Arachnoiditis

What it is

Arachnoiditis is inflammation and scarring of the arachnoid, one of the thin membranes that wrap around the spinal cord and nerve roots. When this membrane becomes inflamed and scarred, the nerve roots can stick together and to the lining. It is uncommon, and it can follow spine surgery, an infection, significant trauma, or, rarely, certain injections.

What it feels like

Symptoms vary, but often include burning or stinging pain in the lower back and legs, numbness or tingling, muscle cramps, and in some people bladder or bowel changes. The pain can be persistent and is frequently described as nerve-type pain. Because it is a chronic condition, the focus is usually on managing symptoms and maintaining function rather than on a single cure.

How we evaluate it

An MRI can show nerve roots that are clumped or displaced, which supports the diagnosis when it fits your symptoms. I also look carefully for any other, more treatable cause of the same symptoms, since several conditions can overlap.

How we treat it

Treatment centers on a thoughtful, multidisciplinary plan to control pain and protect function: physical therapy to stay mobile, medications aimed at nerve pain, and a coordinated pain-management approach. Surgery generally does not help arachnoiditis itself and can sometimes aggravate it, so I am cautious and reserve any procedure for a separate, clearly treatable problem. The honest goal is meaningful relief and a full a life as possible, managed over time.

The science — for the curious

Arachnoiditis is a condition where doing less surgically is often doing more: because the problem is scarring around the nerves, operating into that scar tends to create more scar. That is why the most effective care is usually non-surgical and team-based, focused on calming nerve pain and keeping you active. Setting honest expectations — management rather than cure — is part of building a plan that actually helps.

Learn more

OrthoInfo — Low Back Pain: orthoinfo.aaos.org

OrthoInfo — Sciatica: orthoinfo.aaos.org

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.