Do you sometimes experience unbearable, strange pain in your back or legs? It feels like an electric shock, or a burning sensation like your skin is burning? Sometimes this pain is so severe that you can't even sit in one place or sleep comfortably. Many people think that this kind of pain is just a simple backache. But sometimes the cause of this can be a more complex condition that many people have never heard of. Today, we are going to talk about such a rare, but life-threatening condition. That is Arachnoiditis .
Simply put, what is Arachnoiditis?
Arachnoiditis is a very painful condition caused by inflammation of the protective membrane that surrounds the nerves in our spine. Although the name may sound a bit complicated, let's keep it simple.
Imagine that our brain and spinal cord are two very valuable and sensitive organs. So to protect them from damage, nature has given us three layers of protective coverings. We call this covering system the meninges .
1. Dura mater: This is the outer, somewhat stronger, thicker covering.
2. Arachnoid mater: This is in the middle. It is a very delicate membrane, like a spider's web. The name arachnoiditis is derived from the name of this membrane.
3. Pia mater: This is the thin covering that is attached to the inside of the brain and spinal cord.
Arachnoiditis occurs when the arachnoid membrane in the middle of the spine becomes damaged and begins to swell. This swelling mainly affects the nerves in the lower back (lumbar spine) and the middle back (thoracic spine). The entire spine is rarely affected by this condition.
This is like three layers of wrapping around a valuable item. Something has happened to the middle layer of the wrapping and it is starting to press against the wires (nerves) inside.
What actually happens inside the body when arachnoiditis occurs?
When the arachnoid membrane swells, a chain of events begins. It's a complex process that starts with one thing and then causes more problems.
- Scar tissue: When there is swelling or damage somewhere, our body tries to heal it. In this process, just like a scar forms when our skin is injured, scar tissue begins to form around this delicate membrane.
- Nerve compression: This scar tissue causes the nerve roots to become compressed and tangled. When nerves that should normally be free to move become compressed, their function is impaired.
- Cerebrospinal fluid obstruction: The nerves inside our spinal cord float in a special fluid called cerebrospinal fluid. This is what nourishes and protects the nerves. When the space becomes narrowed due to scarring caused by arachnoiditis, the flow of this fluid is obstructed.
- Reduced blood supply: As the nerves become compressed and the surrounding tissue thickens, the blood supply to the nerves can decrease. This can damage the nerves and even cause them to gradually atrophy (nerve atrophy).
The end result of all this is unbearable chronic pain and nerve-related problems.
What is Adhesive Arachnoiditis?
As arachnoiditis progresses, it can become progressively worse. That scar tissue we talked about earlier and the nerves sticking together become more and more severe. This is called Adhesive Arachnoiditis . "Adhesive" means "sticky."
In this condition, the nerves become trapped and cannot function properly. This can lead to severe disability in some people. There are cases where the legs become paralyzed and the person cannot walk and uses a wheelchair . This does not happen to everyone. However, it is important to be aware of the possibility of this happening.
What are the symptoms of arachnoiditis?
Not everyone experiences the same symptoms of this disease. It varies depending on which part of the spinal cord is affected. Symptoms can be very mild for some, and very severe for others. But the most common and main symptom is pain.
Since it often affects the nerves in the lower back and legs, symptoms are most commonly seen in that area.
| Symptom | A simple explanation |
|---|---|
| Severe, throbbing pain | A sharp pain, like being hit by an electric shock or stabbed by a knife, starts in the back and travels down the legs. |
| Inflammation and numbness | The skin on your legs feels like it's burning, or your legs feel numb. |
| Unusual sensations | It feels like ants are running along your legs (formication) or like water droplets are falling. This is because the nerves are sending incorrect signals to the brain, even though nothing is actually happening. |
| Weakness in the legs | You feel a sense of weakness in your legs, difficulty walking, and difficulty climbing stairs. |
| Difficulty sitting in one place | The pain increases after sitting for a few minutes at a time, making it impossible to sit for long periods of time. |
| Muscle twitching and twitching | Muscle cramps in the legs, uncontrollable muscle twitching. |
| Urinary and bowel problems | Conditions such as loss of bladder control (neurogenic bladder) and constipation may occur. |
| Sexual immorality | Men may experience erectile dysfunction and women may experience vaginal dryness. |
These symptoms can worsen over time, and sometimes become permanent. This chronic pain makes it impossible for many people to continue working normally.
Why does this Arachnoiditis occur? What are the causes?
Often, it is difficult to find the exact cause of this disease. Because it is a rare disease, and there are several possible causes, sometimes symptoms appear only after a long time has passed since the triggering event.
