The condition arachnoiditis might make you think of the term arachnophobia ― or fear of spiders. Characterized by severe stinging or burning pain of the spinal nerves, arachnoiditis is also derived from the Greek word “arachne” for spider because the tissues that protect your spine are gauzy and thin like a spider web.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Arachnoiditis is inflammation of these delicate tissues surrounding the spinal nerves, which leads to the formation of scar tissue. It can be caused by spinal surgery, direct injury to the spine, chemicals from older diagnostic tests, chronic compression of the spinal nerves, and occasionally from a virus or bacteria.
Fortunately, there are some new treatments that are offering more optimistic prospects for pain relief in this very difficult to treat condition.
“Sometimes people describe the pain of arachnoiditis as vivid ‘electrical’ sensations that don’t follow the path of any nerve,” says pain management specialist Robert Bolash, MD. “It can be a relentless and progressive pain syndrome that really brings down your morale. Thankfully, there are two newer ways to treat this condition today without the use of long-term opioid prescriptions.”
Treatment of nerve pain with opioids is almost always a bad option, as these medicines eventually stop working and lead to side effects, including addiction.
Two new treatments
Two contemporary treatments for arachnoiditis with a growing body of evidence are spinal cord stimulation (SCS) and infusion of the pain reliever ziconotide into the spinal space. Cleveland Clinic was recently involved in a multicenter clinical trial that compared six months of treatment with SCS in patients with chronic pain following back surgery. Some of the subjects reported marked improvement in pain, which allowed them to resume activities they once avoided because of the pain.
“In last five years or so, implanted spinal cord stimulators have come a long way in terms of their effectiveness, with a number of innovations in the type of energy we deliver, the frequencies and waveforms. There have been big advances, and I think we’ll see them improve further,” Dr. Bolash says.
The other approach to pain relief for arachnoiditis involves infusion of ziconotide, which comes from the paralyzing venom of a marine snail and can only be given as an injection by a physician.
These new approaches to treating the pain of arachnoiditis are allowing people to have functional improvement. “We don’t have perfect options or a cure for arachnoiditis,” Dr. Bolash says, “but for those people who have been living in distress, we have something that we can try to help them.”