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Arachnoiditis is one of the less common causes of lower back pain, though without question a serious disease. An inflammation of the arachnoid - an extremely thin, spider-web-like membrane sandwiched between two other membranes, or meninges, that cover and protect the brain and spinal cord - arachnoiditis can result from infection (for example, meningitis, tuberculosis, or syphilis); or trauma, including trauma resulting from surgery, lumbar puncture, or spinal anesthesia.

Besides surgery, the most common cause is the introduction of chemicals into the spinal canal, and the most severe effects have been linked with an oil-based dye formerly used for myelograms. (Such dyes, used as recently as 1991, have been replaced with safer, water-soluble dyes today.)

Sometimes diagnosed as “failed back syndrome,” arachnoiditis can appear soon or many years after the incident that prompted it, causing the membranes encasing the spinal cord to become thickened and scarred, and then trapping the nerve roots within the scar tissue.

Cysts and other complications may occur. The pain is frequently described as a burning or stinging sensation in the back and down one or more limbs as far as the ankles and feet, and it often persists during rest. Depending on the severity of the disease, symptoms can include headaches, seizures, blindness, or progressive paralysis. There may be bladder, bowel, and sexual dysfunction; muscle spasms; rashes; itching; and numbness.

There is no cure for this often disabling disease, and some symptoms may become permanent. Conservative therapy for lower back pain relief such as pain management is generally recommended, because even in patients whose disease is worsening, surgery to remove scar tissue won’t stop new scar tissue from developing. Also, surgery exposes the already irritated spinal cord to additional trauma.