Arachnoiditis is a medical condition where there is inflammation of one of the membranes that cover and protect the nerves of the spinal cord, called the arachnoid. It is a pain disorder that is characterized by a burning pain, severe stinging, and other neurological issues.
Symptoms of Arachnoiditis
There is no pattern of consistency in the symptoms caused by arachnoiditis but the condition does seem to affect the nerves innervating the lower back and legs. The most common problem caused by the condition is pain, but it can also result in the following issues:
- Numbness, tingling sensation, or weakness in the legs.
- A feeling like water is trickling down the leg or that insects are crawling on the skin.
- An electrical shock sensation causing a severe shooting pain in the legs.
- Uncontrollable twitching.
- Muscle spasms and cramps.
- Loss of bladder and/or bowel control.
- Sexual dysfunction.
Arachnoiditis is a progressive disease which means that the symptoms may become more severe over time or even permanent, resulting in patients suffering from a significant disability. Patients are in constant pain and this causes them to be unable to continue working.
Causes
Arachnoiditis occurs due to inflammation of the arachnoid membrane which leads to the formation of scar tissue. This scar tissue causes the spinal nerves to stick to each other resulting in them becoming dysfunctional. Inflammation of the arachnoid membrane can occur due to various problems such as:
- Direct trauma to the spine.
- Viral or fungal meningitis, and even tuberculosis.
- A complication as a result of invasive spinal procedures or surgeries.
- Advanced spinal stenosis or chronic degenerative disc disease leading to chronic compression of the nerves of the spine.
- Exposure of the spinal nerves to contrast dyes that are used when performing investigations such as myelograms. These dyes are no longer used though, but there is a concern over preservatives that are found in epidural steroid injections which can cause arachnoiditis.
Management
Unfortunately, there is no cure for arachnoiditis but there are management options available which are similar to those used for the control of chronic pain.
Most therapies involve focusing on pain relief and improving the symptoms that impair daily functioning. These include the following:
- Pain management through the use of oral medications such as acetaminophen, non-steroidal anti-inflammatory agents (ibuprofen, naproxen), narcotics (codeine, tramadol, morphine), antidepressants (duloxetine, amitriptiline), anticonvulsants (gabapentin), and steroids (prednisone).
- Physiotherapy and exercise programs coordinated through a physical therapist. These healthcare professionals incorporate techniques and exercises to help strengthen the muscles around the affected area of the spine in order to offer more support.
- Psychotherapy through biofeedback therapy where affected patients are taught how to harness the power of their minds in order to become more aware of what is happening to their bodies. When this is achieved, the individual will gain more control over their health which can help to control and reduce the pain experienced as a result of this condition.
If these therapies are ineffective then surgery may be considered. This is controversial though because patient outcomes can be poor and only provide short-term pain relief. Steroid injections and electrical stimulation are potential therapies for this condition but further clinical trials need to be performed to assess their efficacy.