What is Arachnoiditis?

Arachnoiditis ** Provided by Spine Universe**

Written by Edgar G. Dawson, MD and Mary Claire Walsh

Arachnoiditis is a debilitating condition characterized by severe stinging and burning pain and neurologic problems. It is caused by an inflammation of the arachnoid lining—one of the 3 linings that surround the brain and spinal cord. This inflammation causes constant irritation, scarring, and binding of nerve roots and blood vessels. The predominant symptom of arachnoiditis is chronic and persistent pain in the lower back, lower limbs or, in severe cases, throughout the entire body. Other symptoms may include:

• Tingling, numbness, or weakness in the legs
• Bizarre sensations such as insects crawling on the skin or water trickling down the leg
• Severe shooting pain (which some liken to an electric shock sensation)
• Muscle cramps, spasms, and uncontrollable twitching
• Bladder, bowel, and/or sexual dysfunction

If the disease progresses, symptoms may become more severe or even permanent. This disorder can be very debilitating, as the pain is constant and intractable. Most people with arachnoiditis are unable to work and have significant disability.


Causes of Arachnoiditis
There are 3 main causes of arachnoiditis:

• Trauma/surgery-induced
  Arachnoiditis has long been recognized as a rare complication of spinal surgery (particularly after multiple or complex surgeries) or trauma to the spine. Other similar causes include multiple lumbar punctures (especially if there is a "bloody tap" with bleeding into the spinal fluid), advanced spinal stenosis, or chronic degenerative disc disease.
• Chemically-induced
  In recent years, myelograms have come under scrutiny as being a possible cause of this condition. A myelogram is a diagnostic test in which a radiographic contrast media (dye) is injected into the area surrounding the spinal cord and nerves. This dye is then visible on x-rays, CT, or MRI scans and used by physicians to diagnose spinal conditions. There is now a concern that exposure (especially repeated exposure) to some of the dyes used in myelograms may cause arachnoiditis. Similarly, there is concern that the preservatives found in epidural steroid injections may cause arachnoiditis, especially if the medication accidentally enters the cerebral spinal fluid.
• Infection-induced
  Arachnoiditis can also be caused by certain infections that affect the spine such as viral and fungal meningitis or tuberculosis.

Treatment
There is no cure for arachnoiditis. Treatment options are geared toward pain relief and are similar to treatments for other chronic pain conditions. Some examples include the following:

• Pain medications such as NSAIDs, corticosteroids (orally or injected), anti-spasm drugs, anti-convulsants (to help with the burning pain), and in some cases, narcotic pain relievers. Some of these medications may be administered through an intrathecal pump which, when implanted under the skin, can administer medication directly to the spinal cord.
• Physical therapy such as hydrotherapy, massage, and hot/cold therapy.
• Transcutaneous Electrical Nerve Stimulation (TENS) is a treatment in which a painless electrical current is sent to specific nerves through electrode patches that are placed on the skin. The mild electrical current generates heat that serves to relieve stiffness, improve mobility, and relieve pain.
• Spinal cord stimulator is a device that transmits an electrical signal to the spinal cord for pain relief.

Surgery is not recommended for arachnoiditis because it only causes more scar tissue to develop and exposes the already irritated spinal cord to more trauma.


Living with Arachnoiditis
Unfortunately, this condition can cause serious disability. It is never easy to live with chronic pain. Not only does it adversely affect your body, it can also cause mental stress as well. Sufferers of arachnoiditis are encouraged to join support groups or find other therapeutic outlets for stress. Treatment methods should be focused on pain relief and maintaining quality of life. More research is needed about this and other chronic pain conditions so that someday a cure may be found.

Updated on: 12/10/09

Tarlov Cysts: Teach the Teacher

When a cyst has been located on your spinal cord,  size, nerve compression and location will usually bring froward the question of  "are these cysts symptomatic or asymptomatic?" That decision can be made by determining if you present any, most of, or all of the following symptoms. Does the following list accurately explain any of the pain or complications you experience personally.


