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Arachnoiditis
From Wikipedia, the free encyclopedia
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This article may require cleanup to meet Wikipedia's quality standards. Please discuss this issue on the talk page or replace this tag with a more specific message. This article has been tagged since February 2007. |
| ICD-10 | G03.9 |
|---|---|
| ICD-9 | 320-322 |
Arachnoiditis describes a neuropathic disease caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. The arachnoid can become inflamed because of an irritation from chemicals, infection from bacteria or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Inflammation can sometimes lead to the formation of scar tissue and adhesions, which cause the spinal nerves to "stick" together. If arachnoiditis begins to interfere with the function of one or more of these nerves, it can cause a number of symptoms, including numbness, tingling, and a characteristic stinging and burning pain in the lower back or legs. Arachnoiditis has no consistent pattern of symptoms, but it more frequently affects the nerves that supply the lower back and legs.
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Arachnoiditis is a chronic pain disorder and while there is no known cure at this time some quality of life may be redeemed through pain management routines. Prognosis is often complicated by the lack of a clear relationship between time of onset and pattern of symptoms. Aging and pre-existing spinal disorders can make accurate prognosis problematic. For many, arachnoiditis is a disabling disease that causes chronic pain and neurological deficits.
Arachnoiditis remains a difficult condition to treat, and long-term outcomes are unpredictable. Most treatments for arachnoiditis are focused on pain relief and the improvement of symptoms that impair daily function. A regimen of pain management, physiotherapy, exercise, and psychotherapy is often recommended. Surgical intervention is controversial since the outcomes are generally poor and provide only short-term relief. Clinical trials of steroid injections and electrical stimulation are needed to determine the efficacy of these treatments. Steroid injection as a retardant for arachnoiditis pain is highly frowned upon. In all actuality it can make the situation worse if injected.
Recent research has indicated that a group of chemicals called cytokines that are produced by various cells in the body may be responsible for generating the pain response. Medications that affect the release of cytokines or block the action of cytokines may reduce the pain response. Various anti-cytokine medications are now being used to treat painful disease states such as Rheumatoid Arthritis and Crohn's Disease. In a recent study the anti-cytokine medication, Thalidomide, is being evaluated for its effect in treating pain associated with Arachnoiditis.
- Circle Of Friends With Arachnoiditis (COFWA)
- American Chronic Pain Association (ACPA)
- National Chronic Pain Outreach Association (NCPOA)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- National Institute of Dental and Craniofacial Research (NIDCR)
- Arachnoiditis
- eMedicine