WEB ARTICLE
(Posted 1 October 2001)

Contents
Introduction/Methods
Results
Triggers/Treatments
Discussion
Conclusions
References

.

.

.

.

.

.

.

.

.

Arachnoiditis: 
Part I - Comparitive Symptom Study
Part II - Red Blood Cell Shape Analysis

by L.O. Simpson & M.G. Anderson

RESULTS:

Part I.

Red Blood Cell Survey. 1998.

 71 people with symptomatic arachnoiditis volunteered to participate in the study.

 Two  were excluded for the following reasons:-

(1)   A large section of information was missing from the first one.

(2)   There was uncertainty about the value of the contribution from the second one as surgery had been performed relatively recently.

This left 69 participants in the first part of the study.

AGE GROUPS

Age was provided by 57 of the 69 respondents.

GENDER

Information on gender was supplied by 56 of the 69 respondents.

CHRONIC TIREDNESS

A symptom described as marked loss of energy after physical exertion which would not normally be considered excessive. Rated according to 5 levels. Experienced by

68 of the 69 N.Z. respondents.

Tiredness rated as significant by 92% in N.Z. Survey.

Tiredness rated as significant by 76% in Global survey (Smith).

PAIN

Pain was experienced by 100% of the cases in all three studies.

In the NZ questionnaire 5 categories referring to quality of pain were listed:-

            Sharp    Dull    Burning    Stabbing    Electric shock

Two additional categories related to duration of the pain:-

            Constant – which would apply especially to sharp, dull and burning pain.

            Comes and Goes (“Intermittent”) – which could apply to sharp, dull and burning pain but more likely to apply to stabbing and electric shock types of pain.

The last category, “Other”, allowed for descriptions of pain not listed.

Respondents were requested to rate the level of pain intensity in each category, where 1 and 2 indicated mild, 3 moderate, 4 and 5 severe and extreme. 

The following table lists the category of pain in the first column and the percentages of those experiencing the various levels of intensity of this type of pain  in the adjacent columns.  Where a tick was used the intensity was unknown so these have been placed in the first column (where mild is rated as 1 or 2).

Pain - Other.

20 of 69 respondents (29%) described 15 additional types of pain experienced; 16 mentioned one, 4 mentioned two other types of pain. These are listed below, with the number of individuals who reported the pain experiences alongside.

• Hypersensitivity to light touch.  -  3.

• Throbbing.  -  1.

• Stinging  -  4.

• Tightness  - 1.

• Prickly  -  1.

• Heavy aching  -  1.

• Pain in soles of feet, as if walking on rocks, broken glass, a ball, a spike  -  5.

• Right sided Trigeminal (facial) pain  -  1.

• Drilling  -  1.

• Upper back pain with inspiration (breathing in)  -  1.

• Gripping or clawing in calves  -  2.

• Burning tongue  -  1.

• Joint pain – shoulder, knee, hip  -  3.

• Waves of pain into head  -  1.

• Hot patches on legs  -  1.

Range of Pain Experiences.

The majority of respondents identified several different types of pain experiences. Only twelve listed 1 or 2 categories; nineteen listed 3, and eighteen 4 or 5. Thirteen found that 6 or 7 categories applied to them, and seven identified 8 or 9.

Not only is there a wide range of pain manifestations in symptomatic adhesive arachnoiditis, many of these are difficult to describe as they are beyond the usual types of pain associated with injuries or illnesses commonly experienced.

Sites of Pain.

Information on sites of pain was supplied by 66 of the 69 respondents.

SENSORY CHANGES

Other Sensory Disturbances   -  16%      Eleven respondents described additional sensory disturbances (more than one  was noted by some subjects):-

• Temperature changes: 

  • Sensation of cold from the waist downwards.

  • Fluctuating sensations of heat and cold affecting legs and feet.

  • Decreased sensation for cold stimuli and absence of  sensation for hot stimuli in feet, eg for cold and hot water.

  • Extreme sensation of heat in legs and feet at night, in bed.

  • Heaviness of legs.

  • Sensation of tight band around head, calf, ankle.

  • Sensation of “shaking” in buttocks, legs.

  • Hypersensitivity to light touch.

  • Altered sensations in soles of feet – described variously as walking on crumpled paper, on broken glass, directly on bones of feet.

MUSCLE DISTURBANCES

66 of the 69 respondents provided information about muscle disturbances. These are compared with the results of surveys by Smith and Long. 100% of the NZ subjects experienced some type of muscle disturbance.

In the New Zealand study a category was provided for Painful Trigger Spots. This would appear to be indicative of diffuse soft tissue pain. Smith’s figures for symptoms of Fibromyalgia or Fibromyalgia Syndrome are used for comparison, as are Long’s figures for “Diffuse pain – apparently non-radicular”.

GENERAL SYMPTOMS.

This section was completed by 64 of the 69 respondents.

The following symptoms were described under “Other” :-

• Bladder & Bowel dysfunction   ( 9 = 14% )

• Nausea

• Flu-like illness

• Sore enlarged lymph nodes

• Swelling of legs and feet

• Increased sweating – localised or generalised

• Hot or cold sweats

• Hot flushes localised to part of face, or to foot and lower leg

• Sensitivity to chemicals or food

• Difficulty swallowing

• Mood swings

• General debility

• Difficulty with reading, writing, talking

• Difficulty negotiating stairs, driving, walking

• Clumsy movements

• Impairment of memory, especially short term