Syringomyelia Care in Grand Rapids, Michigan

Syringomyelia is a neurological condition in which a fluid‑filled cyst, called a syrinx, forms inside the spinal cord. The most common location is the cervical spine in the neck. As the syrinx enlarges, it can compress the spinal cord and disrupt the normal flow of nerve signals.

In the United States, syringomyelia is considered uncommon, affecting an estimated 8 out of every 100,000 people. Men are affected more often than women, and symptoms most often begin in early to mid‑adulthood (around age 30).

In Grand Rapids, syringomyelia is typically diagnosed and managed by neurologists and neurosurgeons at major centers such as Spectrum Health (Corewell Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health, with additional support from local rehabilitation and pain management clinics.

Types of Syringomyelia

Doctors generally group syringomyelia into three broad types, based on the underlying cause:

1. Syringomyelia from Congenital Brain Abnormalities

The most common form is associated with structural problems in the brain present at birth, especially:

  • Chiari malformation (Arnold–Chiari malformation)
    In this condition, the lower part of the brain (the cerebellum) extends down into the upper spinal canal. Instead of sitting fully inside the skull, part of the cerebellum lies in the upper neck.

This abnormal position can:

  • Obstruct the normal flow of cerebrospinal fluid (CSF)
  • Create abnormal pressure differences between the brain and spinal cord
  • Lead to the formation of a syrinx within the spinal cord

Chiari malformations and related conditions are often evaluated with MRI at Grand Rapids hospitals and may be referred to specialized neurosurgery teams.

2. Syringomyelia from Spinal Injury, Tumor, or Infection

This type develops as a complication of:

  • Spinal trauma (for example, car accidents, falls on ice in Michigan winters, sports injuries)
  • Spinal cord tumors
  • Spinal infections, such as:
    • Meningitis
    • HIV‑related infections
    • Other severe infections causing spinal cord inflammation or compression

Any condition that significantly compresses or scars the spinal cord or surrounding membranes can interfere with CSF flow and contribute to syrinx formation.

3. Idiopathic Syringomyelia

In some people, no clear cause is found. This is called idiopathic syringomyelia. Even without an obvious trigger, abnormal CSF flow and pressure differences are still believed to play a major role.

How a Syrinx Forms in the Spinal Cord

The brain and spinal cord (the central nervous system) are surrounded and cushioned by a clear fluid called cerebrospinal fluid (CSF). CSF:

  • Protects the brain and spinal cord from injury
  • Delivers nutrients
  • Removes waste products

Normally, CSF circulates freely around the brain and spinal cord. When this flow is blocked or redirected—by a Chiari malformation, scar tissue, tumor, or other obstruction—CSF can be forced into the center of the spinal cord, forming a syrinx.

Key points about syrinx formation:

  • The cyst is often small at first and may not cause symptoms.
  • Over time, pressure differences between the brain and spinal cord can push more CSF into the syrinx.
  • The syrinx gradually enlarges, putting pressure on nearby nerve fibers within the spinal cord.
  • This pressure can damage nerves that control sensation, movement, and automatic body functions.

In some people, symptoms may suddenly worsen after coughing, straining, or lifting heavy objects—activities that temporarily increase CSF pressure.

Syringobulbia: When the Cyst Extends into the Brainstem

In more severe cases, the syrinx can extend upward into the brainstem, the area that connects the brain to the spinal cord. This complication is called syringobulbia.

Because the brainstem controls vital functions, syringobulbia can cause:

  • Tongue wasting (atrophy), which can lead to:
    • Slurred or difficult speech
    • Trouble moving the tongue normally
  • Swallowing difficulties
  • Involuntary flickering movements of the eyes (nystagmus)
  • Potential problems with breathing and heart rate in advanced cases

Syringobulbia is a serious condition that usually requires urgent evaluation by a neurosurgeon or neurologist. In Grand Rapids, this type of complex care is typically managed at major hospital systems with neurosurgical services.

