Conventional Medical Treatments for Arachnoiditis

What is arachnoiditis?

Arachnoiditis is a health condition that involves inflammation of the arachnoid membrane, which is one of three meninges (protective membranes) that surround and protect the brain and spinal cord. Arachnoiditis typically causes shooting, stinging or burning pain in the lower back or lower limbs. Other neurological symptoms of arachnoiditis include, but are not limited to, abnormal skin sensations; numbness and weakness; muscle spasms or cramps; and bowel or bladder dysfunction. Paralysis can occur in severe cases.

Treatment options for arachnoiditis are limited. Treatments generally focus on reducing pain and improving function. Treatment options include medications and manual therapies. Surgery is not a recommended treatment for arachnoiditis because pain relief tends to be short-lived, and surgery can cause additional scar tissue or adhesions to form, worsening the condition.

Medications

• Opioid pain medications to reduce pain
• Muscle relaxants, such as baclofen and carisoprodol, to reduce spasms and cramps
• Antidepressants, such as duloxetine to reduce nerve pain or amitriptyline to aid with sleep
• Anticonvulsants, such as gabapentin or pregabalin, to reduce nerve pain
• Low-dose naltrexone to reduce inflammation
• Oral corticosteroids to reduce inflammation and prevent development of adhesions
• Acetazolamide to decrease the volume of lymph-related fluids, including spinal fluid, which reduces pain
• Lidocaine or ketamine infusions to reduce inflammation and pain

Manual therapies

• Physical therapy is a valuable treatment option for individuals with arachnoiditis. However, it should be done under the supervision of a doctor who specializes in arachnoiditis and with a physical therapist who is trained in the treatment of the condition. This is important because over manipulation of the spine can cause further damage. Stretching, hydrotherapy, inversion table therapy, and trampoline walking can be helpful therapies.
• Massage therapy can be helpful for arachnoiditis. Massage is thought to help spinal fluid and electrical charges pass through scarred areas.