Adhesive Arachnoiditis is not a well-known condition, and its true prevalence remains largely unknown due to poor recognition and inaccurate client records.
The condition is caused by injury to the arachnoid layer of the meninges in the brain, often due to rupture, trauma or infection. This leads to chronic inflammation and causes the cerebrospinal fluid to become sticky, resulting in nerves “adhering”sticking” together and creating widespread neurological symptoms.
There is currently no cure, and treatment is typically focused on symptom management.
Background
Gina worked with a 74-year-old lady with Adhesive Arachnoiditis for three years.
She had undergone a failed myelography (a procedure involving dye being injected into the spine) in 1969 and later developed symptoms following surgery in 2002. A scan confirmed the diagnosis.
When we first met, she was seeking help for knee pain that was significantly limiting her ability to walk.
She was largely bed-bound, unable to cook, drive or leave the house for long periods. She had been told she would likely be in a wheelchair within a year.
She was not prepared to accept this.
Initial Assessment
With complex clients, we always begin by putting the medical condition to one side and assessing biomechanics.
The reason for her knee pain quickly became apparent:
- Posteriorly positioned pelvis with rotation and lateral tilt.
- Very weak, severely pronated feet.
- No ability to balance.
- Weakness in the right leg and overuse of the left (painful) side.
- Swollen, hot and painful knee.
Any client presenting with these bio-mechanical issues would be experiencing pain, due to the forces acting around the knee.
Early Treatment & Unexpected Outcome
Initial treatment focused on rebalancing the pelvis and leg strength.
In the first session, only 10 minutes of light hands on was able to be tolerated.
However, the response was significant.
Within one week:
- Coccyx pain (present for over a decade) had almost disappeared
- Knee pain had resolved completely
This demonstrated that we could alter her pain, so we agreed to continue.
Rehabilitation Approach
Over the following year, we worked fortnightly to restore strength and alignment.
This included:
- Core and spinal stabilisation
- Pelvic realignment
- Soft tissue work (trigger point and myofascial release)
- Progressive strengthening exercises
- Balance retraining
- Gait re-education
We rebuilt:
- Core stability
- Spinal alignment
- Shoulder and postural control
- Leg strength and balance
Gradually, she progressed from:
- Being bed-bound
→ to standing, balancing, squatting and walking independently
Myofascial Release & Neurological Impact
Once she was physically stronger, we began to address the neurological component.
In Adhesive Arachnoiditis, cerebrospinal fluid becomes sticky, we hypothesised that by using a hands on technique, known as myofascial release, it may help to draw fluids back into this area, creating less stickiness.
We introduced myofascial release (MFR) at the base of the skull.
The response was notable:
- Significant increase in energy levels
- Improved ability to carry out daily tasks
- Reduced numbness and tingling
- Improved overall function
Over time:
- Medication was reduced under medical supervision
- Symptoms continued to improve
Outcome
Three years later:
- Significantly reduced pain
- Reduced medication
- Increased energy
- Improved mobility and independence
- No longer facing a life in a wheelchair
She now:
- Walks independently
- Drives
- Socialises
- Attends exercise classes
Conclusion
This case highlights the importance of addressing biomechanics, even in complex neurological conditions.
By focusing on:
- Movement
- Strength
- Alignment
We were able to significantly alter pain and function in a condition widely considered untreatable.
Gina was presented with the FHT Award for pain management, injury prevention and rehabilitation for her work with this client and was invited to write a 3 page article in the International Therapist Magazine for her work with this client.
If you are dealing with complex conditions, and feel you have limited options, it may be worth assessing the biomechanics involved. Feel free to get in touch and we can see what we can do to help.
#chronicpain #adhesivearachnoiditis #painmanagement #biomechanics #chronicpaintreatment