Transverse Myelitis: Causes, Symptoms, and Treatment

Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.

What kind of doctor treats transverse myelitis?

Transverse myelitis, inflammation of the spinal cord that can cause weakness, numbness, or trouble with bladder control, is treated by a neurologist (brain and nerve doctor). It usually needs urgent hospital evaluation and treatment to reduce inflammation, followed by rehabilitation therapy to help regain strength and function. Go to the emergency room right away for sudden leg weakness or loss of bladder control.

What is transverse myelitis?

Transverse myelitis is caused by swelling, called inflammation, of the spinal cord. The spinal cord is the bundle of nerves that runs down your back. The swelling can damage myelin, the coating that covers nerve fibers.

Damaged myelin disturbs signals between the spinal nerves and the body. The disorder is rare.

Symptoms

Symptoms can start within hours or days, or build up over 1 to 4 weeks. They can quickly become severe. Common symptoms include:

  • Weakness in the legs that gets worse quickly. If the upper spinal cord is affected, the arms are weak too. It can lead to paralysis, which means being unable to move.
  • Pain, often starting in the lower back. It can shoot down the legs or arms or wrap around the torso.
  • Strange feelings such as burning, tingling, pricking, numbness, or coldness.
  • Bladder and bowel problems, such as needing to urinate often, leaking urine, or constipation.
  • Trouble walking, such as stumbling or dragging the feet.

Causes and who gets it

Often doctors cannot find the cause. This is called idiopathic, which means the cause is unknown. When a cause is found, it can be:

  • Immune system disorders, where the body attacks itself, such as multiple sclerosis (MS) or lupus.
  • Infections from viruses, bacteria, fungi, or parasites.
  • Other inflammatory disorders, such as sarcoidosis or scleroderma.
  • Blood vessel problems that affect the spine.

It can affect people of any age, sex, or race. It happens most often in teens (ages 10 to 19) and in people in their thirties. It does not appear to be genetic or to run in families.

How doctors diagnose it

Doctors ask about your symptoms and health history. They also do a nervous system exam. Tests can include:

  • An MRI, a scan that makes pictures inside the body, of the spinal cord and brain. It almost always shows a damaged area.
  • Blood tests, to find or rule out other causes.
  • A spinal tap, also called a lumbar puncture. Doctors test the fluid around the spinal cord. They look for infection, extra protein, and more white blood cells than usual in some people.

Treatment

Treatment aims to treat any infection behind it. It also lowers swelling in the spinal cord and eases symptoms. Common first treatments are:

  • Steroid medicines given through a vein (IV corticosteroids). They can lower swelling and inflammation in the spinal cord. These are among the most common first treatments.
  • Plasma exchange (plasmapheresis). Doctors remove the liquid part of the blood and replace it. This takes out antibodies thought to cause the swelling. It may be used if IV steroids do not work well.
  • IV immunoglobulin (IVIG), an injection of antibodies from healthy donors that can help reset the immune system.
  • Medicines for pain, muscle spasms, bladder problems, or depression.
  • Antiviral medicines, if a virus infected the spinal cord.

After the first treatment, rehab helps people rebuild strength. Physical therapy helps with muscle strength, coordination, and bladder and bowel control. Occupational therapy teaches new ways to bathe, dress, and do daily tasks. Counseling helps with stress. Rehab cannot undo the damage. Still, strength can get better even years later.

Most people get at least some function back, mostly in the first three months. About a third recover completely. Some have moderate disabilities, such as bowel problems and trouble walking. Others have permanent disability and need help with daily activities. It usually happens only once but can return in people with an underlying cause such as MS.

When to see a doctor

Go to the emergency room right away for sudden weakness in the legs or loss of bladder control.

Call 911 or go to the emergency room for severe trouble breathing, fainting, or sudden confusion.

Contact your doctor for sudden, sharp back pain that shoots down your arms or legs or wraps around your trunk. Also call for sudden numbness in an arm or leg, needing to urinate often, or constipation. Call too if symptoms get worse with treatment.

How a direct primary care or concierge doctor fits in

A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either one can send you to a neurologist quickly. Later, they can help coordinate rehabilitation and follow-up care.

Common questions

What are the warning signs of transverse myelitis?

Warning signs include sudden weakness or numbness in the legs or arms, back pain, and trouble controlling the bladder or bowels. Because symptoms can worsen quickly, anyone with these signs should be seen urgently by a doctor.

Does transverse myelitis go away completely?

Recovery is not guaranteed for everyone, but many people regain some or most function with prompt treatment and rehabilitation. A neurologist monitors recovery closely and adjusts therapy plans as symptoms change over time.

Can a direct primary care doctor manage transverse myelitis?

A direct primary care doctor cannot treat the spinal cord inflammation directly and will refer you urgently to a neurologist. Afterward, the primary care doctor can help coordinate rehabilitation and long-term follow-up care.

Sources

  1. National Institute of Neurological Disorders and Stroke - Transverse Myelitis
  2. MedlinePlus - Transverse myelitis

Medical Disclaimer

This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.