Arachnoiditis

Written by Edgar G. Dawson, MD

Arachnoiditis is a debilitating condition characterized by severe stinging and burning pain

and neurologic problems. It is caused by an inflammation of the arachnoid lining—one of the
3 linings that surround the brain and spinal cord. This inflammation causes constant irritation,
scarring, and binding of nerve roots and blood vessels.

The predominant symptom of arachnoiditis is chronic and persistent pain in the lower back,
lower limbs or, in severe cases, throughout the entire body. Other symptoms may include:

 Tingling, numbness, or weakness in the legs

 Bizarre sensations such as insects crawling on the skin or water trickling down the leg
 Severe shooting pain (which some liken to an electric shock sensation)
 Muscle cramps, spasms, and uncontrollable twitching
 Bladder, bowel, and/or sexual dysfunction

If the disease progresses, symptoms may become more severe or even permanent. This
disorder can be very debilitating, as the pain is constant and intractable. Most people with
arachnoiditis are unable to work and have significant disability.

Causes of Arachnoiditis
There are 3 main causes of arachnoiditis:

 Trauma/surgery-induced
Arachnoiditis has long been recognized as a rare complication of spinal surgery
(particularly after multiple or complex surgeries) or trauma to the spine. Other similar
causes include multiple lumbar punctures (especially if there is a "bloody tap" with
bleeding into the spinal fluid), advanced spinal stenosis, or chronic degenerative disc
disease.
 Chemically-induced
In recent years, myelograms have come under scrutiny as being a possible cause of
this condition. A myelogram is a diagnostic test in which a radiographic contrast
media (dye) is injected into the area surrounding the spinal cord and nerves. This dye
is then visible on x-rays, CT, or MRI scans and used by physicians to diagnose spinal
conditions. There is now a concern that exposure (especially repeated exposure) to
some of the dyes used in myelograms may cause arachnoiditis. Similarly, there is
concern that the preservatives found in epidural steroid injections may cause
arachnoiditis, especially if the medication accidentally enters the cerebral spinal fluid.
 Infection-induced
Arachnoiditis can also be caused by certain infections that affect the spine such as
viral and fungal meningitis or tuberculosis.

Treatment
There is no cure for arachnoiditis. Treatment options are geared toward pain relief and are
similar to treatments for other chronic pain conditions. Some examples include the following:
  Pain medications such as NSAIDs, corticosteroids (orally or injected), anti-spasm
drugs, anti-convulsants (to help with the burning pain), and in some cases, narcotic
pain relievers. Some of these medications may be administered through an intrathecal
pump which, when implanted under the skin, can administer medication directly to
the spinal cord.
 Physical therapy such as hydrotherapy, massage, and hot/cold therapy.
 Transcutaneous Electrical Nerve Stimulation (TENS) is a treatment in which a
painless electrical current is sent to specific nerves through electrode patches that are
placed on the skin. The mild electrical current generates heat that serves to relieve
stiffness, improve mobility, and relieve pain.
 Spinal cord stimulator is a device that transmits an electrical signal to the spinal cord
for pain relief.

Surgery is not recommended for arachnoiditis because it only causes more scar tissue to
develop and exposes the already irritated spinal cord to more trauma.

Living with Arachnoiditis

Unfortunately, this condition can cause serious disability. It is never easy to live with chronic
pain. Not only does it adversely affect your body, it can also cause mental stress as well.
Sufferers of arachnoiditis are encouraged to join support groups or find other therapeutic
outlets for stress. Treatment methods should be focused on pain relief and maintaining quality
of life. More research is needed about this and other chronic pain conditions so that someday
a cure may be found.

Updated on: 08/23/16