Spinal arachnoiditis is a painful condition caused by the inflammation of the arachnoid (a membrane that surrounds and protects the nerves of the spinal cord). The arachnoid membrane can become inflamed after spinal surgery, an infection from bacteria or viruses, injection of dyes or steroids, compression of spinal nerves, or from a traumatic injury to the spine.
When arachnoiditis interferes with the spinal nerves, it can cause persistent stinging and burning pain in the lower back and legs and numbness and tingling in the hands or feet. Most cases of arachnoiditis are in the lumbar region of the back, where it can affect bladder and bowel control, sexual function, and the ability to sit for more than a couple of hours. More rarely, arachnoiditis can occur in the cervical (neck) region.
Arachnoiditis (sometimes abbreviated as ARC) is not curable; patients are treated for chronic pain. Many patients who suffer from arachnoiditis are unable to work because of the pain, the impairment of bodily functions, and the ability to sit for long periods of time.
Arachnoiditis can occur on its own or in conjunction with another back condition such as degenerative disc disease, nerve root compression from arthritis or a herniated disc, failed back syndrome (also known as failed back surgery syndrome), fracture of vertebrae, or spinal cord injury.
Before April 2021, arachnoiditis had its own official listing in Social Security's list of impairments, under musculoskeletal disorders. In April 2021, Social Security removed the listing; the agency now evaluates arachnoiditis as a neurological disorder since it affects the nerves of the spine. If you have severe arachnoiditis, you may be able to meet the requirements for neurological listing 11.08, spinal cord disorders.
To meet listing 11.08, you need to have either:
The SSA will request your medical records from your treating doctor. The SSA wants to see the objective evidence that you have arachnoiditis, rather than just a diagnosis by a doctor based on your pain symptoms and medical history. The SSA will want to see one of the three following objective forms of evidence to confirm the doctor's diagnosis:
The documentation should show the thickening and swelling of nerve roots, and if adhesive arachnoiditis has occurred, the clumping together of nerve roots.
Your records should also include a detailed physical exam, including tests of your sensation, reflexes, and range of motion, as well as your ability to walk, bend, squat and rise. Your records should include the various treatments you have tried, such as pain medication, physical therapy, or nerve or spinal cord stimulation, and the side effects of the pain medication. You should ask your doctor to record how your pain, medication side effects, and other symptoms limit your ability to work, and what functional restrictions the doctor has placed on you (for example, no heavy lifting or sitting for longer than two hours at a time).
If you have been diagnosed with arachnoiditis but don't meet the requirements for the spinal cord disorders listing, above, you may still be able to qualify for disability benefits if you can't do your past work because it's too strenuous and there isn't other work you can switch to. For example, if your doctor says you can't walk 6 hours a day or lift 20 pounds, you can only do sedentary jobs. But many patients with ARC can't sit for long periods of time, ruling out most sedentary jobs. It's common for arachnoiditis sufferers to need to change their position or posture more than once every two hours to reduce pain. In short, if your doctor says that you can't stand or walk six hours a day, you can't lift 20 pounds, and you need to change your position or posture more than once every two hours, you have a good chance of qualifying for disability benefits. For more information on getting benefits without meeting a listing, see our article on Disability Benefits for Reduced Capacity Caused by Back Problems.
You can call the SSA at 800-772-1213 to set up a phone appointment to fill out an application for disability benefits (SSDI and SSI), or you can start your application online. When you are answering questions for your application, include both how your back pain affects your life outside of work and how it impairs your ability to work. If you have both arachnoiditis and a mental impairment, such as depression (as many people with back problems do), be sure to include symptoms and documentation of the mental impairment as well.
If you want help with the application or you've been denied benefits, consider contacting a disability lawyer for help. The attorney's fee will come out of your award of back pay from your disability benefits; if you don't win, the lawyer won't get paid. When you are interviewing lawyers, ask if they have experience with spinal cases, and in particular arachnoiditis. Your lawyer can help you appeal a denial by the SSA or file an initial claim for arachnoiditis.