Understanding Arachnoiditis
Arachnoiditis - It sounds like something out of a horror film, conjuring up mental images of 8-legged furry nightmares but, in truth, Arachnoiditis has nothing to do with spiders at all. Arachnoiditis is an unusual pain disorder that is caused when one of the membranes surrounding the spinal cord become inflammed. While people who suffer Arachnoiditis may jest that they'd rather deal with the spiders, this condition is no laughing matter.
What is Arachnoiditis?
As we all know, the spinal cord is a delicate thing and something that our body goes to great lengths to keep protected. This is for good reason - the spinal cord is the main part of the information network, connecting our brain with the rest of our nervous system. Extending down from the brain and into the second lumbar vertebrae, it helps with motor control and sensory information, as well as coordinating our reflexes. Damage to the spinal cord can even result in loss of feeling and paralysis if the injury is extensive.
Nestled within the spinal column, the spinal cord is wrapped in membranes, one of which is called the arachnoid. While these membranes usually provide added protection to the delicate spinal cord and its surrounding nerves, in some cases, the arachnoid can become damaged or irritated. This can lead to a build-up of scar tissue and adhesions that may cause the nerves of the spinal cord to stick together. This can lead to numbness, tingling or extreme pain.
Causes of Arachnoiditis
There are a wide number of things that can cause damage to the arachnoid. It can be adversely affected by various chemicals, or may become inflamed due to a bacterial, parasitic, fungal or viral infection. Compression of the spinal nerves or complications resulting from spinal procedures or spinal surgery can also cause a flare-up of the arachnoid, putting you at risk of developing arachnoiditis. Some anesthetics and steroids can also cause an inflammation.
Symptoms and Diagnosis
The symptoms of arachnoiditis vary, though many experience a painful burning and stinging sensation in the lower back or their legs. This may or may not be accompanied by numbness or tingling in the area, twitches, spasms or debilitating muscle cramps. Some people who suffer with arachnoiditis experience complications with their bladder, bowel or with sexual function with the onset of arachnoiditis. In severe cases, the lower limbs may even become paralyzed.
Magnetic resonance imaging (MRI) is the most common study used to determine whether or not a person is suffering from arachnoiditis, due to it's noninvasive qualities and its excellent soft-tissue representations. Using MRI technology, doctors are able to observe if and where nerve roots are adhering to one another, often giving an appearance of a tethered spinal cord. An alternate form of diagnosis is computed tomography (CT) myelography in cases where the MRI studies are contraindicated.
How to Treat Arachnoiditis
Unfortunately, arachnoiditis has proven a very difficult condition to treat. In most cases, doctors focus mainly on comfort, pain reduction and the improvement of symptoms that interfere with day-to-day life and function. Due to the fact that few surgeries work, it is not a recommended alternative and most doctors focus on exercise, pain management, physiotherapy and psychotherapy to help the patient cope with their condition.
Fortunately, there are many studies going on, centered around arachnoiditis and different forms of pain management. While surgery is not usually an option, given the unpredictability of this condition, hopefully this will change in the near future.
Sources:
http://emedicine.medscape.com/article/336605-overview - Information on diagnosing Arachnoiditis
https://www.webmd.com/pain-management/guide/pain-management-arachnoiditis - Further information on Arachnoiditis
http://rarediseases.info.nih.gov/GARD/Condition/5839/Arachnoiditis.aspx
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