Spinal arachnoiditis is a painful condition of the spinal region. It involves inflammation of the arachnoid, which is the middle of the three membranes that protect the brain and spinal cord nerves.

Inflammation of the arachnoid layer around the spinal cord can start after surgery, spinal cord injury, infection, or irritation from chemicals injected into the spine.

This inflammation can cause pressure on the spinal nerves, leading to pain, and it may also damage the spinal nerves. Inflammation can also affect the flow of cerebrospinal fluid. This is the fluid that bathes and protects the brain and spinal cord.

Nerve irritation and pressure can cause neurological symptoms, including severe pain, intense headaches, numbness and tingling, and difficulty moving. Keep reading to learn more.

The location of your symptoms depends on which nerves or areas of the spinal cord have inflammation or damage. Spinal arachnoiditis can cause intense pain near the area of inflammation, which can include the lower back, legs, buttocks, or feet.

The pain may feel like an electric shock or a burning sensation. It can spread across your back and down your legs. The pain may get worse when you move.

Other common symptoms of spinal arachnoiditis include:

  • numbness, tingling, or a pins-and-needles feeling
  • crawling sensation on the skin, as if ants are walking up and down your back
  • muscle cramps or spasms
  • weakness
  • trouble walking
  • nausea
  • bladder or bowel problems
  • loss of balance

In the most severe cases, the legs can become paralyzed.

Spinal arachnoiditis is a rare complication of surgery, injury, or epidural injection into the spine.

Causes include:

  • epidural steroid injections to treat disk problems and other causes of back pain
  • epidural anesthesia, for use during labor and delivery
  • chemotherapy drugs, such as methotrexate (Trexall), that a doctor injects into the spine
  • injury or complications during spinal surgery
  • spinal cord injury
  • bleeding in the area of the spine or spinal cord
  • spinal tap or lumbar puncture, which is a test that removes a sample of cerebrospinal fluid from your spine to look for infections, cancer, and other nervous system conditions
  • myelogram, which is an imaging test that uses contrast dye and X-rays or CT scans to look for problems in your spinal cord
  • meningitis, which is a viral or bacterial infection that causes inflammation of the membranes around the brain and spinal cord
  • tuberculosis, which is a bacterial infection that can affect the lungs, brain, and spine
  • inflammation due to a tumor in or around the spinal cord

Arachnoiditis can be difficult to diagnose because its symptoms are similar to those of other nerve problems in the back. Knowing that you’ve recently had spinal surgery, an injury, or an epidural injection would raise your doctor’s suspicion of arachnoiditis.

To diagnose this condition, your doctor may perform a neurological examination. They’ll check your reflexes and look for any areas of weakness.

To confirm the diagnosis, doctors perform an MRI of the lower back. An MRI uses powerful magnets and radio waves to create detailed pictures of the inside of your body. Contrast dye can help highlight the arachnoid inflammation more clearly in the pictures.

If there’s suspicion of an infection, a cerebrospinal fluid sample may be necessary to identify the infectious organism and to guide treatment, such as antibiotics.

Treatment for acute arachnoiditis would include anti-inflammatory medication if it stems from an inflammatory condition, or it would include medication to treat an infection, such as antibiotics, antifungal therapy, or antiviral therapy. Treatment may involve surgery if there is bleeding or a tumor.

Several therapies can help alleviate your pain and other symptoms. Some of the treatments for this condition include:

  • Opioids: These medications can help relieve severe pain, but a person should use them with caution. Opioids can cause side effects and may become addictive.
  • Physical therapy: Working with a physical therapist can help you regain movement in the affected parts of your body. Your physical therapist may use various interventions, including exercise, massage, heat and cold therapy, and water therapy.
  • Talk therapy: Talk therapy can help with any mood changes related to arachnoiditis. Many people with this condition also experience depression. Therapy can help you cope with the emotional and physical pain of the disorder.

Surgery may be necessary if spinal arachnoiditis stems from inflammation resulting from cancer – the tumor may need removal.

Additionally, if arachnoiditis stems from an inflammatory response to bleeding around the spine and spinal cord, the blood may need to be surgically removed.

Arachnoiditis is an inflammatory or in infectious condition – it needs to be treated otherwise it will progress and may cause death.Arachnoiditis is an inflammatory or an infectious condition – it requires treatment otherwise it will progress and may cause death.

Yes, an MRI will show arachnoiditis.

Arachnoiditis pain can feel like chronic shooting pain, alongside numbness, tingling, stinging, or burning.

Spinal arachnoiditis causes chronic pain and neurological problems like numbness and tingling. Symptoms can range from mild to severe, and most people have mild to moderate symptoms.

The progression of arachnoiditis can be hard to predict. In some individuals, the symptoms can worsen over time. Others find that their symptoms remain stable for many years.

Although there isn’t a cure for this condition, treatments can help you manage pain and other symptoms.