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Adhesive Arachnoiditis: An Old Disease Re-Emerges in Modern Times

Handbook to Live Well With Adhesive Arachnoiditis


REPORTS – Click on the link in blue to download complete reports.

2020 AA Update Report published in Practical Pain Management


Adhesive arachnoiditis (AA) is an inflammatory disease of the lower spinal canal that involves cauda equina nerve roots and the arachnoid-dural covering (meninges) of the spinal canal. While once a rare disease, it is now emerging in every community. Diagnostic and treatment protocols have been developed and are presented here. A clinical profile of 80 MRI-confirmed cases show that AA is primarily a disease of mid to late-age females. The most common underlying cause is a structural disorder of the spine. Genetic connective tissue/collagen disorders of the Ehlers-Danlos Syndrome type appear to be the second most common cause of AA. Multiple surgeries and spinal interventions were common in these cases. A symptom profile of AA is quite uniform and includes pain relief on change of position, jerks or tremors in the legs, urinary dysfunction, and sensations of insects crawling or water dripping on the skin. Treatment specifically directed at suppressing neuroinflammation, promoting tissue regeneration, and providing aggressive pain management Is the most successful approach for halting the progression of the disease, restoring function, and enhancing patient quality of life.

The Intractable Pain Syndrome: A Call for Recognition and Prevention


Astute observers have long recognized that a sub-group of persons with chronic pain develop constant pain accompanied by such severe impairment of physiologic and psychosocial functions that the person is incapacitated and may suffer an early death. There have even been calls to label this occurrence a “disease”. Over the past 5 decades this subgroup of chronic pain patients has often been labeled “persistent” or “intractable”. This recognition has had enough merit that the latest International Classification of Disease (ICD-10) now lists intractable pain as a separate condition with its own identification number. Based on recent research it is most appropriate and accurate to diagnose certain individuals as having the Intractable Pain Syndrome (IPS). This syndrome is not a symptom or disease, but a complication of an underlying, painful disease or injury that produces excess electrical impulses that travel into the brain and spinal cord (central nervous system or CNS) and create pockets of tissue-destructive inflammation. Loss of CNS tissue in this process may include the neurotransmitter-receptor systems that control pain and regulate the cardiovascular, endocrine, and immunologic systems. With this loss of tissue, the afflicted persons develop constant pain and measurable evidence of cardiovascular, endocrine, and immunologic abnormalities. Hence, the systemic signs and symptoms indicate a specific syndrome of multiple bod-wide manifestations termed Intractable Pain Syndrome (IPS). There is, however, some promising news for afflicted with IPS. Clinicians have achieved good results in treating some patients by following a medication protocol designed to treat the underlying disease and to provide pain relief, while simultaneously correcting detected physiological abnormalities which has resulted, in some cases, in the reduction or reversal of the magnitude of the impairments that patients have developed. In other words, some patients with severe long-standing pain and significant impairments can, with a regimen tailored to their needs, achieve effective pain relief, and regain lost capabilities and function. To date this new understanding is not well known outside research circles. Therefore, the Tennant Foundation has initiated a Research and Education Project to bring information on this syndrome to patients, families, and medical practitioners. This paper presents the background, history, and basics of the Intractable Pain Syndrome as well as the rationale to treat it and initiate research and education on it. The overall goal of this new project is to bring recognition and treatment of the syndrome to pain care and to foster its prevention, since it is often a devastating, catastrophic medical condition.

Anabolic Therapy for Combined AA-EDS

Anabolic Therapy Precis
Some adhesive arachnoiditis (AA) patients who seek treatment for this condition will also have an Ehlers-Danlos/Hypermobility Syndrome. In order to provide comfort, maintain stability and retard connective tissue complications, we found it necessary to administer anabolic hormones.

The Way Forward for AA: Confronting An Urgent Public Health Issue

Summary for The Way Forward
Adhesive arachnoiditis (AA) has become an urgent public health issue. It now affects millions and is increasing in number. Unlike other causes of back pain, AA is an inflammatory disease inside the spinal canal which, if untreated and unchecked, may cause unbearable pain, dysfunction of legs and internal organs, dementia, a generalized autoimmune disorder, and adrenal failure. All its complications can lead to a suffering, shortened lifespan. This report calls for immediate action to diagnose, treat, and prevent AA.