Make Pain a Thing of the Past – arachnoiditis – Physician Partners of America

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PPOA Treatment Can Ease Back Pain from This Rare Disorder

Arachnoiditis has nothing to do with spiders, but its symptoms can be pretty scary. Difficult to diagnose and difficult to treat, this rare nerve inflammation can trigger excruciating lower back and leg pain. It is a progressive and debilitating disorder that can cause some people to become bedridden and unable to work.

What is Arachnoiditis?

The condition affects only about 11,000 people a year, according to the National Organization for Rare Disorders.  It is almost always caused by a medical procedure.

It starts in the web-like arachnoid membrane that protects the spine and brain. When the membrane becomes inflamed, it can cause the nerves to fuse together. This causes them to malfunction. The resulting scar tissue can press against the nerve roots that exit the spine, causing severe pain.

Arachnoiditis pain usually affects the lower back and legs and causes a variety of sensations.

  • Tingling or “creepy-crawly” feelings on the skin
  • Muscle cramps, twitching and spasms
  • Shooting, “electric shock” pain
  • Bowel, bladder and sexual problems

“It causes a number of symptoms and they can vary in the same individual,” said Dr. Abraham Rivera, chief medical officer of Physician Partners of America.

What Causes Arachnoiditis?

This condition has many causes. The majority are related to contaminants that accidentally get into the dura – the fluid surrounding the spinal column – during certain medical procedures like epidurals and spinal taps.  These contaminants include preservatives or impurities. Long ago, oil-based chemicals used in contrast dye tests, like myelograms, were blamed for some cases of arachnoiditis.

How is Arachnoiditis Diagnosed?

This disorder is so uncommon that most doctors rarely see it in their practices, making detection difficult. Fortunately, Physician Partners of America Pain Relief Group has the expertise to identify it and attempt to treat the pain.

The most helpful diagnostic tests are MRIs (magnetic resonance imaging) and CAT scans (computerized axial tomography). Another test, an EMG (electromyogram), uses electrical impulses to determine the extent of damage to nerve roots. PPOA specialists can perform this test.

What is the Best Arachnoiditis Treatment?

Unfortunately, there is no cure for this condition, but Physician Partners of America offers the hope of relief from arachnoiditis pain.   “One common treatment is oral pain medication, but it doesn’t tend to work well,” says Dr. Rivera. “The pain can be managed for some people with a spinal cord stimulator.”

Spinal cord stimulators are minimally implantable devices that send electrical signals to targeted areas of the spinal cord to treat specific pain conditions. It is a minimally invasive procedure that PPOA physicians perform routinely.

Stems cell therapy for arachnoiditis is only in the experimental stage and has not yet been proven helpful.

“We are keeping our eye on the latest research to treat this debilitating condition,” says Dr. Rivera. “Not every current treatment works for everyone, but we make every effort to treat the pain and help sufferers lead a more normal life.”





Interviewer: People who are in pain oftentimes don’t go to the doctor because they fear the worst. We all sometimes feel like that, right? But some pain can actually be treated without surgery. Dr. Rudy Gari from Florida Pain Relief Group is back to tell us more. And good to see you, doctor.

Dr. Gari: Good seeing you.

Interviewer: And specifically, we’re talking about something called a rhizotomy. Now, what is a rhizotomy and what does it do?

Dr. Gari: Certainly. So a rhizotomy, basically, what we’re doing is we’re finding ways to deaden the nerves in a permanent way. There are tiny little nerves that give sensation to your joints, and they’re just purely sensory nerve. They don’t do anything else other than just cause you to have pain if you have some sort of inflammatory process, which can happen a lot. So, people, if they have some sort of a chronic inflammatory process through the joints, those nerves are constantly reminding them. What we do is we first make sure that that’s the cause of the pain, and once we’ve diagnosed that, we do something that’s called rhizotomy. And what that does is, we place these needles right into those tiny little nerves. The needle tip heats up and it burns those little nerves off, and that relief can last several months, sometimes up to a year.

Interviewer: So it’s not a permanent relief but it is something that will give you relief for, like you said, a certain amount of time.

Dr. Gari: Yes. Unfortunately, a lot of those tiny little nerves tend to grow back, but I’ve had people who’ve had relief for over a year. And if you have pain on a daily basis, that’s a lifetime.

Interviewer: Yeah, no kidding. And it’s not too much trouble, then, to just come back when the pain flares up again, too?

Dr. Gari: Absolutely. We can repeat this. And the nice thing about it is that this is done through a needle, so we’re not cutting skin, it’s not a permanent operation and it’s a relatively benign procedure. We have a lot of safety measures in check.

Interviewer: So does it hurt at all? You mentioned needle. That’s the first thing I think of, “How much pain is involved to get pain relief?”

Dr. Gari: Yes. No, it’s actually fairly painless. We give a local anesthetic at the skin. We then go ahead and use some intravenous sedatives. And, in fact, just this morning I had four patients that had the rhizotomy done and they went home already.

Interviewer: So what areas does this benefit, primarily? Is it the knee? Is it the shoulder? Can it be any joint?

Dr. Gari: Well, the rhizotomy can occur in just about anywhere. The most common places happens to be at the neck and the lower back. The reason for that, most of the bending takes place at your neck and lower back, so that’s where a lot of the trauma and a lot of the pain comes from.

Interviewer: Now, what makes this kind of a good idea to do as a procedure to relieve the pain, as opposed to other treatments?

Dr. Gari: Well, what happens is, there’s not a whole lot of treatments that are available when you have chronic pain of your joints, for example. It’s usually medications, and those medications have significant side effects. Anti-inflammatories can cause an ulcer, can cause bleeding. You have opioids. We all know about the problems with opiate addiction. So this is an alternative to you having to take medications. Medications are not benign. They’re not mean to be taken on a long-term basis, but people have to take them that way. This is an option so that you don’t have to take these medications long-term.

Interviewer: You know, it’s funny you mentioned that because I know so many people who have their elderly parents actually hooked on opiates, and they don’t even know it. Because that’s what they’re prescribed, that’s what they take. So this is something that’s so much healthier and so much better for you.

Dr. Gari: Absolutely. I had an 81-year-old female today, a very nice lady, that was taking a lot of medications. And the problem with that, if they get a little bit groggy, and they fall and they break a hip, that can be lethal.

Interviewer: Absolutely. All right, Dr. Gari, great information. Now, Florida Pain Relief Group even schedules same-day appointments. Be sure to visit their website,, or give them a call, 844-KICK-PAIN. Simple as that. We’ll be right back.