation earned them his name. Tarlov cysts are sacs filled with cerebrospinal fluid located in the lower part of the spine . As defined by the Madrid Regional Health Service , these masses "form, at the expense of the two outermost layers of the meninges, the dura mater and the arachnoid, around the posterior sacral or coccygeal nerve roots."
From lower back pain to the head: What symptoms does it cause?
Tarlov cysts are usually asymptomatic ; however, this does not rule out the possibility that many patients may live with symptoms. The most common symptom is chronic lower back pain , due to the position in which these small sacs appear. Although it may also be accompanied by sciatica, numbness, or loss of control in the legs and feet, it is generally impossible to sit for more than half an hour. It also has significant pelvic involvement , causing sexual dysfunction, urinary incontinence, or constipation.
Another symptom that draws attention is headaches . Some patients with Tarlov cysts often experience dizziness if they stand up suddenly or quickly. This, according to the National Institutes of Health (NIH) in its section on rare diseases, is explained by the changes that occur in cerebrospinal fluid pressure .

The causes of Tarlov cysts appear to be unclear within the scientific community. However, there are some theories, as outlined by the NIH . The appearance of these fluid-filled sacs could be due to congenital, traumatic, or hemorrhagic problems.
- Congenital cause : a structural failure in the meninges.
- Traumatic cause : trauma in the sacral region or caused by spinal puncture, epidural or spinal anesthesia.
- Hemorrhagic cause : due to subarachnoid hemorrhage, between the brain and the tissues that cover it.
Among their treatments, there is no specific cure, and they are more focused on improving the patient's quality of life. Thus, if the cysts are small, the most common approach is to use pharmacological treatment to alleviate the pain, while if they are large, professionals may consider surgical treatment or fluid drainage. This also largely depends on the potential impact of compression on the surrounding nerves .
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