Is There a Cure for Adhesive Arachnoiditis?

Treatment options for arachnoiditis include:

• Managing pain similar to that of other chronic pain conditions
• Improving symptoms that impair daily activities
• Exercise
• Psychotherapy
• Physical therapy
• Biofeedback
• Imagery

Medications commonly used for the treatment of adhesive arachnoiditis include:

• Nonsteroidal anti-inflammatory drugs
• Opioids
• Duloxetine
• Gabapentin
• Pregabalin
• Muscle relaxants

Physicians don’t recommend surgery to cure this condition most likely due to the poor outcome. Additionally, there are high chances of recurrence after surgery. Surgery may be limited to reduce epidural infection.

Adhesive arachnoiditis is a type of arachnoiditis that is characterized by inflammation of one of the three meninges of the brain and spinal cord (the arachnoid membrane) and further adhesion of the neighboring tissues and membranes.

• The brain is surrounded by three membranes or meninges—the innermost pia mater, middle arachnoid, and outermost dura mater.
• The arachnoid mater is located outside the pia mater and is separated from it by a space called the subarachnoid space.
• In adhesive arachnoiditis, adhesion occurs between the meninges and nerve roots.

As the disease progresses, it blocks the flow of the cerebrospinal fluid, leading to a condition called chronic adhesive arachnoiditis.

The exact cause of arachnoiditis is unknown because it is a rare condition with multiple causative factors.

Three causes of adhesive arachnoiditis include:

1. Chemical
2. Mechanical
3. Infectious

Possible chemical causes of adhesive arachnoiditis include:

• Intentional or unintentional injections into the subarachnoid or subdural space where injectates might contain various neurotoxic substances such as:
  • Sulfite-containing preservatives
  • Other contaminants
  • Direct local anesthetic toxicity

Mechanical causes of adhesive arachnoiditis include:

• Accidental trauma
• Surgical interventions

Possible infectious causes of adhesive arachnoiditis include:

• Bacterial or viral infections such as
  • Tuberculosis
  • Human immunodeficiency virus

Other causative factors include:

• Previous trauma
• Spinal surgery
• Subarachnoid hemorrhage

Some commonly listed causes of adhesive arachnoiditis include:

• Injury during spinal surgery
• Trauma to the spine
• Cancer in or around the spine
• Epidural anesthesia
• Myelography (a diagnostic procedure in which a dye is injected into the spinal column)
• Chemicals injected into the spine
• Infections (viral or bacterial)
• Exposure of the brain to harmful chemicals
• Lumbar puncture
• Genetics (rare)

Less common causes of adhesive arachnoiditis include:

• Ankylosing spondylitis (inflammatory arthritis that affects the spine and large joints)
• Guillain-Barré syndrome (an autoimmune condition that affects the nerves)
• Autoimmune vasculitis
• Idiopathic (no known cause)

Ten symptoms of adhesive arachnoiditis include:

1. Muscle pain
2. Joint pain
3. Nerve pain
4. Burning or tingling
5. Muscle weakness
6. Fatigue
7. Neck stiffness
8. Unusual or involuntary body movements
9. Urinary problems
10. Headaches

Some complications of adhesive arachnoiditis include:

1. Paralysis
2. Urinary, bowel, and sexual dysfunction
3. Spinal fluid flow obstruction causes a headache, blurred vision, and tinnitus
4. Spinal fluid seepage leads to back pain and paraspinal tissue contractures
5. Joint pain
6. Muscle pain
7. Hormone imbalance
8. Cardiac arrest
9. Adrenal failure

This condition is usually long-term and progressive. Symptoms can vary in intensity from time to time. However, with consistent treatment, the person can lead a quality life.