July is Arachnoiditis Awareness Month

**Note: I will be making a post soon to share my Adhesive Arachnoiditis story**

What is Arachnoiditis?

Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. Severe stinging, a “burning” pain, and neurological problems characterize the condition. Inflammation (swelling) of the arachnoid can lead to the formation of scar tissue and can cause the spinal nerves to stick together and malfunction (not work properly).

Causes:

The arachnoid can become inflamed because of irritation for one of the following reasons:

• Syman injury during spinal surgery, myelography, when a dye is injected into the spinal column
• exposure to chemicals that damage the meninges
• injections into the spine, such as following an epidural
• lumbar puncture
• viral and bacterial infections of the spine
• physical trauma to the spine, such as from a car accident
• cancer in or around the spine

A very small number of arachnoiditis cases are genetic.

Symptoms:

Arachnoiditis has varying symptoms and needs to be considered on a case by case basis, but in many people it affects the nerves connecting to the lower back and legs and the most common symptom is pain.  Arachnoiditis can cause the many symptoms including the following:

• Tingling, numbness or weakness in the legs
• Sensations that may feel like insects crawling on the skin or water trickling down the legs
• Severe shooting pain that can be similar to an electric shock sensation
• Muscle cramps, spasms and uncontrollable twitching
• Bladder, bowel and/or sexual dysfunction

Symptoms may become more severe or even permanent if the disease progresses. Many people with arachnoiditis are unable to work and have a significant disability because of constant pain.

Diagnosis:

Arachnoiditis can be difficult to diagnose, but tests such as a CT scan, MRI have helped with diagnosis. An EMG can assess the severity of ongoing damage to affected nerve roots by using electrical impulses to check nerve function.

Stages:

• First Stage — Radiculitis: The spinal nerve roots are inflamed in response to an event such as surgery in the area and the adjacent blood vessels distended (hyperaemia). The subarachnoid space is encroached upon by the swollen nerve roots and practically disappears. Deposition of collagen fibrils begins. Substances in the body involved with inflammation can sensitize nerves, and these nerves begin to fire abnormally.
• Second Stage — Arachnoiditis: The scar tissue increases, and the nerves begin to adhere to each other and the dura. At this stage they begin to resemble strands of overcooked spaghetti sticking to each other and local tissue.
• Third Stage — Adhesive Arachnoiditis: This involves complete encapsulation of the nerve roots by scar tissue with the subsequent smothering causing them to atrophy. The scarring prevents contact with surrounding spinal fluid and severe adhesive arachnoiditis may be obliterative, causing completely impeded CSF flow within the affected area. The isolated nerve roots are therefore starved of oxygen and nutrients and waste products of metabolism accumulate. There may be cysts containing CSF or oil-based myelogram dye. There may also be calcification or ossification of the affected tissues.

Treatment:

There is no cure for arachnoiditis.  Treatment is geared toward palliative care.  Most treatments for arachnoiditis focus on relieving pain and improving symptoms that impair daily activities. 

Genetic and Rare Disease Information Center: https://rarediseases.info.nih.gov/diseases/5839/arachnoiditis

Arachnoiditis Hope: http://arachnoiditishope.com/