What is Arachnoiditis?

What is Arachnoiditis?

Arachnoiditis is a pain disorder caused by an inflammation of the arachnoid—a protective membrane surrounding the spinal cord's nerves. The condition can cause neurological symptoms, including chronic pain, muscle weakness, and, in severe cases, paralysis.

Three layers (meninges) protect your spinal cord and brain. The arachnoid is the middle layer, located between the dura mater and the pia mater. Spinal arachnoiditis occurs when the arachnoid is inflamed or damaged.

Arachnoiditis is rare; some cases are so mild they may not be reported. Damage to the arachnoid membrane is typically caused by a traumatic spinal injury. It is a progressive disorder, so the sooner you seek treatment, the better your chance of preventing debilitating outcomes.

Stages of Arachnoiditis

Stages

The progression of arachnoiditis is different for every person. From the outset, the condition may present as radiculitis—pain that starts in the spine and radiates along a nerve. You may experience a burning or stinging sensation and numbness in the lower back or legs.

As arachnoiditis progresses, pain can become more chronic, accompanied by muscle cramps or spasms. Inflammation and injury to the arachnoid can eventually lead to more serious issues, such as muscle weakness and nerve atrophy.

What is adhesive arachnoiditis?

Adhesive arachnoiditis is the most progressive and severe form of arachnoiditis. As a result of persistent arachnoid inflammation, scar tissue on the arachnoid causes the spinal nerves to stick together.

The complications of adhesive arachnoiditis can be debilitating. Many people have partial paralysis in the lower limbs and require a wheelchair.

Signs & Symptoms of Arachnoiditis

Symptoms

Arachnoiditis symptoms can develop slowly over a period of weeks or months after the inciting incident and continue progressing for years. People experience a range of symptoms that can come and go, but the most consistent symptom is pain.

Symptoms of arachnoiditis can include:

  • Mild to severe pain, similar to an electric shock in the back
  • Numbness or tingling in the legs
  • Muscle weakness in the lower extremities
  • Muscle cramps or spasms
  • Headaches/migraines
  • Fatigue
  • Joint pain
  • Tinnitus (ringing in the ears)
  • Difficulty sitting, especially for long periods, due to discomfort
  • Bladder issues
  • Bowel dysfunction
  • Vaginal dryness or erectile dysfunction

Symptoms of adhesive arachnoiditis can include loss of muscle strength and partial paralysis in the lower extremities. Some people with adhesive arachnoiditis have constant burning pain, impaired mobility, and cannot work.

If you are experiencing symptoms from arachnoiditis, a doctor or spine specialist at NewYork-Presbyterian can help with pain management and offer treatment options.

What Causes Arachnoiditis?

Causes

Inflammation of the arachnoid and the resulting arachnoiditis can be triggered by various causes, including:

  • Spinal surgery complications. Most arachnoiditis cases stem from punctures during lumbar spine surgeries, even though this is a rare complication.
  • Spinal cord injuries. Car accidents, serious falls, or other direct trauma to the spine can cause arachnoiditis.
  • Infection. Viral and bacterial infections, such as meningitis, HIV, or tuberculosis, can result in inflammation that can damage the spinal cord.
  • Chronic spinal compression. Ongoing compression of your spinal nerves, due to diseases such as spinal stenosis and degenerative disc disease, can lead to arachnoiditis.

Risk Factors

Risk Factors

In addition to the causes listed above, some diseases and other factors can raise your risk for developing arachnoiditis. These less commonly reported risk factors include:

Complications

Complications

Complications of arachnoiditis depend on the progression of the disease. Some complications can include:

  • Sexual dysfunction
  • Interrupted sleep, due to persistent pain, twitching or spasms
  • Loss of mobility in advanced stages of adhesive arachnoiditis
 

This content has been reviewed by the following medical editors.

Evan Johnson, PT

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Trust NewYork-Presbyterian for Arachnoiditis Care

The spine specialists at NewYork-Presbyterian are experts at recognizing the signs and symptoms of arachnoiditis. Our compassionate doctors will provide treatment options to help manage your constant pain and to prevent debilitating complications from the disease.

NewYork-Presbyterian can offer long-term solutions for patients living with arachnoiditis. Contact us today for an appointment.