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About spinal arachnoiditis

What is spinal arachnoiditis?

Arachnoiditis is a disease characterized by an acute inflammatory stage that occurs in the dura (exterior) and the arachnoid (interior), two of the three membranes that cover and protect the brain, the spinal cord and the nerve roots. The arachnoid contains the cerebrospinal fluid which circulates from the brain to the sacral area, about every two hours; it filters any invasion and usually responds first by inflammation and follows with a chronic stage life-lasting phase characterized by scarring and fibrosis. As a result, abnormal adhesion of nerve roots to the dural sac or to each other (clumping) occurs in a variety of configurations that alter significantly the function of the roots and the spinal cord. This causes a variety of neurological deficits and severe chronic neuropathic pain usually located in the area affected. In the pre-antibiotic era, severe cases of tuberculosis or syphilis invaded the spine causing arachnoiditis; currently these infections are rare, but it is important to mention that arachnoiditis will result in most patients affected by fungal meningitis from attempted epidural injections of tainted steroids.

What are the symptoms for spinal arachnoiditis?

Your symptoms depend on which nerves or areas of the spinal cord are damaged by inflammation. Arachnoiditis often causes intense Pain in the injured area, which can include the lower back, legs, buttocks, or feet.

The Pain may feel like an electric shock or a Burning sensation. It can spread across your back and down your legs. The Pain may get worse when you move.

Other common symptoms of arachnoiditis include:

  • numbness, tingling, or a pins-and-needles feeling
  • crawling sensation on the skin, as if ants are walking up and down your back
  • muscle cramps or spasms
  • weakness
  • trouble walking
  • severe headaches
  • vision problems
  • hearing problems
  • dizziness
  • nausea
  • bladder or bowel problems
  • trouble sleeping
  • fatigue
  • joint pain
  • loss of balance
  • sexual dysfunction
  • depression
  • ringing in the ears (tinnitus)
  • inability to sweat normally (anhidrosis)

In the most severe cases, the legs can become paralyzed.

What are the causes for spinal arachnoiditis?

Arachnoiditis often starts after surgery, injury, or epidural injection into the spine.

Causes include:

  • epidural steroid injections used to treat disk problems and other causes of back pain
  • epidural anesthesia, which is often used during labor and delivery
  • chemotherapy drugs, such as methotrexate (Trexall), that are injected into the spine
  • injury or complications during spinal surgery
  • spinal cord injury
  • bleeding in the spine due to injury or surgery
  • spinal tap (lumbar puncture), which is a test that removes a sample of cerebrospinal fluid from your spine to look for infections, cancer, and other nervous system conditions
  • myelogram, which is an imaging test that uses contrast dye and X-rays or CT scans to look for problems in your spinal cord
  • disk prolapse, which occurs when the inner part of a disk in your spinal cord bulges out
  • meningitis, which is a viral or bacterial infection that causes inflammation of the membranes around the brain and spinal cord
  • tuberculosis, which is a bacterial infection that can affect the lungs, brain, and spine

What are the treatments for spinal arachnoiditis?

Some of the treatments for this condition include:

Opioids: These medications can help relieve severe pain, but they should be used with caution. Opioids can cause side effects and may become addictive.

Physical therapy: Working with a physical therapist can help you regain movement in the affected parts of your body. Your physical therapist may use interventions such as exercise, massage, heat and cold treatment, and water therapy.

Talk therapy: Therapy can help with any mood changes related to arachnoiditis. Many people with this condition also experience depression. Therapy can help you cope with the emotional and physical pain of the disorder.

Surgery usually isn’t recommended to treat arachnoiditis. That’s because it relieves pain only temporarily, and it may cause more scar tissue to form.

What are the risk factors for spinal arachnoiditis?

Spinal cord injuries, meningitis of the spine, and spinal nerve compression

Is there a cure/medications for spinal arachnoiditis?

There isn’t a cure for arachnoiditis, and the condition can be difficult to treat. A few therapies can help relieve your pain and other symptoms. (see treatment section)

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