Hi...I know most meds will not affect the pain from Chiari.
What u need to find out is, do u have a CSF obstruction, overcrowding...and other related chiari conditions as they too can affect the out come of surgery.
U may have some period of time where u can actually go for a hike, but it could be the pace, the elevation and the incline that may affect how u feel...u will have to see which is ok for u.....and factor in all the different possibilities.
Plus, b4 u start PT u should find out if u have Ehlers-Danlos...many with chiari do, and it will affect what type of PT u can do.....so , do get checked first.
I will say, most NS's will suggest surgery for chiari if, u developed a syrinx, have a really bad obstruction, breathing issues, swallowing issues, drop attacks...
Chiari in itself is life altering....and yes we do have to make changes to accommodate it to avoid the HA's....
U need to find a true chiari specialist, see a couple to find the one that is right for u...look at our list of Drs to get some names to research, the list is not meant as a referral.....
http://www.medhelp.org/health_pages/Neurological%20Disorders/DOCTORS-LIST-FOR-CHIARI-SYRINGOMYELIA/show/1062?cid=186
"selma"