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Spinal Arachnoiditis: Causes, Symptoms, Diagnosis, & Treatment

QI Spine Clinic, 3 weeks ago

Spinal arachnoiditis is an inflammation of the arachnoid membrane, which forms the middle covering of the nerves of the spinal cord. It is a spinal cord disease that causes pain. It is a neurological condition and mostly affects the lumbar and thoracic nerves. It can also affect the entire spine in some cases. The symptoms may remain constant but may get worse with the progression of the disease. Read below to know more about what is spinal arachnoiditis, its causes, symptoms, and treatment. 

Causes of Spinal Arachnoiditis

Sometimes, it is not possible to determine the real cause of spinal arachnoiditis. It is a rare disorder and has several causes. The inflammation of the arachnoid occurs due to one of the following causes:
  • Complications due to Spinal Surgery: Most cases of spinal arachnoiditis are due to spinal surgery or multiple lumbar punctures. 
  • Direct Spinal Injury: In some cases, direct trauma or injury to the spine due to a fall or a vehicle accident can cause arachnoiditis. 
  • Chemical Dyes: Diagnostic tests such as myelograms use chemicals that can cause inflammation of the arachnoid. The due is injected into the area to get radiographic images. This dye is no longer used. 
  • Epidural Steroid Injections: In some patients, epidural steroid injections are given to relieve pain or other diseases. This may cause an infection or inflammation of the arachnoid membrane. 
  • Infection: Viral and bacterial infections such as HIV, meningitis, and tuberculosis can cause inflammation of the spinal layer. 
  • Compression of the Spinal Nerves: Degenerative disc disease or spinal stenosis can cause compression of the spinal nerves, which can lead to arachnoiditis. 
Other causes of spinal arachnoiditis include Guillain-Barre syndrome, ankylosing spondylitis, and autoimmune vasculitis.

Symptoms of Spinal Arachnoiditis

The most common symptom of spinal arachnoiditis is chronic pain. Therefore, it is also called chronic pain syndrome. The symptoms of spinal arachnoiditis also depend on the part of the spine affected, and symptoms can be mild to moderate.  Some important symptoms of spinal arachnoiditis are:
  • Severe pain in the back
  • Headache
  • Tingling and numbness in the legs
  • The Sensation is as if insects are crawling on the skin or water is trickling down the leg.
  • Uncontrollable twitching
  • Muscle cramps or spasms
  • Difficulty in sitting or standing for a long time
  • Sexual dysfunction in men and women
  • Bowel dysfunction
Symptoms become worse if it is not detected at an early stage. Many people find it difficult to perform daily living activities independently due to pain. 

Diagnosis of Spinal Arachnoiditis

Reliable tests are not available to diagnose spinal arachnoiditis because it is a rare condition. Diagnosis is based on imaging tests and symptoms like MRI and CT myelography. An orthopaedic doctor may order the following tests if you experience severe back pain and other associated symptoms:
  • MRI: This helps to get clear images of the bones and other structures. This may help to see the thickening of the nerve roots and clumping. 
  • Computed Tomography (CT) Myelogram: This test helps to establish a relationship between vertebrae and discs through the spinal cord, nerves, and nerve roots. 
  • Lumbar Puncture: This procedure is done to withdraw spinal fluid using a needle to test for the signs of infection in the spinal fluid. 
  • Electromyogram (EMG): This is done to assess the damage to the spinal nerves using electrical impulses. 

Treatment of Spinal Arachnoiditis

Treatment of spinal arachnoiditis aims to relieve pain, manage other symptoms, & improve quality of life. Treatment of spinal arachnoiditis includes the following:
  • Non-steroidal or anti-inflammatory drugs may be given to reduce severe pain and inflammation of the spine. 
  • Physical therapy is recommended to relieve stiffness and pain. Your doctor may also suggest hydrotherapy and massage to improve the strength of the muscles. 
  • Stretching and other exercises may be advised to enhance the strength of the back muscles. 
  • Adaptive equipment may be advised to improve mobility and reduce discomfort. This can also help the patient to become independent. 
  • Spinal cord stimulation may be done using a device that transmits electrical signals to the spinal cord and gives relief from pain. 

Conclusion

Spinal arachnoiditis is a rare neurological condition in which the arachnoid membrane covering the spinal nerves becomes inflamed. It causes severe pain in the back and can also affect the normal body functioning. It is a rare spinal cord disease and difficult to diagnose. There is no permanent treatment or cure. Symptoms can be managed with physical therapy, medications, and other exercises. Therefore, you must consult with an orthopaedic doctor if you experience severe pain in the back for a quick diagnosis and better management. 

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FAQs

Is Spinal Arachnoiditis a progressive condition?

Although it varies from person to person, certain instances may worsen over time, resulting in neurological deficiencies or increasing discomfort. Monitoring and therapy on a regular basis can help control the development.

 How does Spinal Arachnoiditis impair daily activities?

Chronic discomfort and decreased mobility, which make it difficult to do everyday tasks, are symptoms of spinal arachnoiditis. However, many individuals may have fulfilling lives if they receive the proper care and assistance.

Can Spinal Arachnoiditis be prevented?

Since prevention may not always be possible, minimizing risks during spinal procedures, avoiding unnecessary spinal injections, and promptly treating infections may help reduce the risk of the said condition.

Are there lifestyles that would help a patient to manage the disorder?

Yes, maintaining a healthy weight, engaging in mild exercise like yoga or swimming, and avoiding activities that put undue strain on the spine can all help to improve quality of life and lessen symptoms.

Are there advanced or experimental treatments for Spinal Arachnoiditis?

Advanced spinal implants and regenerative medicine are two examples of emerging treatments. To receive these procedures, a referral to experts at advanced spine care centres is usually required.

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