I have been dealing with my symptoms various ways for the past 5-6 yrs.I have a 10mm herniation & was advised to be very conservative consider surgury as a last resort if symptoms become so disabling there is nothing to loose by trying it.Because it is not a cure.It comes with its own risks,side effects,and may not stop your symptoms,or may do so only temporaily. Once I got the just of that I figured medicine,massage thearpy, injections in the neck do the same thing bring some short term relief with very miniml to no side effects. So that is the route I have chosen for now.Yet I st here tying with a nasty occipital headache,and chronic arm pain flared up today.I can just tell you my choice & why.Now as far as the surgury goes there are alot of sucess stories and temporary sucess stories, a chiari isnt a tumor and it doesnt really have a predicable course. It can sit like a silent volcanoe your whole life, erupt now & then, or become like Mt St Helens and then there is no longer a choice and surgury must be done,there is a site called ConquerChiari with alot of useful information