Arachnoiditis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Arachnoiditis?
A neurologist, a doctor who treats brain and nerve problems, usually evaluates arachnoiditis. A pain medicine doctor often helps with the pain. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is arachnoiditis?
Arachnoiditis is a rare condition. It happens when the arachnoid gets inflamed. The arachnoid is one of the membranes that surround and protect the spinal cord and its nerves. Inflammation is the body's immune system reacting to injury or infection. It can lead to scar tissue or adhesions. These bands of scar tissue make the spinal nerves stick together.
Symptoms
When the lower back is affected, arachnoiditis can cause these problems in the lower back or legs:
- Chronic and persistent pain, including a stinging and burning pain.
- Numbness.
- A tingling feeling.
Some people have muscle cramps, twitches, or spasms. These can affect daily life. It may also affect bladder, bowel, and sexual function. Trouble walking and weakness can happen. Severe disease can cause leg paralysis. Symptoms depend on the part of the spine that is affected.
The lower back is the most common spot. But the neck and chest areas of the spine can be affected too. That can cause weakness, loss of feeling, and pain in the arms, legs, chest, belly, or pelvis. Neck or chest disease can also cause myelopathy, a spinal cord problem that may come with cysts in the cord.
Causes and who gets it
The cause is often unknown. Known risk factors fall into four groups: chemical, mechanical, inflammatory, and infectious causes. Mechanical causes include trauma, spine surgery, and disk herniation. Disk herniation means a cushion between the spine bones pushes out of place. This is a slipped disk. Chemical causes include spinal anesthetic agents and contrast dye used in myelography. Neurotoxic substances can also cause it. Infectious causes include infections from bacteria, viruses, fungi, and tuberculosis. Past trauma, spine surgery, and bleeding around the brain are the most reported causes. About 25,000 new cases happen worldwide each year. Lumbar cases have grown as more spine surgeries are done.
How doctors diagnose it
Arachnoiditis is rare, and it can be hard to diagnose. A doctor does a physical exam and reviews the medical history and symptoms. Imaging tests help. MRI (magnetic resonance imaging) and CT (computed tomography) can show the problem. Sometimes doctors use myelography. This test injects a contrast dye into the spinal canal. The dye makes the spine show up better. An EMG (electromyogram) can show how bad the nerve damage is.
Treatment
Arachnoiditis has no definitive cure. Treatment is mainly supportive. The goal is to control symptoms and improve daily life. Doctors often recommend a mix of pain care, physical therapy, exercise, and counseling. Counseling means talk therapy. Pain treatment may include anti-inflammatory medicines and opioids. Added medicines may help. These include duloxetine, gabapentin, pregabalin, and the muscle relaxant baclofen. Psychological support can help people cope with long-lasting pain. Surgery is not typically recommended or effective for arachnoiditis of the lower back. But in focal cases, where one area of the spine is affected, surgery to remove scar tissue may help.
When to see a doctor
Call 911 or go to the emergency room right away for sudden, severe back pain with weak or numb legs. Also call for new loss of bladder or bowel control. These can be signs of serious nerve problems. See a doctor if burning back or leg pain will not go away, especially after spine surgery or a shot.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can start the evaluation. They can help with pain medicines and coordinate care between your neurologist and pain specialists over time.
Common questions
Is arachnoiditis curable?
No. Arachnoiditis has no definitive cure. Most patients have a fairly steady level of disability, but symptoms can change. Treatment focuses on relieving pain and improving daily function.
Does surgery help?
Usually not. Surgery is not typically recommended or effective for arachnoiditis of the lower back. It often brings no lasting benefit. For focal disease in one area, surgery to remove scar tissue may help.
Can arachnoiditis be prevented?
Sometimes. Not all cases can be prevented. But reducing exposure to known risk factors may lower the chance. Steps include fewer invasive spine procedures. Others are preventing spinal infections and avoiding intrathecal injections when possible.
Is arachnoiditis life threatening?
It is not typically life threatening. But it can cause permanent disability and severe mental distress.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
