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Arachnoiditis is a debilitating condition characterized by severe stinging
and burning pain and neurologic problems. It is caused by an inflammation of
the arachnoid lining—one of the 3 linings that surround the brain and spinal
cord. This inflammation causes constant irritation, scarring, and binding of
nerve roots and blood vessels.
The predominant symptom of arachnoiditis is chronic and persistent pain in
the lower back, lower limbs or, in severe cases, throughout the entire body.
Other symptoms may include:
- Tingling, numbness, or weakness in the legs
- Bizarre sensations such as insects crawling on the skin or water
trickling down the leg
- Severe shooting pain (which some liken to an electric shock sensation)
- Muscle cramps, spasms, and uncontrollable twitching
- Bladder, bowel, and/or sexual dysfunction
If the disease progresses, symptoms may become more severe or even permanent.
This disorder can be very debilitating, as the pain is constant and intractable.
Most people with arachnoiditis are unable to work and have significant disability.
Causes of Arachnoiditis
There are 3 main causes of arachnoiditis:
- Trauma/surgery-induced
Arachnoiditis has long been recognized as a rare complication of spinal surgery
(particularly after multiple or complex surgeries) or trauma to the spine.
Other similar causes include multiple lumbar punctures (especially if there
is a "bloody tap" with bleeding into the spinal fluid), advanced spinal stenosis,
or chronic degenerative disc disease.
- Chemically-induced
In recent years, myelograms
have come under scrutiny as being a possible cause
of this condition. A myelogram is a diagnostic test in which a radiographic
contrast media (dye) is injected into the area surrounding the spinal cord
and nerves. This dye is then visible on x-rays, CT, or MRI scans and used
by physicians to diagnose spinal conditions. There is now a concern that exposure
(especially repeated exposure) to some of the dyes used in myelograms may
cause arachnoiditis. Similarly, there is concern that the preservatives found
in epidural steroid injections may cause arachnoiditis, especially if the
medication accidentally enters the cerebral spinal fluid.
- Infection-induced
Arachnoiditis can also be caused by certain infections that affect the spine
such as viral and fungal meningitis or tuberculosis.
Treatment
There is no cure for arachnoiditis. Treatment options are geared toward pain
relief and are similar to treatments for other chronic pain conditions. Some
examples include the following:
- Pain medications such as NSAIDs, corticosteroids (orally or injected),
anti-spasm drugs, anti-convulsants (to help with the burning pain), and in
some cases, narcotic pain relievers. Some of these medications may be administered
through an intrathecal pump
which, when implanted under the skin, can administer
medication directly to the spinal cord.
- Physical therapy such as hydrotherapy, massage, and hot/cold therapy.
- Transcutaneous Electrical Nerve Stimulation (TENS) is a treatment
in which a painless electrical current is sent to specific nerves through
electrode patches that are placed on the skin. The mild electrical current
generates heat that serves to relieve stiffness, improve mobility, and relieve
pain.
- Spinal cord stimulator is a device that transmits an electrical signal
to the spinal cord for pain relief.
Surgery is not recommended for arachnoiditis because it only causes more scar
tissue to develop and exposes the already irritated spinal cord to more trauma.
Living with Arachnoiditis
Unfortunately, this condition can cause serious disability. It is never easy
to live with chronic pain. Not only does it adversely affect your body, it can
also cause mental stress as well. Sufferers of arachnoiditis are encouraged
to join support groups or find other therapeutic outlets for stress. Treatment
methods should be focused on pain relief and maintaining quality of life. More
research is needed about this and other chronic pain conditions so that someday
a cure may be found.
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