Arachnoiditis: Causes of Back Pain

Arachnoiditis is the scarring of tissues surrounding the spinal nerve roots (where the nerves exit the spine between the vertebrae). Arachnoiditis can cause tingling of the legs, numbness, and pain. Previous back surgery is the most common cause of the scarring and the symptoms of this condition.

Arachnoiditis is a neuropathic disease caused by inflammation of the arachnoid membrane that insulates and provides protection for the spinal cord. The tissues in this layer may develop inflammation due to scarring from a surgical procedure (e.g. spinal fusion), unremitting compression of spinal nerves, trauma (injury) to the spine, infectious disease (viruses of bacteria), and/or adverse reactions to medications or toxins. Chronic inflammation in the arachnoid membrane can cause the buildup of scar tissue and adhesions that can cause the spinal nerves to bind up with each other. This sticking together, or binding up of the spinal nerves can cause numbness, tingling, pain, and other neurologic dysfunction related to the section of the spinal cord affected by arachnoiditis. This condition may be diagnosed with high definition medical scanning such as Magnetic Resonance Imaging (MRI), it is difficult to treat, and there is no known cure at this time.

Symptoms. Common symptoms of this chronic condition numbness and neuralgia (nerve pain). Scarring around the nerve roots of the lower lumbar spine may cause tingling and numbness in the legs. Arachnoiditis in the lumbar spine may also cause sexual dysfunction, and incontinence of the bladder and bowels. While arachnoiditis is not always restricted to the lumbar spine, it is most often found in the lower spine.

Treatment. Arachnoiditis is a difficult condition to treat, since the scarring, in the section of the spine affected, is irreversible. Treatment is restricted to moderating the symptoms such as pain and burning. Surgical intervention may provide some sort term relief from pain and stiffness, but long term relief from surgery is uncommon. Steroid injections to relieve some if the inflammation around the affected joints and nerve roots may provide some short term relief, but great caution should be taken before considering this therapy, especially if prior injections or surgery are thought to be a cause of Arachnoiditis. Patients should take an active role in considering which doctors to consult before agreeing to any treatments for this condition, since many primary care doctors and orthopedists are not thoroughly knowledgeable of it. The symptoms of Arachnoiditis (stiffness, numbness, burning, pain) are similar to other back problems such as nerve impingement or disc problems. Because of these similarities of symptoms, Arachnoiditis is sometimes misdiagnosed, and therefore, mistreated, sometimes exacerbating the condition. For this reason, patients will want to seek counsel from doctors knowledgeable in this spine condition.

Caution. Arachnoiditis is a horrible disease, and the possibility of developing it as the result of repeated spinal injections or spinal operations would be one of the reasons to consider against surgery (please know that I'm aware back surgery has brought many people back from despair to healthy functioning). If you want to know more about this disease and some related treatment options, you can view the Arachnoiditis Information page of the National Institute of Neurologic Disorders and Stroke NINDS.