Be Our Partner! Book a Free Consultation Now! Become a Member > Get Involved >
Health Conditions > Health Articles > Find a Practitioner > Events >

Home  /  Health Conditions  /  Transverse Myelitis

Transverse Myelitis

A rare inflammation of the spinal cord that can cause weakness, numbness and loss of bladder or bowel control within hours to days. Sudden symptoms need emergency care so the cause can be found and treated quickly — and most people recover at least in part.

Go to the emergency room or call 911 right away if you or someone you care for has sudden weakness in the legs or arms, new numbness or loss of feeling, trouble controlling the bladder or bowels, back pain together with symptoms that are quickly getting worse, or any trouble breathing. Do not wait to see whether it passes.

  • In transverse myelitis, weakness in the legs often worsens rapidly, and bladder and bowel problems are common (NINDS).
  • Back pain with pain, tingling, weakness or numbness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowel control is an emergency-room situation (NHS; the NHS gives UK numbers — in the U.S. call 911).
  • Pressure on the spinal cord from something else, such as a disc or tumor, can look the same as myelitis and may need emergency surgery (review, PubMed). Only scans and tests in a hospital can tell the difference.
  • Starting treatment quickly is linked to better outcomes (review, PubMed).
  • In rare cases when breathing is significantly affected, a person may need a respirator, usually only for a while (NINDS). When the inflamed area is high in the neck, breathing can fail and needs close watching (review, PubMed Central).

What is transverse myelitis?

Transverse myelitis (TM) is a neurological disorder caused by inflammation of the spinal cord. The inflammation can damage myelin, the insulating coating around nerve fibers. The part of the spinal cord that is hurt decides which parts of the body are affected, usually from that level downward (NINDS). “Transverse” refers to the pattern of symptoms: a person often feels a band-like sensation across the trunk, with sensory symptoms and weakness below it. Myelin damage most often happens in the nerves of the upper back (NINDS).

TM can be acute, developing over minutes to several days, or subacute, usually developing over one to four weeks (NINDS). In one review, most people reached their worst within 10 days of onset; at the worst point half had weakness in both legs, and almost all had sensory changes and bladder problems (MRI review, PubMed).

It is better thought of as a description than a final diagnosis. A group of experts proposed uniform diagnostic criteria in 2002 so that doctors could separate “idiopathic” TM (no cause found) from TM caused by a known disease (2002 consensus criteria, PubMed). Specialists stress that the aim is to name the specific underlying cause, because treatment and outlook depend on it (review, PubMed).

Symptoms

Classic features of TM include (NINDS):

  • Weakness of the legs and arms. Leg weakness often worsens rapidly and can progress to complete paralysis; if the upper spinal cord is involved, the arms are affected too.
  • Pain. Initial symptoms usually include lower back pain or sharp, shooting pain that radiates down the legs or arms or around the torso.
  • Sensory changes such as burning, tickling, pricking, numbness, coldness or tingling, or loss of sensation in parts of the body, including the torso and genital region.
  • Bowel and bladder problems: increased frequency or urgency, incontinence or being unable to pass urine, and constipation.

Other symptoms can include muscle spasms, a general feeling of discomfort, loss of appetite, breathing problems, sexual dysfunction and chronic pain (NINDS). MedlinePlus likewise lists pain, numbness and weakness as signs of spinal cord problems (MedlinePlus).

Who gets it, and how common is it?

TM can affect people of any age, sex or race. It does not appear to be genetic or to run in families. It occurs most often in adolescents and teens (ages 10 to 19) and in people in their thirties (NINDS). It is rare: in one Minnesota county, TM with no known cause occurred at about 8.6 per million people (population study, PubMed).

What causes it?