Symptoms of expanding/enlarging cysts occur due to compression of nerve roots that exit from the sacral area. Symptoms may include the following, dependent on the location of the cysts and the section of the spine they occur:

• Pain in lower back (particularly below the waist) and in buttocks, legs, and feet
  
• Pain in the chest, upper back, neck, arms and hands
  
• Weakness and/or cramping in legs and feet / arms and hands
  
• Parasthesias (abnormal sensations) in legs and feet or arms and hands, dependent on cyst locations
  
• Pain sitting or standing for even short periods of time
  
• Pain when sneezing or coughing
  
• Inability to empty the bladder or in extreme cases to urinate at all
  
• Bowel or bladder changes, including incontinence
  
• Swelling over the sacral (or cervical, thoracic, or lumbar) area of the spine
  
• Soreness, a feeling of pressure and tenderness over the sacrum and coccyx (tailbone), extending across the hip and into the thigh with cysts in the sacrum. Same feelings in upper sections of the spine dependent on cyst locations
  
• Headaches (due to the changes in the CSF pressure) and sometimes accompanied by blurred vision, pressure behind the eyes and optic nerve pressure causing papilledema (optic nerve swelling)
  
• Dizziness and feeling of loss of balance or equilibrium
  
• The feeling of sitting on a rock
  
• Pulling and burning sensation in coccyx (tailbone) area, especially when bending
  
• Sciatica
  
• Vaginal, rectal, pelvic and/or abdominal pain
  
  
  

The sciatic nerve is the longest nerve in the body and it originates at the S2, S3 level of the spinal column. It crosses the buttocks and extends down the leg into the foot. Sciatica is a syndrome that results in burning, tingling, numbness, stinging, electrical shock sensations in the lower back, buttocks, thigh, and pain down the leg and foot. Severe sciatica may also result in weakness of the leg and foot.

**Symptoms list Copied and provided by the Tarlov Cyst Disease Foundation. Link to the Foundation can be found in the link lists to the left of this blog page.**

Some of the issues I have personally faced include:

• repeated urine infections
• blood in the urine
• urinary stasis in both kidneys, marked more on the right than left kidney.
• urinary reflux
• bowel or bladder changes, including incontinence and loss of feeling
• pain in lower back (particularly below the waist) and in buttocks, legs, and feet
  
• pain in the chest, upper back, neck, arms and hands
  
• weakness and/or cramping in legs and feet / arms and hands
  
• soreness, a feeling of pressure and tenderness over the sacrum and coccyx (tailbone), extending across the hip and into the thigh with cysts in the sacrum. Same feelings in upper sections of the spine dependent on cyst locations
• headaches (due to the changes in the CSF pressure) and sometimes accompanied by blurred vision, pressure behind the eyes and optic nerve pressure causing papilledema (optic nerve swelling)
  
• dizziness and feeling of loss of balance or equilibrium
  
• the feeling of sitting on a rock
  
• pulling and burning sensation in coccyx (tailbone) area, especially when bending
  
• Sciatica
  
• vaginal, rectal, pelvic and/or abdominal pain 
  
  
  I'm sure you can see that when the symptom list is compared to my personal list the similarities are quite obvious.
  
  
  Review the symptom list and compare your pain or personal experiences to that list to help with determining if your cysts are indeed symptomatic. Be as honest as you can to ensure accuracy and that your claims can be scientifically supported by the specific location, size and the afflicted and compressed, nerve roots. 
  
  
  This experience could provide you with legitimate knowledge, and allow you to explain in plain English when describing your issues, and your beliefs to your physician. Although Tarlov Cysts are typically deemed to be asymptomatic, science cannot be ignored in the face of accurate and scientifically sound information.
  
  
  Sometimes we, the patient, have to be the teacher. To be a teacher you must be informed.