Adhesive arachnoiditis (AA) is emerging as a clinical entity in the 21st Century. It is an intraspinal inflammatory disorder that is one of the toughest to treat in the pain management field. If it goes uncontrolled and untreated it may cause severe pain and disabling neurologic abnormalities including paraparesis, bladder and bowel dysfunction, headache, blurred vision, and an early death. AA has a typical, clinical profile that includes the unusual sensations of water dripping or insects on the skin, discomfort when standing or reclining, and numbness, weakness, and radiating pain down the leg. It is diagnosed by symptoms and confirmatory, magnetic resonance imaging. First generation treatment protocols have been developed which can and should be implemented by medical practitioners in every community.
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