However, there are several main reasons that have been found through research.
| Reason | Description |
|---|---|
| Spine surgery | About 90% of cases of arachnoiditis are caused by a complication of spinal surgery. However, this does not mean that everyone who has spinal surgery will develop it. It is a very rare complication. Even a small amount of bleeding during surgery can cause this membrane to swell. |
| Spinal cord injuries | This condition can occur due to a severe injury directly to the spine, such as a car accident or fall. |
| Chemicals | A dye used in the old myelogram test (which is no longer used) has been identified as a cause, and there is also concern that preservatives in some epidural steroid injections may also be a cause. |
| Infections | This condition can be caused by bacterial or viral infections, especially infections that affect the spinal cord, such as meningitis and tuberculosis. |
| Long-term nerve compression | This can also be caused by prolonged compression of the nerves due to degenerative disc disease or narrowing of the spinal canal (spinal stenosis). |
In addition, other medical conditions such as Ankylosing spondylitis and Guillain-Barré syndrome can also rarely cause Arachnoiditis.
How to diagnose this disease?
Arachnoiditis can be a bit challenging to diagnose because it is a rare condition and not all doctors have much experience with it. There is no single test that can confirm it for sure.
If a doctor suspects this disease, they will listen carefully to your symptoms, examine you, and refer you for these tests.
- MRI (Magnetic Resonance Imaging) scan: This can produce very clear images of the spine, nerves, and surrounding tissues. MRI can check for things like thickening or adhesions in the nerve roots.
- CT Myelogram: This involves injecting a special dye into the spinal cord and performing a CT scan. This allows for a clearer picture of the nerves and the space around them.
- Lumbar Puncture: This involves inserting a needle into the spine and taking a sample of cerebrospinal fluid for testing. This test is important to determine if an infection is causing the condition.
- EMG (Electromyogram) test: This is used to measure the severity of nerve damage. It uses electrical signals to see how the nerves are functioning.
The doctor comes to a final conclusion after considering both the information obtained from these tests and your symptoms.
What are the treatments for arachnoiditis?
Unfortunately, there is no cure for arachnoiditis. It is a chronic, lifelong condition. Therefore, the main goals of treatment are to control pain, manage symptoms, and improve quality of life.
A combination of several treatments is more effective than a single treatment.
- Pain management: This is the most important thing. Your doctor may prescribe medications ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) to stronger medications like opioids for severe pain. In addition, there are medications that are specifically designed for nerve pain. For example, medications like duloxetine, gabapentin, and pregabalin . If you have muscle spasms, you may also be given medications like baclofen .
- Physical therapy: Exercises under the guidance of an experienced physical therapist are very important. Hydrotherapy , which is exercises done in water, can be especially effective. Because the body feels less weight in water, you can exercise without putting pressure on your back and joints. Gentle massage and stretching can also help reduce pain.
- Spinal Cord Stimulation: This involves surgically implanting a small device into the body and sending subtle electrical signals to the spinal cord, which blocks pain signals from reaching the brain. While this is not suitable for everyone, it is a good way to control pain for some people.
- Psychotherapy: Living with chronic pain for a long time can increase the risk of depression, anxiety, and depression. Therefore, talking to a psychologist (talk therapy) can help you learn how to live with this pain mentally.
The most important thing is to talk to your doctor and come up with the best treatment plan for you. If one medication doesn't work, there are other options. So don't give up hope.
How to live with arachnoiditis?
Living with this disease is not easy, but by making small changes to your lifestyle and taking care of yourself, you can face this challenge.
- Avoid smoking: Smoking interferes with blood circulation in the body, which can further damage the nerves.
- Know your limits: Don't try to do too much in one day. Plan your work. Set aside time for rest and for yourself.
- Healthy Diet: Eating a nutritious diet is good for overall health.
- Exercise as much as possible: It may be difficult to exercise due to pain. But ask your doctor or physical therapist and engage in simple exercises that you can do.
- Get a good night's sleep: Pain can disrupt sleep, but getting a good night's sleep can go a long way in helping you cope with pain.
- Manage stress: Try to reduce stress through things like meditation, aromatherapy, and mindfulness.
- Join a support group: Joining a support group with people who are experiencing chronic pain like you can help you feel like you're not alone. You can also learn from the experiences of others.
- Limit alcohol: Alcohol can cause more problems with sleep and pain.
Living with chronic pain is both a physical and mental challenge. So never be afraid to stand up for yourself and ask for the help you need. It's best to find a doctor who is knowledgeable about arachnoiditis and work closely with him.
Take-Home Message
- Arachnoiditis is a rare condition that causes severe chronic pain caused by inflammation of the membrane that protects the nerves in the spinal cord.
- This is often caused by a complication of spinal surgery, but it can also be caused by other factors, such as accidents and infections.
- The main symptoms are electric shock-like pain, inflammation, numbness, weakness in the legs, and urinary problems.
- Although this disease cannot be completely cured, pain and symptoms can be successfully managed with medication, physical therapy, and other treatments.
- It is very important to work closely with your doctor, follow a treatment plan that suits you, and maintain a healthy lifestyle.
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