Arachnoiditis is a rare pain disorder caused by inflammation (swelling) of the arachnoid, one of the membranes that surrounds and protects the nerves of your spinal cord.
Arachnoiditis causes severe stinging, “burning” pain and neurological problems. It most commonly affects the nerves of your lumbar (low back) and thoracic spine (middle back). It rarely affects your entire spine.
The course of this condition remains highly variable since arachnoiditis can be either a static (stays the same) or progressive (gets worse over time) disease.
What are the symptoms of arachnoiditis?
Arachnoiditis has no consistent pattern of symptoms, though the most common symptom is pain. The symptoms can vary based on which part of your spine (which spinal nerve) is affected and can range from mild to severe.
Arachnoiditis most commonly affects the nerves connecting to your lower back and legs (lumbar spine).
Symptoms may become more severe or even permanent if the condition progresses. Many people with arachnoiditis are unable to work and have a significant disability because of constant pain.
How is arachnoiditis treated?
Unfortunately, there’s no cure for arachnoiditis. Treatment mainly focuses on alleviating pain, improving quality of life and managing symptoms.
Treatment options for arachnoiditis are similar to those for other chronic pain conditions. Often, healthcare professionals recommend a program of the following:
Physical therapy, such as hydrotherapy and massage.
Stretching and range-of-motion exercises.
Psychotherapy (talk therapy).
Adaptive equipment or technology to help with mobility and comfort.
Specific types of treatment include:
Spinal cord stimulation: A spinal cord stimulator is a device that transmits an electrical signal to your spinal cord for pain relief.
Medications: Your provider may recommend medications, such as NSAIDs or stronger medications, to help manage pain. They may also prescribe other drugs, such as duloxetine, gabapentin, pregabalin, and muscle relaxants, such as baclofen.
How is arachnoiditis diagnosed?
Arachnoiditis can be difficult to diagnose since it’s rare and not all healthcare providers are familiar with it. There are also no reliable laboratory tests or imaging test findings to definitively diagnose arachnoiditis. Providers base the diagnosis on clinical presentation and symptoms, along with supporting MRI or CT myelography.
What tests will be done to diagnose arachnoiditis?
If you have symptoms of arachnoiditis, your healthcare provider may order the following tests to help diagnose it:
Magnetic resonance imaging (MRI): MRI is a painless test that produces very clear images of the organs and structures within your body. It uses a large magnet, radio waves and a computer to produce detailed images. Your provider will look for certain signs of arachnoiditis, such as nerve root thickening and clumping, in an MRI of your spine.
Computed tomography (CT) myelogram: A myelogram is an imaging procedure that examines the relationship between your vertebrae and discs, through your spinal cord, nerves and nerve roots. Your provider will look for certain signs of arachnoiditis.
Lumbar puncture: Sometimes a lumbar puncture, in which spinal fluid is withdrawn with a needle for testing, is important if arachnoiditis may be due to infections in the spinal fluid.
Electromyogram (EMG): An EMG can help your provider assess the severity of the damage to the affected nerve roots by using electrical impulses to check nerve function.
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