Symptoms of Syringomyelia

Symptoms of syringomyelia can develop slowly over years, which may delay diagnosis. They vary widely based on:

  • The size of the syrinx
  • Its location along the spinal cord
  • The underlying cause

Common symptoms include:

  • Pain

    • Chronic pain in the neck, shoulders, back, arms, or legs
    • Severe shoulder and neck pain, sometimes worsened by coughing or straining

  • Weakness and muscle wasting

    • Muscle atrophy (wasting), often beginning in the hands
    • Weakness that may spread to the arms and shoulders
    • Difficulty with fine hand movements (buttoning clothes, writing, typing)

  • Changes in sensation

    • Reduced ability to feel temperature extremes, such as heat and cold
    • Reduced or lost pain sensation in the hands or arms
    • Numbness, tingling, or “pins and needles” sensations

  • Headaches

    • Often in the back of the head or upper neck
    • May worsen with coughing, sneezing, or straining

  • Bowel and bladder changes (usually in later stages)

    • Difficulty controlling urination
    • Occasional loss of bowel control

  • Sexual dysfunction

Because these symptoms can mimic other neurological or orthopedic conditions (such as cervical disc disease, diabetic neuropathy, or multiple sclerosis), careful evaluation is important.

Potential Complications

Without appropriate treatment, syringomyelia can lead to progressive spinal cord damage. Possible complications include:

  • Paraplegia – paralysis of the legs and lower body
  • Quadriplegia – paralysis of all four limbs
  • Chronic severe pain
  • Swallowing difficulties (especially with syringobulbia)
  • Abnormal eye movements (nystagmus)
  • Long‑term disability affecting work, driving, and daily activities

In colder climates like West Michigan, reduced sensation in the hands can be especially dangerous—you may not feel frostbite or burns from hot surfaces or heaters in winter. Extra caution with temperature exposure is important for Grand Rapids residents with syringomyelia.

Diagnosing Syringomyelia in Grand Rapids

Because syringomyelia can resemble many other conditions, a thorough evaluation is essential. Diagnosis typically includes:

Medical History and Physical Examination

A neurologist or spine specialist will:

  • Review your symptoms and how they have changed over time
  • Ask about past spinal injuries, infections, or surgeries
  • Perform a detailed neurological exam to check:
    • Strength
    • Reflexes
    • Sensation
    • Coordination and balance

Imaging Tests

  • Magnetic Resonance Imaging (MRI)

    • The primary and most accurate test for syringomyelia
    • Shows the syrinx, its size, and location
    • Can detect associated conditions such as Chiari malformation, tumors, or spinal cord compression
    • Widely available at major Grand Rapids hospitals and imaging centers

  • Computed Tomography (CT) Scan

    • May be used if MRI is not possible or to further assess bone structures

  • Myelogram (now less common)

    • An X‑ray or CT scan performed after injecting contrast dye into the CSF
    • Used in select cases where MRI images are not sufficient

Nerve and Muscle Testing

  • Electromyography (EMG) and nerve conduction studies
    • Measure the electrical activity of muscles and nerves
    • Help distinguish syringomyelia from other nerve or muscle disorders

In Grand Rapids, these tests are typically coordinated by neurologists at Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health, often with referrals from primary care providers.

Treatment Options for Syringomyelia

Treatment is tailored to the cause, size of the syrinx, symptoms, and rate of progression. Management usually involves a team that may include neurologists, neurosurgeons, pain specialists, and physical therapists.

1. Careful Monitoring (“Wait‑and‑See” Approach)

If:

  • The syrinx is small
  • You have no or very mild symptoms
  • There is no evidence of rapid progression

Your doctor may recommend:

  • Regular neurological exams
  • Periodic MRI scans to monitor the syrinx

This conservative approach is common when syringomyelia is discovered incidentally on imaging done for other reasons.

2. Medications for Symptom Relief

There is no medication that can directly shrink a syrinx or cure syringomyelia. However, medications can help manage symptoms:

  • Pain relievers
    • Over‑the‑counter or prescription medications for chronic pain
  • Muscle relaxants
    • To reduce muscle spasms and stiffness
  • Neuropathic pain medications
    • Such as certain antidepressants or anti‑seizure medications for nerve pain

Pain management specialists in Grand Rapids can help tailor a regimen that balances relief with safety.