TM is usually caused by other conditions, and in many cases the cause is never found; doctors then call it idiopathic (NINDS). The causes NINDS lists include:

  • Immune system disorders, and for some people TM is the first sign of one: multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD); an autoimmune reaction after an infection or, rarely, a vaccine; and an abnormal immune response to an underlying cancer (NINDS). See our Multiple Sclerosis guide.
  • Viral infections, including herpes viruses (chickenpox/shingles, herpes simplex, Epstein-Barr), West Nile, Zika and influenza. It is unclear whether direct infection or a post-infectious response causes the damage (NINDS).
  • Bacterial, fungal and parasitic infections, such as syphilis, tuberculosis and Lyme disease (NINDS).
  • Other inflammatory diseases, such as sarcoidosis, lupus, Sjögren’s syndrome, scleroderma and Behçet’s syndrome (NINDS). See our Lupus, Sarcoidosis and Sjögren’s guides.
  • Vascular problems such as a stroke of the spinal cord or an abnormal tangle of blood vessels (NINDS).

A note on vaccines: NINDS lists a post-vaccine autoimmune reaction as a rare cause (NINDS). The sources we opened for this guide do not give a risk figure or tell people with a past episode whether to vaccinate, so please talk with your neurologist.

Three disorders doctors look for

  • Multiple sclerosis (MS) is a disorder in which immune cells attack myelin in the brain, optic nerves and spinal cord (NINDS).
  • NMOSD is an autoimmune disorder of the optic nerves and spinal cord. Most people have antibodies against a protein called aquaporin-4. It can be relapsing (most people) or happen only once (NINDS). Each episode can damage new areas, so preventing relapses matters (NINDS).
  • MOGAD involves antibodies to myelin oligodendrocyte glycoprotein. TM is its second most common presentation, in roughly a quarter of affected patients (review, PubMed).

Testing for the two antibodies changes labels. In the Minnesota study above, 3 of 24 people who first met criteria for idiopathic TM turned out to carry one of the antibodies and were reclassified, and 3 people (14%) later met criteria for MS (population study, PubMed). A neurology review argues that a person should not be called “idiopathic” without a comprehensive search for a more specific cause (review, PubMed).

How it’s diagnosed

Doctors diagnose TM from a medical history and a thorough neurological exam. NINDS lists tests that confirm it and look for causes (NINDS):

  • MRI will almost always show the damaged area in the spinal cord; an MRI of the brain can give clues to other causes, especially MS. A review calls MRI of the whole spine and the brain the most important investigation (review, PubMed Central).
  • Blood tests can find or rule out other disorders, including HIV infection and vitamin B12 deficiency. Specialists also test blood for aquaporin-4 and MOG antibodies (review, PubMed).
  • A lumbar puncture (spinal tap) with analysis of the spinal fluid can find infection, more protein than usual in some people, and increased white blood cells. A needle is placed in the lower back to collect a small sample of the fluid around the spinal cord.
  • In some cases a PET scan helps find causes such as sarcoidosis or cancer.

Because compression of the cord can mimic TM, ruling it out is a priority (review, PubMed). Delays happen: one case report describes about five weeks to reach a neurologist and four more months to a diagnosis (case report, PubMed).

Why it needs urgent care

Because the cause decides the treatment, and because rapid treatment is linked to a better outcome (review, PubMed), suspected TM is handled as an urgent problem. The goals are to treat any infection that may be responsible, reduce spinal cord inflammation, and manage and reduce symptoms (NINDS). Details follow in the conventional medicine section below.

