Arachnoiditis

Arachnoiditis

Arachnoiditis is a chronic pain condition characterized by inflammation and scarring of the arachnoid. The arachnoid is the middle of three membrane coverings, or meninges, that envelop the spinal cord and brain.

When the arachnoid becomes inflamed through injury or illness, it adheres to the spinal cord and the nerve roots where they exit the spinal cord. This can result in severe, chronic pain in the low back. The low back pain often radiates into the legs and persists even when resting.

In addition to pain, arachnoiditis can also affect neurological function, including loss of motor function, numbness and tingling; loss of bladder and bowel function; sexual dysfunction; and in rare instances, paralysis.

Arachnoiditis can result from infection, trauma (including surgery, lumbar puncture and spinal anesthesia), or from exposure to a foreign substance such as the oil-based radiographic dye used for myelograms or from the introduction of blood into the epidural and intrathecal spaces.

In these cases, arachnoiditis occurs commonly in the lumbar region of the back due to the downward movement of dye and blood after a procedure is completed. Arachnoiditis is difficult to diagnose.

The treatment plan for arachnoiditis depends upon many factors, such as the severity of the disease, dysfunction and pain, the type and location of the pain, as well as patient’s age, ongoing medical conditions, and ability to tolerate other medical therapies. The doctor will take all of these factors into consideration when prescribing a treatment plan.

In general, the standard course of therapy for pain associated with arachnoiditis will follow the chronic pain treatment continuum, and may include medications, physical therapy, or nerve blocks. Neurostimulation may also be an option to treat unresolved neuropathic pain.