Surrounding the spinal cord are protective layers of tissue called the spinal meninges, specifically the pia mater, arachnoid and dura mater layers. Arachnoiditis refers to chronic inflammation of the arachnoid layer of these meninges. Inflammation can occur to the arachnoid following spinal injury, surgery, infection, the introduction of foreign substances to the area such as intraspinal medications or interventions such as epidural steroid or anaesthetics as some examples.
Symptoms and characteristics:
Symptoms of arachnoiditis vary greatly in range and severity between individuals. Symptoms may also ‘flare up’, resolve and vary over time or may progressively worsen. Some examples of potential symptoms may include:
- pain and sensory disturbances in the lower back, legs and feet
- easily fatigued
- muscle weakness, cramps or spasms
- bladder, bowel and sexual dysfunction
- chronic nerve pain
- sensitivity to temperature changes
- increased pain response
- altered capacity to judge position of body (proprioception) which may appear as clumsiness
- cardiovascular disturbance – altered blood pressure, Raynaud’s phenomenom in extremities
- vertigo and ataxia (unsteady walking gait)
- either increased or decreased sweating
- weight gain or loss
- headaches or migraines
- insomnia or sleep disturbance
- vision disturbance such as sensitivity to light
- short term memory loss and altered capacity to think clearly
- anxiety and or depression secondary to chronic pain
- potential paralysis in lower limbs.
Severity of symptoms varies and is unpredictable and therefore prognosis is difficult.
Workplace adjustments and solutions:
In the workplace there are various factors that would assist people with arachnoiditis to manage their condition. These include changes to work tasks and the environment, and will vary depending upon symptoms experienced, severity and type of work undertaken. Some suggestions for workplace modifications include:
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flexible work hours or the capacity to work from home to minimise fatigue and allow for treatment
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rotation of physically demanding tasks
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use of a stool or chair to allow postural rotation and breaks when needed
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use of lifting aids such as trolleys or cranes where possible to minimise physical exertion requirements
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modifying workstation set up to accommodate strengths and abilities and overcome barriers
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use of adaptive technology to overcome any barriers to independent work such as vision related equipment
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if a walking or mobility aid is required, ensure wheelchair or walking aid accessibility to all areas of the workplace including kitchen and bathroom amenities, workspace and other doorways or emergency exits along with installation of ramps for independent building access.
Employers of people with disability may be eligible for free workplace assessments and modifications through the Workplace Modifications Scheme. The Workplace Modification Scheme pays for the costs involved in modifying the workplace or purchasing special equipment for employees with disability. To determine eligibility, please refer to the full guidelines:
There are solutions and adjustments for the following job requirements
(NINDS 2007; Andreae-Jones, S. 2000; Arachnoiditis Foundation, Inc. 2000; MedicineNet 2005)
References:
Arachnoiditis Foundation, Inc. 2000, Arachnoiditis; Symptoms, Causes and Treatments, Arachnoiditis Foundation, Inc., Baltimore, viewed 13 March 2009, <http://www.arachnoiditis.com/disease.asp>.
Andreae-Jones, S. 2000, The Adhesive Arachnoiditis Syndrome, Arachnoiditis Sufferers Action and Monitoring Society New Zealand Inc., Wanganui, viewed 13 March 2009, <http://www.arachnoiditis.info/content/the_adhesive_arachnoiditis_syndrome/the_adhesive_arachnoiditis_syndrome_toc.html>.
MedicineNet 2005, Pain Management: Arachnoiditis, MedicineNet, Inc., online, viewed 13 March 2009, <http://www.medicinenet.com/arachnoiditis/article.htm>.
NINDS 2007, NINDS Arachnoiditis Information Page, National Institute of Neurological Disorders and Stroke, Maryland, viewed 13 March 2009, <http://www.ninds.nih.gov/disorders/arachnoiditis/arachnoiditis.htm>.