3. Surgical Treatment

Surgery is considered when:

  • Symptoms are significant or worsening
  • The syrinx is growing
  • There is a clear underlying cause that can be corrected (such as Chiari malformation, tumor, or severe spinal stenosis)

Common surgical approaches include:

Surgery for Chiari Malformation

  • Posterior fossa decompression
    • Removes a small portion of bone at the back of the skull and possibly part of the upper cervical spine
    • Creates more space for the cerebellum
    • Improves CSF flow at the base of the skull
    • Often leads to stabilization or improvement of the syrinx

Tumor or Compression Removal

If a spinal cord tumor or other mass is causing syringomyelia, neurosurgeons aim to:

  • Remove or reduce the tumor
  • Relieve pressure on the spinal cord
  • Restore more normal CSF flow

Shunting Procedures

In some cases, a neurosurgeon may place a shunt:

  • A thin tube is inserted into the syrinx to drain fluid into another part of the body, often the abdominal cavity.
  • The shunt includes a one‑way valve to prevent backflow.
  • Shunting is sometimes used when:
    • Other surgical options are not possible
    • Hydrocephalus (excess CSF in the brain) is also present

Treating Hydrocephalus

If hydrocephalus is present, it is usually treated first, often with a ventriculoperitoneal (VP) shunt to divert excess CSF from the brain. Correcting hydrocephalus can help normalize CSF flow and may improve or stabilize the syrinx.

In Grand Rapids, these neurosurgical procedures are typically performed at large hospital systems with specialized spine and brain surgery programs.

Living with Syringomyelia in Grand Rapids

With modern imaging and neurosurgical care, many people with syringomyelia can maintain a good quality of life, especially when the condition is diagnosed early.

Daily Management Tips

  • Avoid heavy straining when possible (heavy lifting, prolonged coughing without treatment)
  • Protect your hands from extreme temperatures—important in Michigan winters:
    • Wear insulated gloves outdoors
    • Use caution with hot water, stoves, and space heaters
  • Follow up regularly with your neurologist or neurosurgeon
  • Stay active within your limits:
    • Low‑impact exercise
    • Physical therapy to maintain strength and flexibility
  • Address pain early with your healthcare team to avoid chronic disability

Local Resources in Grand Rapids

  • Primary Care Providers
    • First step for evaluation of new symptoms such as unexplained weakness, numbness, or chronic neck and shoulder pain.
  • Neurologists and Neurosurgeons
    • Available at Spectrum Health/Corewell Health, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health.
  • Rehabilitation Services
    • Physical and occupational therapy programs to help with strength, coordination, and daily living skills.
  • Public Health and Support
    • Kent County Health Department and Grand Rapids Public Health can connect you with community resources, disability services, and support programs if syringomyelia affects your ability to work or function independently.

When to Seek Medical Help

Contact a healthcare provider in Grand Rapids promptly if you experience:

  • New or worsening weakness in your arms or legs
  • Loss of sensation or inability to feel heat or cold, especially in your hands
  • Persistent neck, shoulder, or back pain
  • Bowel or bladder control problems
  • Difficulty swallowing or changes in speech
  • New or unusual eye movements or dizziness

Early evaluation can help prevent long‑term complications and improve outcomes.

Key Points About Syringomyelia

  • Syringomyelia is the formation of a fluid‑filled cyst (syrinx) within the spinal cord.
  • The most common site is the cervical spine in the neck region.
  • There are three main types:
    • Associated with congenital brain defects (especially Chiari malformation)
    • Following spinal injury, tumor, or infection
    • Idiopathic syringomyelia, where the cause is unknown
  • Disrupted cerebrospinal fluid (CSF) flow plays a central role in syrinx formation.
  • Without treatment, syringomyelia may lead to paraplegia or quadriplegia and other serious complications.
  • Symptoms vary from person to person and may include pain, weakness, muscle wasting, sensory loss, headaches, and bowel/bladder changes.
  • MRI is the most important test for diagnosis.
  • Treatment options range from careful monitoring and symptom management to surgery to correct the underlying cause or drain the syrinx.
  • In Grand Rapids, specialized care is available through major hospital systems and local rehabilitation services, with public health resources to support long‑term management.