Arachnoiditis treatments focus on alleviating chronic pain and symptoms that make it difficult to go about everyday activities. It is frequently advised to follow pain management, physiotherapy exercise, and psychotherapy programs. Surgical interventions are not oftentimes done because the results are often poor and only provide short-term relief.
There is no cure for arachnoiditis. Managing symptoms, improving quality of life, and reducing pain are the primary goals of treatment.
The following programs are frequently suggested by healthcare professionals:
- Pain management: Using nonsteroidal anti-inflammatory drugs, steroids, and narcotic painkillers (such as opioids).
- Physical therapy and hydrotherapy:
- Physical therapy may help reduce pain and prevent any future damage by strengthening the person’s muscles.
- Water therapy can temporarily relieve nerve pain, whereas massages may reduce muscle tension produced by pain.
- Some find that applying hot or cold compresses to the spinal cord or other painful body parts might temporarily reduce swelling.
- Psychotherapy (talk therapy):
- Living with chronic pain can be stressful. Therapy might help some people survive by changing how they think about their pain and providing emotional support.
- Support groups for those with chronic pain or rare diseases may help people feel less lonely. These groups help find new resources and beneficial lifestyle solutions and provide a space to share concerns.
- Leg and arm stretch: Prevent the lower back muscles from constricting or shrinking. If left unstretched, these muscles will exacerbate your back pain over time.
- Deep breathing: The spinal canal receives oxygen through deep and rapid breathing, which helps the area heal. The movement of spinal fluid improves. Though you should stand for deep breathing, it can be practiced while seated for activities, such as driving, dining, or watching TV.
Other treatment options
- Nerve stimulation: Treatments that stimulate the spinal cord or nerves may provide relief without the use of medication. There are two choices.
- Spinal cord stimulation: Can provide long-lasting pain relief by using a device to provide an electrical signal directly to the spinal cord.
- Transcutaneous electrical nerve stimulation: Delivers electricity to the location with pain to reduce discomfort and improve movement.
- Medicine: To manage pain, the doctor might prescribe medication, such as NSAIDs or stronger drugs; baclofen and muscle relaxants and gabapentin, pregabalin, and duloxetine.
What are the diagnostic tests for arachnoiditis?
The following additional medical tests could be ordered:
- MRI: Arachnoiditis can be diagnosed using an axial view with contrast, particularly when the three essential symptoms of nerve root inflammation are present: displacement, enlargement, and clumping.
- CT scan: Confirms an arachnoiditis diagnosis or rules out other possible medical conditions.
- Electromyogram: Determines the extent of nerve root damage.
- Spinal tap: Also called a lumbar puncture and examined the spinal fluid for the presence of infection.
- Blood tests: Elevated erythrocyte sedimentation rates and high levels of C-reactive protein could be signs of arachnoiditis. Interleukins, myeloperoxidase, a1-antitrypsin, and tumor necrosis factor could be increased.
What are the symptoms of arachnoiditis?
Pain is the most prevalent symptom of arachnoiditis, but there is no set pattern of symptoms. The severity of the symptoms can be mild to severe depending on which spinal nerve (part of the spine) is damaged.
Most commonly, arachnoiditis affects the nerves that connect to your legs and lower back (lumbar spine).
The following signs and symptoms of arachnoiditis include:
- Joint pain
- Bladder problems
- A severe shooting pain that may seem like an electric shock
- Leg tingling, numbness, or weakness
- Sensations, such as insects crawling on your skin (formication) or water trickling down your leg
- Difficulty sitting for a very long time
- Cramps, spasms, and/or involuntary twitching of the muscles
- Bowel dysfunction
- Sexual dysfunction, such as a dry vagina or erectile dysfunction
If the condition is severe, the symptoms can become permanent. Because of chronic pain, many people with arachnoiditis are unable to work and have a major disability.
What are the causes of arachnoiditis?
In many cases of arachnoiditis, practitioners are unable to determine the specific etiology. It is a rare disorder with several plausible origins, and the symptoms can take months or years to appear.
One of the following sources of irritation might cause the arachnoid to become inflamed:
- Complications from spinal surgery or multiple lumbar punctures: Even though arachnoiditis is a rare complication of these treatments, up to 90 percent of instances of arachnoiditis have been linked to lumbar spine surgeries.
- Direct trauma or injury to the spine: In rare situations, a fall or car accident may injure the spine and lead to arachnoiditis.
- Chemicals: Dye used in myelograms has been connected to some arachnoiditis cases. When performing a myelogram, a radiographic contrast media dye is administered into the region surrounding your spinal cord and nerves. The iofendylate radiographic contrast material that caused this, however, is no longer in use. Additionally, there is concern that the preservatives in epidural steroid injections could lead to arachnoiditis.
- Infection caused by bacteria or viruses: Arachnoiditis can be brought on by bacterial or viral diseases, such as HIV, tuberculosis, viral, and fungal meningitis, and meningitis.
- Chronic spinal nerve compression: Chronic spinal nerve compression brought on by advanced spinal stenosis (narrowing of the spinal column) or degenerative disc degeneration can result in arachnoiditis.
Less frequent causes of arachnoiditis include:
What is the arachnoiditis prognosis?
Arachnoiditis is mostly chronic (lifelong) and may advance. It grows worse over time. There is no cure, however, therapies and treatments can help manage symptoms.
People with severe arachnoiditis frequently have a poor quality of life because of their severe neurological symptoms and discomfort.
Some people with arachnoiditis may develop a disability and be unable to work a full-time job due to chronic pain and various neurological problems. However, many persons with arachnoiditis can walk and operate a vehicle with little difficulty.
Pain Management: arachnoiditis. https://www.webmd.com/pain-management/guide/pain-management-arachnoiditis
The agony of arachnoiditis pain. https://www.brainandlife.org/articles/named-after-its-inflammation-of-the-brains-spider-membrane-arachnoiditis
NIH GARD Information: Arachnoiditis. https://rarediseases.org/gard-rare-disease/arachnoiditis/
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