Arachnoiditis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Arachnoiditis
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Chronic pain, neurological deficits, muscle weakness, numbness, tingling
Complications	Paralysis, bladder dysfunction, sexual dysfunction
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Spinal surgery, spinal injury, infection, chemical irritation
Risks	Spinal injections, spinal surgery, trauma
Diagnosis	MRI, CT scan, myelogram
Differential diagnosis	Multiple sclerosis, spinal stenosis, herniated disc
Prevention	N/A
Treatment	Pain management, physical therapy, surgery
Medication	Analgesics, anti-inflammatory drugs, corticosteroids
Prognosis	Variable, often chronic
Frequency	Rare
Deaths	N/A

Arachnoiditis is caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. 

Arachnoiditis

Pathophysiology

The arachnoid can become inflamed because of an irritation from chemicals, infection from bacteria or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. 

Adhesions

Inflammation can sometimes lead to the formation of scar tissue and adhesions, which cause the spinal nerves to “stick” together.

CT arachnoiditis

Symptoms

• If arachnoiditis begins to interfere with the function of one or more of these nerves, it can cause a number of symptoms, including chronic and persistent pain, ¬†numbness, tingling, and a characteristic stinging and burning pain in the lower back or legs.¬†
• Some people with arachnoiditis will have debilitating muscle cramps, twitches, or spasms.¬†
• It may also affect bladder, bowel, and sexual function.¬† In severe cases, arachnoiditis may cause paralysis of the lower limbs.

Arachnoiditis in lumbar spine

Prognosis

• Arachnoiditis is a disorder that causes chronic pain and neurological deficits and does not improve significantly with treatment. ¬†
• Surgery may only provide temporary relief.¬† The outlook for someone with arachnoiditis is complicated by the fact that the disorder has no predictable pattern or severity of symptoms.

Treatment

• Arachnoiditis remains a difficult condition to treat, and long-term outcomes are unpredictable.¬†
• Most treatments for arachnoiditis are focused on chronic pain relief and the improvement of symptoms that impair daily function.¬†
• A regimen of pain management, physiotheraphy, exercise, and psychotheraphy is often recommended.¬†
• Surgical intervention is controversial since the outcomes are generally poor and provide only short-term relief.
• Arachnoiditis Information Page at NINDS
• Arachnoiditis; Familial spinal arachnoiditis (subtype); Spinal tuberculous arachnoiditis (subtype) at NIH's Office of Rare Diseases

• Online Mendelian Inheritance in Man (OMIM) Spinal arachnoiditis -182950

• Arachnoiditis UK website offering information and a Facebook Support Group
• The Official YouTube site of the End Depo-Now Campaign

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