Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. It is characterized by severe stinging, "burning pain", and neurological problems.
Symptoms
Arachnoiditis has no consistent pattern of symptoms, but in many people it affects the nerves connecting to the lower back and legs. The most common symptom is pain; but, arachnoiditis can also cause:
- Tingling, numbness, or weakness in the legs
- Sensations that may feel like insects crawling on the skin or water trickling down the leg
- Severe shooting pain that can be similar to an electric shock sensation
- Muscle cramps, spasms and uncontrollable twitching
- Bladder, bowel and/or sexual dysfunction
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.
Causes of Arachnoiditis
Inflammation of the arachnoid can lead to the formation of scar tissue and can cause the spinal nerves to stick together and malfunction. The arachnoid can become inflamed because of an irritation from one of the following sources:
- Direct injury to the spine
- Chemicals: Dye used in myelograms (diagnostic tests in which a dye called radiographic contrast media is injected into the area surrounding the spinal cord and nerves) have been blamed for some cases of arachnoiditis. The radiographic contrast media responsible for this is no longer used, however. Also, there is concern that the preservatives found in epidural steroid injections may cause arachnoiditis.
- Infection from bacteria or viruses: Infections such as viral and fungal meningitis or tuberculosis can affect the spine.
- Chronic compression of spinal nerves: Causes for this compression include chronic degenerative disc disease or advanced spinal stenosis (narrowing of spinal column).
- Complications from spinal surgery or other invasive spinal procedures: Similar causes include multiple lumbar (lower back) punctures.
Making the Diagnosis
Diagnosing arachnoiditis can be difficult, but tests such as the CAT scan (computerized axial tomography) or MRI (magnetic resonance imaging) have helped with diagnosis. A test called an electromyogram (EMG) can assess the severity of the ongoing damage to affected nerve roots by using electrical impulses to check nerve function.
Note: Myelograms with the radiographic contrast currently in use, combined with CAT scanning, are not considered to be responsible for causing arachnoiditis or causing it to worsen.
Treating Arachnoiditis
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.
Reviewed by the doctors at The Cleveland Clinic Neuroscience Center.
Edited by Charlotte E. Grayson, MD, WebMD, September 2004.
Portions of this page © The Cleveland Clinic 2000-2005
IMAGES
Arachnoiditis See brain scan pictures of Alzheimer's and types of dementia See ImagesHealth Solutions From Our Sponsors
Complete List
Top Arachnoiditis Related Articles
Brain Tumor: Warning Symptoms, Types, Causes, Treatments, and Cure
A brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
CT Scan (Computerized Tomography)
A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
Electromyogram (EMG)
Electromyogram or EMG is defined as a test that records the electrical activity of muscles. Normal muscles produce a typical pattern of electrical current that is usually proportional to the level of muscle activity. Diseases of muscle and/or nerves can produce abnormal electromyogram patterns.
Lumbar Puncture (LP or Spinal Tap)
A lumbar puncture or "LP" is a procedure whereby spinal fluid is removed from the spinal canal for the purpose of diagnostic testing. It is particularly helpful in the diagnosis of inflammatory diseases of the central nervous system, especially infections, such as meningitis. A lumbar puncture is also known as a spinal tap.
MRI (Magnetic Resonance Imaging Scan)
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Tuberculosis (TB)
Mycobacterium tuberculosis is the bacterium that causes tuberculosis (TB). Symptoms and signs of TB include bloody sputum, fever, cough, weight loss, and chest pain. Treatment depends upon the type of TB infection.