Summary about Disease
Arachnoiditis is a painful and often progressive inflammation of the arachnoid, one of the membranes that surround and protect the brain and spinal cord. This inflammation can cause the arachnoid to thicken, scar, and stick together, potentially damaging the nerve roots within the spinal cord. This can lead to chronic pain, neurological problems, and other complications.
Symptoms
Symptoms of arachnoiditis vary in severity and manifestation. Common symptoms include:
Burning, stinging, or electric shock-like pain
Numbness, tingling, or weakness in the legs or feet
Muscle cramps, spasms, or uncontrollable twitching
Bowel, bladder, or sexual dysfunction
Headaches
Chronic fatigue
Cognitive problems (e.g., memory loss, difficulty concentrating)
Balance problems
Pain that is positional (worse when standing or sitting)
Causes
Arachnoiditis can be caused by various factors, including:
Infections: Bacterial or viral infections, such as meningitis.
Chemicals: Exposure to certain chemicals, including some myelography contrast agents (although modern agents are safer).
Spinal Surgery: Complications from spinal surgery.
Spinal Trauma: Injuries to the spine.
Spinal Injections: Especially epidural steroid injections.
Chronic Compression of Spinal Nerves: Due to conditions like spinal stenosis or disc herniation.
Medicine Used
There is no cure for arachnoiditis, and treatment focuses on managing pain and improving quality of life. Medications used may include:
Pain relievers: Over-the-counter or prescription pain medications, including opioids in some cases (used with caution due to risk of dependence).
Anti-inflammatory medications: Corticosteroids (to reduce inflammation) and NSAIDs.
Antidepressants: Certain antidepressants, such as tricyclic antidepressants and SNRIs, can help manage chronic pain.
Anticonvulsants: Medications used to treat seizures can also help with nerve pain.
Muscle relaxants: To help relieve muscle spasms.
Injections: Epidural steroid injections (although these are sometimes implicated as a cause, they may be used in some cases for short-term pain relief). Other treatments may include physical therapy, transcutaneous electrical nerve stimulation (TENS), and spinal cord stimulation.
Is Communicable
Arachnoiditis is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
While there's no guaranteed way to prevent arachnoiditis, some precautions may reduce the risk:
Minimize unnecessary spinal procedures: Weigh the risks and benefits of spinal surgeries and injections carefully.
Use sterile techniques: Ensure that any spinal procedures are performed using strict sterile techniques to prevent infection.
Treat infections promptly: Seek medical attention for any spinal infections promptly.
Proper posture and ergonomics: Practicing good posture and using ergonomic principles in daily activities and work settings can help reduce the risk of spinal problems that might lead to arachnoiditis.
How long does an outbreak last?
Arachnoiditis is a chronic condition. It is not an "outbreak" that resolves. Symptoms may fluctuate in intensity, but the underlying inflammation and scarring can persist indefinitely. Management focuses on long-term symptom control.
How is it diagnosed?
Diagnosis of arachnoiditis can be challenging. It typically involves:
Medical history and physical exam: A thorough review of the patient's symptoms and medical history.
Neurological examination: Assessing nerve function, muscle strength, reflexes, and sensation.
Imaging studies: MRI (magnetic resonance imaging) is the primary imaging technique used to visualize the spinal cord and arachnoid membrane. CT myelography (computed tomography with contrast dye injected into the spinal canal) may also be used.
Exclusion of other conditions: Ruling out other conditions that can cause similar symptoms, such as spinal stenosis, disc herniation, and multiple sclerosis.
Timeline of Symptoms
The timeline of symptoms can vary greatly depending on the cause and severity of arachnoiditis.
Acute onset: In some cases, symptoms may develop rapidly, especially after an infection, injury, or spinal procedure.
Gradual onset: In other cases, symptoms may develop gradually over months or years.
Progressive nature: Arachnoiditis is often a progressive condition, meaning that symptoms tend to worsen over time. However, the rate of progression can vary considerably.
Fluctuating symptoms: Symptoms may fluctuate in intensity, with periods of exacerbation (flare-ups) and remission.
Important Considerations
No cure: It is important to understand that there is no cure for arachnoiditis.
Multidisciplinary approach: Management requires a multidisciplinary approach involving physicians, physical therapists, pain specialists, and other healthcare professionals.
Psychological support: Chronic pain and disability associated with arachnoiditis can lead to depression, anxiety, and other psychological problems. Psychological support and counseling can be helpful.
Research: Ongoing research is aimed at finding new and more effective treatments for arachnoiditis.
Variability: The severity and progression of arachnoiditis vary greatly from person to person.