The Unexpected Danger of Back Pain Treatments — Arachnoiditis

7 min readMay 8, 2024

We Take a Closer Look at a Rare yet Serious Condition

If you suffer from low back pain and are considering trying some of the more risky treatments for low back pain you are doing to want to check out this article first!

Today, we’re delving into the mysterious world of arachnoiditis — a condition that might not be on everyone’s radar but it is one that definitely deserves our attention. We are going to investigate what this condition is all about, its symptoms, its causes, and most importantly, how understanding arachnoiditis can lead to better diagnosis and management of back pain.

Also, one of the major reasons we are talking about this condition is because knowing about this condition might change your mind about which back pain treatments you really want to try and which ones you might want to skip. Curious to learn more? Let’s check it out!

What is Arachnoiditis?

To start off, let’s get familiar with the term “arachnoiditis.” It’s a persistent inflammation of the arachnoid mater and subarachnoid space, primarily affecting the spinal cord.

All of that might sound like a mouthful, but in simpler terms, it’s an inflammation in the protective layers surrounding your spinal cord. This inflammation can lead to a range of symptoms, from severe back pain to nerve-related issues like paresthesia (tingling or numbness), limb weakness, and even bowel or bladder dysfunction.

Getting to Know the Meninges

Now, before we go any further, let’s take a quick tour of the spinal structures involved. The meninges are these crucial membranous layers protecting our central nervous system, including the brain and spinal cord.

Picture them as the body’s natural armor, shielding our delicate nerves from harm. These layers consist of the dura mater, arachnoid mater, and pia mater — all working together to keep everything in place.

Why do we need to know about these structures? Because all of these things together make up a very delicate system that isn’t particularly well protected. This leaves the system rather vulnerable to inflammatory conditions like arachnoiditis. Let’s see how that happens.

The Role of Inflammation

When arachnoiditis strikes, it is like a disruptor in this delicate system. The inflammation thickens the membranous layers, forms scar tissue, and can even lead to ossification (bone formation) of the arachnoid mater.

All of this spells major trouble for the nerves, as they become trapped and compressed, leading to pain, sensory changes, and even motor weakness. So, you can see why understanding arachnoiditis is crucial for accurately diagnosing back pain problems and effective managing these complications.

Types and Causes Of Arachnoiditis

When it comes to this scary inflammatory condition unfortunately we have more bad news: There’s also a more severe form of this condition known as adhesive arachnoiditis.

This more severe form is as unpleasant as it sounds. It generally involves scar tissue formation, nerve root clumping, and it can be incredibly painful and debilitating. But what causes all this trouble in the first place?

Well, the causes can be quite diverse — ranging from mechanical issues like trauma or disk herniation to chemical exposure from substances like contrast myelographic agents. Infections, inflammatory conditions, and even spinal surgery can also play a role.

The Link Between Steroid Shots And Arachnoiditis

Speaking of causes, did you know that long-term use of steroid shots can also lead to arachnoiditis? Yes, you heard that right!

While steroids can be a helpful tool in managing pain and inflammation, especially in conditions like arthritis or back pain, their prolonged use, particularly when injected into the spine, can cause complications.

When the arachnoid mater is repeatedly exposed to steroid injections in the spine the inflammatory process can be triggered. This inflammation then often leads to complications like scarring, eventually leading to arachnoiditis.

Clinical Presentation and Diagnosis

How does arachnoiditis show itself? Well, the symptoms can vary widely, making it a bit of a chameleon in the medical world. Some people might experience gradual back and leg pain with some tingling sensations, while others might face more severe issues like bladder or bowel dysfunction.

This variability in symptoms can make arachnoiditis somewhat challenging to diagnose (as if low back pain itself wasn’t challenging enough!), but imaging studies like MRI and CT myelography are often used to get a clearer picture.

How To Manage and Treat Arachnoiditis

So, you received a diagnosis of arachnoiditis. What can you do about it? Unfortunately, there’s no magic cure for this condition. Generally speaking, treatment focuses on managing symptoms and doing things to improve your quality of life.

Pain management is a significant aspect, often involving a combination of medications, physical therapy, and even psychological support. Doctors often prescribe medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, along with other options like duloxetine (an SSRI) or gabapentin for nerve-related pain.

Surgical Options For Treating Arachnoiditis

While surgery isn’t a cure-all solution, it can help in certain cases. Procedures like shunting, cyst fenestration, or myelotomy are options that are sometimes considered to alleviate symptoms.

However, the long-term outcomes of surgery aren’t always promising, and symptoms can return or even get worse over time. If you are considering one of these surgical options to manage your condition it is important to understand that surgery is a delicate balance between potential relief and the risks involved.

Prognosis and Complications

As with any medical condition, the prognosis for arachnoiditis varies. Some individuals may have a relatively stable course, while others may experience a progressive decline in function.

Complications can include chronic pain, neurological deficits, syringomyelia (a fluid-filled cyst in the spinal cord), and even loss of bladder or bowel control. It’s a challenging road, but with proper management and support, patients can find ways to cope and improve their quality of life.

Preventive Measures

While this article might seem quite gloomy and doom-y there is a little ray of hope when it comes to managing arachnoiditis. If you aren’t already struggling with this condition there are some things you can do to prevent it from happening in the first place.

When it comes to prevention, it’s all about minimizing risks. This includes being cautious and conservative with spinal procedures like MRIs and epidural steroid shots. It is also important to try and avoid infections and to use spinal medications carefully.

Incorporating healthy lifestyle habits like staying active, exercising, maintaining a healthy weight and avoiding unnecessary spinal interventions, can also play a role in prevention.

The Interdisciplinary Approach

Lastly, managing arachnoiditis often requires a team effort. A range of healthcare professionals, from primary care physicians to neurologists, pain management specialists, physical therapists, and mental health professionals, all play a crucial role in providing comprehensive care.

This interdisciplinary approach ensures that patients receive a holistic treatment plan tailored to their specific needs.


Arachnoiditis might not be a household name, but it’s a condition that deserves our attention. With its complex symptoms and challenging management, understanding arachnoiditis can make a significant difference in patient outcomes.

When it comes to managing and treating low back pain the guidelines recommend gold-standard, low risk treatments like physical therapy and exercise because they are both effective and have few side effects and complications compared to more risky treatments like steroid shots.

Knowledge is power. If you don’t know about the condition then you won’t know what sort of treatments you might want to avoid.




LivaFortis is an innovative global company that uses AI and biofeedback technology to make digital physical therapy accessible to all.