Staying on topic (regarding syrinx size), I have heard many concerns from other SM sufferers who have been told by their physicians that their syrinx is too small to be causing pain (or symptoms). I also remember an OB/GYN telling my mother that she had a tumor much to my mother's disagreement.
Regarding size... Let's just say I take an ice pick and a sewing needle. Now, for arguments sake, I am going to stick each of these two foreign objects into a disbelieving person's (translated - doctor's) thigh. Certainly the size of the ice pick would frighten (and hurt) most people. So, let's just put that away and go with the sewing needle. Why? Because, according to a LOT of physicians, that little needle will not cause symptoms. Yeah, right. My money is on "OUCH!"
Not being a MD, I can only say that I believe anytime you insert something into a mass of nerves, you're going to get pain. Period. So, if you ask my opinion about second opinions when you have a doctor who insists size "does matter", I am always going to suggest that you keep seeking until you find someone who understands YOU and YOUR PAIN.
That's what my mother did. By the way, she named the tumor Amy. :-)
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