About arachnitis

What is arachnitis?

Arachnoiditis is a disease characterized by an acute inflammatory stage that occurs in the dura (exterior) and the arachnoid (interior), two of the three membranes that cover and protect the brain, the spinal cord and the nerve roots. The arachnoid contains the cerebrospinal fluid which circulates from the brain to the sacral area, about every two hours; it filters any invasion and usually responds first by inflammation and follows with a chronic stage life-lasting phase characterized by scarring and fibrosis. As a result, abnormal adhesion of nerve roots to the dural sac or to each other (clumping) occurs in a variety of configurations that alter significantly the function of the roots and the spinal cord. This causes a variety of neurological deficits and severe chronic neuropathic pain usually located in the area affected. In the pre-antibiotic era, severe cases of tuberculosis or syphilis invaded the spine causing arachnoiditis; currently these infections are rare, but it is important to mention that arachnoiditis will result in most patients affected by fungal meningitis from attempted epidural injections of tainted steroids.

What are the symptoms for arachnitis?

Symptoms of arachnoiditis can vary, but the most common is Pain in the lower back or legs that is often described as Burning or stinging pain. Others include:

  • Weakness, Numbness or tingling in the legs
  • Pins and needles sensation (paresthesia)
  • Joint pain
  • Ringing in the ears (tinnitus)
  • Fatigue
  • Bladder problems

As the disease progresses, symptoms may become more severe or even permanent. Many people with arachnoiditis are unable to work and suffer significant disability because they are in constant pain.

What are the causes for arachnitis?

Inflammation of the arachnoid can be triggered by a number of different irritants, including:

  • Spinal cord injury: In most cases, it is related to complications from spinal surgery or procedure such as epidural injection and spinal tap.
  • Infection: Viruses or bacteria such as bacterial meningitis of the spine can trigger the inflammation.
  • Spinal nerve compression: Chronic degenerative disc disease or advanced spinal stenosis (narrowing of spinal column) can lead to compression of the spinal nerves, triggering inflammation of the arachnoid.

What are the treatments for arachnitis?

There is no cure for arachnoiditis. Treatment options for arachnoiditis are similar to those for other chronic pain conditions. Most treatments focus on relieving pain and improving symptoms that impair daily activities. Often, health care professionals recommend a program of pain management, physiotherapy, exercise, and psychotherapy. Surgery for arachnoiditis is controversial, because outcomes can be poor and provide only short-term relief. Clinical trials of steroid injections and electrical stimulation are needed to determine whether those treatments are effective.

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