12062 Arachnoiditis
Informed by recognized medical guidance
Overview
Arachnoiditis is a rare and often painful condition where the arachnoid, a thin, protective membrane that surrounds the spinal cord and nerve roots, becomes inflamed and thickened. This irritation can cause the nerves to stick together and not work normally, leading to pain and other symptoms.
Key facts
- Arachnoiditis is not contagious.
- It often develops after spinal surgery, spinal injections, infection, or injury.
- Symptoms can vary widely from person to person.
- While there is no cure, many people manage symptoms with a care plan.
No, arachnoiditis is uncommon. Most doctors may see only a few cases in their career.
It can affect anyone, but it is more often seen in adults who have had spinal procedures. It appears slightly more often in women than men.
Symptoms
- Sudden loss of bladder or bowel control
- Numbness in the 'saddle area' (the area that would touch a horse saddle)
- Sudden severe weakness or paralysis in one or both legs
- New difficulty standing or walking
- ⚠Worsening leg weakness that affects daily tasks
- ⚠New or increasing bladder or bowel trouble
- ⚠Severe pain that does not go away
- ⚠Back pain with fever or chills
Common symptoms
- Burning or stinging pain in the lower back, buttocks, or legs
- Unusual tingling or numbness in the legs or feet
- A feeling of water running down the leg
- Muscle weakness or cramps
- Sensitivity to touch
- Bladder or bowel problems in more severe cases
Causes
Main causes
- Spinal surgery, especially repeated surgery
- Spinal injections, such as epidural steroid injections
- A spinal infection
- Trauma to the spine
- Complications from myelography, an older imaging test using contrast dye
Risk factors
- Having previous spinal surgery
- Receiving multiple spinal injections
- Having a spinal infection
- Having a spinal injury or bleeding in the spine
- Conditions that cause severe, ongoing inflammation
When to see a doctor
See a doctor urgently if:
- New bladder or bowel changes
- Rapidly worsening leg weakness
- Severe symptoms that limit your independence
Book a routine appointment if:
- Persistent back or leg pain
- Numbness or tingling that does not get better after a few weeks
- Muscle weakness that is not improving
Diagnosis
A doctor will listen to your story, examine your nerves and muscles, and review your history of spinal procedures or infections. Arachnoiditis is often confirmed with MRI, which shows detailed images of the spine and nerve roots.
Tests that may be done
- MRI of the spine (with contrast)
- Sometimes a CT scan or myelogram
- Electromyography (EMG) to check how well your nerves respond
- Physical examination of reflexes, strength, and sensation
What to expect at your appointment
The process can take time. There is no single blood test. Your doctor may refer you to a neurologist or pain specialist for a full assessment.
Treatment
Treatment focuses on managing symptoms and improving quality of life. Your care team may include a doctor, physiotherapist, psychologist, and pain specialist.
Self-care at home
- Pace your daily activities and avoid overdoing it
- Use positions or supports that reduce pain
- Gentle stretching and movement as guided by a therapist
- Apply heat or cold packs to ease muscle discomfort
- Maintain a consistent daily routine
Medical treatments
Medications may be offered to help with nerve pain, muscle spasms, or mood. Sometimes interventional procedures, such as nerve blocks, or treatments like physiotherapy, occupational therapy, and psychological support are recommended. Your care team will tailor the plan to your needs.
When is surgery considered?
Surgery is usually not recommended for arachnoiditis itself. It is sometimes considered for specific complications, such as releasing nerve tethering, but only after careful discussion with a specialist.
Living with this condition
Living with arachnoiditis usually means finding ways to adapt. Learn to read your body's signals and balance rest with activity. Support from family and friends helps.
Lifestyle tips
- Build a sustainable daily routine with breaks
- Use mobility aids if they help
- Talk openly with your care team
- Prioritise good sleep
- Explore relaxation techniques like breathing exercises or mindfulness
Diet and exercise
A healthy, balanced diet may help you feel better overall. Low-impact activities such as walking, swimming, or cycling, if comfortable, can keep muscles strong without jarring the spine. Work with a physiotherapist to find what is safe for you.
Mental health and emotional wellbeing
Living with chronic pain can be exhausting and distressing. It is normal to feel frustrated, worried, or low. Please speak with your doctor about mental health support. You are not alone.
Prevention
You cannot always prevent arachnoiditis, but reducing unnecessary spinal procedures and making sure any spinal infection is treated quickly may lower the risk. If you are about to have spinal treatment, ask your healthcare team why it is needed and what the risks are.
Complications
If left untreated
- Progressive nerve damage that may cause permanent weakness or loss of function
- Chronic severe pain that makes daily life harder
- Bladder and bowel difficulties
- Reduced mobility
Long-term outlook
Living with arachnoiditis is different for everyone. Many people find meaningful ways to manage pain and maintain their independence. With the right support team, you can live well even with chronic symptoms. Focus on what you can control and take each step at a time.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.