ARACHANIODITIS:

Arachnoiditis refers to inflammation or injury to the membrane that separates the outer covering of the spinal cord (dura mater) from the surface of the spinal cord (pia mater). Cerebrospinal fluid bathes the spinal cord beneath this arachnoid membrane. Symptoms consists of persistent burning, aching through the day and evening unrelieved by movement or change in position.

Arachnoiditis has been an extremely difficulty problem. Most patients remain symptomatic for a lifetime. A few patients have shown progressive worsening of their condition even to the point of paraplegia. Fortunately this has been a rarity balanced by another group of patients who have shown resolution of their symptoms.

Support has been low impact aerobics, pain medicines including anti-inflammatory drugs, a variety of narcotics, anti-depressants and anti-seizure medicines. Emotional support and low impact aerobics have been elements that have been the most helpful in the group of patients that we have seen. Narcotics have been helpful but have also been problematic in the sense that the patients who rely on narcotics for pain relief tend to need a constantly increasing dosage.

Implants such as spinal cord stimulators or intrathecal narcotic pumps have been useful but have not been a panacea as there are problems associated with these modalities as well. The spinal cord stimulators have been most helpful for patients who have primarily peripheral pain. The intrathecal narcotic pumps have been more useful for patients with central pain that is along the spinal axis. Those types of surgery are associated with problems in the sense that there is tolerance with time and the implants become less effective. There has also been a significant risk of infection with the pumps due to the need to refill the reservoirs intermittently. Of course, these procedures are expensive. Physicians that might be helpful to you would be anesthesiologists who have an interest in chronic pain problems or physiatritst, that is, physicians specializing in rehabilitation medicine.

In the meantime, you can always search for other problems that might be contributing to the pain which might be correctable, in particular, instabilities or residual infections.