Spinal Problems Spinal Cord Arachnoiditis

What is arachnoiditis? Spinal arachnoiditis is a disorder that causes severe and chronic pain due to the inflammation of one of the three membranes (meninges) that surround the spinal cord. This membrane, called the arachnoid mater or arachnoid lining, is the middle layer of the meninges that protects the spinal cord.

Spinal arachnoiditis is also called adhesive arachnoiditis because the inflammation causes scar tissue in the arachnoid lining that adheres to the spinal cord and the nerve roots.

Causes of spinal arachnoiditis pain include:

  • Chronic spinal nerve compression
  • Complications from spinal surgery or other invasive procedures
  • Direct injury to the spine
  • Irritation from chemicals
  • Infection from bacteria or viruses.

Arachnoiditis Symptoms

Among arachnoiditis symptoms, the most common is chronic and persistent pain in the lower back and legs. In severe cases, however, arachnoiditis pain may affect the entire body. Other arachnoiditis symptoms may include:

  • Bladder, bowel or sexual dysfunction
  • Muscle cramps, spasms and uncontrollable twitching
  • Sensations such as insects crawling on the skin or water trickling down the leg
  • Severe shooting pain
  • Tingling, numbness or weakness in the legs.

In severe cases, spinal arachnoiditis may cause paralysis of the legs.

Types of Spinal Arachnoiditis

Spinal arachnoiditis can occur along various parts of the spinal cord, and can fall within one of three categories. The three types of lumbar arachnoiditis are the following:

  • Type I is an adhesion that destroys the nerve root sheath and may look like a herniated disc on X-ray.
  • Type II is an adhesion on the nerve roots, with the spinal canal remaining open.
  • Type III is complete obliteration of the subarachnoid space, which is the space between the arachnoid lining and the pia mater. This space is important because it houses the cerebrospinal fluid that nourishes the spinal cord.

Lumbar Arachnoiditis Treatment

What is arachnoiditis treatment like? Since spinal arachnoiditis has no cure, treatments typically focus on relieving pain and improving arachnoiditis symptoms that interfere with daily life. Treatment options include:

  • Arachnoiditis pain medications
  • Exercise
  • Physical therapy such as hydrotherapy, massage and hot/cold therapy
  • Spinal cord stimulator; an implanted device that transmits an electrical signal to the spinal cord for pain relief
  • Transcutaneous Electrical Nerve Stimulation (TENS); a painless electrical current that generates heat to relieve stiffness, improve mobility and relieve pain.

In most cases of lumbar arachnoiditis, doctors won’t recommend surgery, since these procedures cause more scar tissue, possibly leading to moretrauma of the already irritated spinal cord.

The prognosis for arachnoiditis pain is problematic and complicated, as the condition has no predictable pattern or severity of symptoms. Lumbar arachnoiditis can cause serious disability. Sufferers may want to consider joining support groups for people living with spinal arachnoiditis.

Resources

Circle Of Friends With Arachnoiditis Staff. (2007). Arachnoiditis information and support. Retrieved March 22, 2010, from http://www.cofwa.org/

Dawson, E., M.D. and Walsh, M., M.D. (2009). Arachnoiditis. Retrieved March 22, 2010, from http://www.spineuniverse.com/conditions/arachnoiditis

National Institute of Neurological Disorders and Stroke Staff. (2007). NINDS arachnoiditis information page. Retrieved March 22, 2010, from http://www.ninds.nih.gov/disorders/arachnoiditis/arachnoiditis.htm

Spine Dr. Staff. (n.d.). Arachnoiditis and syringomyelia. Retrieved March 23, 2010, from http://www.spine-dr.com/site/surgery/surgery_article4.html