it is implanted, it may take a few months of trial and error before a satisfactory dose of a drug is found. And not everyone can tolerate the drugs used in the pump.

Most people who have call BPAA seem pretty satisfied with it. Only two of them had an adverse reaction and one of those was quite severe.

Oral analgesics, including non-steroidal anti-inflammatory drugs are used to control the symptoms, but they are often discontinued because they cause gastric upset. In some cases there is liver damage. Oral steroids are often prescribed to help control the inflammation in people who can tolerate them. Unfortunately, the side effects of steroids can be devastating. They may cause osteoporosis, diabetes, depression, and sometimes death. (NEVER stop taking oral steroids suddenly or without your doctor’s permission. It can be very dangerous to do so.) Acetaminophen and drugs containing acetaminophen help many people but they must be monitored by a doctor. Large doses can cause kidney and liver damage, so it is imperative to have periodic blood tests. Muscle relaxants are often prescribed for spasms in the back. Narcotic analgesics may benefit arachnoiditis sufferers with intractable pain, but most doctors reserve them for patients with intractable pain.

Alternative treatments are beneficial as well. Relaxation techniques, guided imagery, biofeedback and self-hypnosis may help when pain becomes intolerable. Trigger point injections may also help. This method of treatment can be taught to a partner, friend or family member, who then administers the daily injections. Some people have found acupuncture helps their pain. Alternative medicine is becoming more acceptable in modern medicine.

In India, Dr. M Gourie-Devi used intrathecal injections of hyaluronidase to treat non-infective arachnoiditis after there were favorable results in the treatment of tuberculous spinal arachnoiditis. The following results are only preliminary, but promising. In one group of 15 patients administered the enzyme, eleven of them had satisfactory recovery and three had mild but significant improvement, and in one no change occurred. According to Gourie-Devi, “Except for mild pain during injection, worsening of spinal cord or bladder functions and other serious toxic effects like allergic reactions or convulsions were not observed in our study.” (7)

BPAA has written to Dr. Gourie-Devi to see if she has found continued success with hyaluronidase in the treatment of arachnoiditis patients. You will receive more information when we receive it.

In Argentina, Dr. Luis Gegalian, (5) a neurosurgeon, also began using hyaluronidase to treat arachnoiditis.

In 1976. A 73 year old man with paraparesis had a myelogram that revealed a block to the flow of contrast medium at T-10. Surgery revealed adhesive arachnoiditis and the adhesions were lysed as far as possible. He developed bedsores over the sacrum and both heels. The man also had a large second degree burn on his right leg from contact with a hot stove, which had failed to heal. After surgery, he showed slow functional improvement and he was able to walk up stairs. A year later, paraparesis reappeared and he progressed to paraplegia. He developed muscular atrophy of the lower extremities and there was loss of sensation up to the umbilical area.

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