Arachnoiditis

THE CLINICAL SYNDROME

Arachnoiditis is a term used to describe thickening, scarring, and inflammation of the arachnoid membrane. These abnormalities may be self-limited or may lead to compression of the nerve roots and spinal cord. In addition to pain, the patient with arachnoiditis may experience associated numbness, weakness, loss of reflexes, and bowel and bladder symptomatology. The cause of arachnoiditis is unknown but may include herniated disc, infection, tumor, myelography, spine surgery, or intrathecal administration of drugs. Anecdotal reports of arachnoiditis after epidural and subarachnoid administration of methylprednisolone acetate preparations have surfaced.

SIGNS AND SYMPTOMS

The patient suffering form arachnoiditis will complain of pain, numbness, tingling, and paresthesias in the distribution of the affected nerve root or roots. Patients may also note weakness and lack of coordination in the affected extremity. Muscle spasms and back pain as well as pain referred into the buttocks are common.

ecreased sensation, weakness, and reflex changes are demonstrated on physical examination. Occasionally, a patient suffering from arachnoiditis will experience compression of the lumbar spinal cord, nerve roots, and cauda equina resulting in myelopathy or cauda equina syndrome. Patients suffering from lumbar myelopathy or cauda equina syndrome due to arachnoiditis will experience varying degrees of lower extremity weakness and bowel and bladder symptomatology.

Arachnoiditis may result in lumbar myelopathy or cauda equina syndrome.

TREATMENT

There is little consensus as to how best treat the patient suffering from arachnoiditis, and most efforts are aimed at decompressing nerve roots and spinal cord and/ or treating the inflammatory component of the disease. Epidural neurolysis and/or caudal administration of steroids may help decompress nerve roots if the pathology is localized. More generalized cases of arachnoiditis will often require surgical decompressive laminectomy. The results of all modalities are disappointing at best. Underlying sleep disturbance and depression are best treated with a tricylic antidepressant compound such as nortriptyline, which can be started at a single bedtime dose of 25 mg. Neuropathic pain associated with arachnoiditis may also help provide symptomatic relief. Opioid analgesics should be used with caution if at all.

Low intensity laser therapy as well as a coordinated wellness program is also effective in treating this disorder.

Low Intensity Laser Therapy (LILT)

The low intensity Laser (LILT) sends photons (light) into the injured tissues and can penetrate two to three inches to treat affected areas. It uses a natural enhancement of the cellular machinery that can and has been dynamically measured in published studies to promote healing without burning affected tissue. Once the photons find the injured tissues, they stimulate and energize the cells to repair and strengthen at a remarkable rate. The treatment does not hurt, takes about 30 minutes and is very cost advantageous.

Wellness Program

A wellness program whichindividualizes treatment for age, performance and function has been shown in pilot studies to improve the overall health and well being of the individuals evaluated. A well conceived dietary and supplementary regimen based on scientific age–related decline in certain necessary compounds can improve quality of life, correct the ravages of hormone imbalance, balance critical neurotransmitter function without resorting to powerful drugs for depression that often have unfavorable side-effect profiles and restore vitality and youth in daily exercise routines. Furthermore, when wellness products are utilized with success, individuals often seek less costly interventions including unnecessary surgeries and narcotic options to treat pain. For more information go to www.drpwellness.com.