Related MBHA guides: Spinal Cord Injury, Guillain-Barré Syndrome and Nerve Damage. Separate MBHA guides on Paraplegia and Wheelchair Users are on the way.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Hospital evaluation (MRI, blood tests, spinal tap); treating infection; high-dose IV steroids; plasma exchange or IVIG if steroids are not enough; long-term medicines when MS, NMOSD or MOGAD is found; rehabilitation; bladder, bowel, spasm and pain care. Medicare Part B covers medically necessary outpatient physical therapy (20% after the deductible). IVIG commonly runs about $5,000–$15,000+ per infusion before insurance; plasma exchange is priced per session. Hospital and per-session therapy costs: cost estimate being researched. No randomized trials settle which treatment is best, but starting early is linked to better results. Most people recover at least in part, mostly in the first three months; some are left with lasting weakness, bladder or bowel problems or pain.
Chiropractic No role in diagnosing or treating TM. Later, at most gentle care for ordinary aches, with your neurologist’s clearance. About $55–$100 for a follow-up visit and $90–$200 for a first appointment without insurance. We found little research on chiropractic care for TM. Back or neck pain with new weakness, numbness or bladder changes needs emergency care first. MBHA advises against neck manipulation after spinal cord inflammation.
Acupuncture Fine needles, sometimes with a mild electrical current, used alongside rehabilitation for pain, sleep, or bladder and bowel symptoms. About $90–$185 for a follow-up visit and $125–$230 for a first private visit; community clinics about $50–$90. Medicare covers acupuncture only for chronic low back pain. We found little research: a small uncontrolled study of 16 people and case reports. It is not known whether acupuncture helps TM. Never a substitute for hospital treatment.
Herbal medicine No herb or supplement treats TM. Cost estimate being researched. We found little research on herbs for TM. Some herbs may worsen autoimmune disease or interact with immune-suppressing medicines, so check with your neurologist and pharmacist first.
Massage therapy Gentle massage during rehabilitation for muscle tightness and aches, cleared by your care team. One national chain advertises memberships of about $70–$90 a month. Small studies of people with spinal cord injury (not TM) suggest it may ease pain and fatigue. Take extra care where feeling is reduced.
MBHA Wellness Coach Daily routines for bladder and bowel care, skin checks, pacing and heat management, home safety, emotional recovery, caregiver support and connection with patient organizations. MBHA coaching cost estimate being researched. Supports — never replaces — your neurology and rehabilitation team. Mood changes are common after TM and can be helped.

Approach 1 of 6

Conventional medicine (AMA)

Treatment aims to treat infections that may cause the disorder, reduce spinal cord inflammation, and manage symptoms (NINDS). We list drugs by class only and give no doses. Honest context first: a 2002 expert statement said that no clearly established medical treatment existed for idiopathic acute TM (2002 consensus criteria, PubMed), and a later review notes the lack of randomized controlled studies, yet still advises starting high-dose steroids as early as possible (review, PubMed Central).

1. Treating the cause

If tests point to an infection, treatment is aimed at it; antiviral medicines may help people who have a viral infection of the spinal cord (NINDS).

2. Intravenous (IV) steroids

Corticosteroid drugs such as methylprednisolone or dexamethasone given through a vein may decrease swelling and inflammation in the spinal cord and reduce immune activity. They may also reduce the chance of a recurrence in people with an underlying disorder (NINDS). Reviews describe this as the usual first step, started as early as possible (review, PubMed Central). The same review cautions that in idiopathic TM the response to steroids is often disappointing (review, PubMed Central).

3. Plasma exchange (plasmapheresis)

Plasma exchange may be used for people who don’t respond well to IV steroids. Blood plasma is removed and replaced with special fluids, which takes out antibodies and other proteins thought to drive the inflammation (NINDS). One review says plasma exchange has been shown to help in acute attacks of demyelinating disease of the brain and spinal cord, and that starting within 15 days of onset predicted a better response (review, PubMed Central). For NMOSD attacks, plasma exchange is also used (NINDS).

The evidence in children: in a hospital review of 19 children with TM, 15 had major improvement after a course of plasma exchanges; the authors note there was no comparison group (pediatric study, PubMed). In another review of 23 children with TM, flaccid myelitis or Guillain-Barré, 17 improved; two died, one from an air bubble in a vein, so the procedure is not risk-free (pediatric study, PubMed).

4. IV immunoglobulin (IVIG)

IVIG is a concentrated injection of antibodies pooled from many healthy donors. NINDS says it can help “reset” the immune system by binding to the antibodies that may cause TM and removing them from circulation (NINDS). The NHS lists immunoglobulins among initial treatments for NMO attacks (NHS).

5. Stronger or long-term immune treatment, depending on the cause

  • NMOSD: three medicines are FDA-approved to prevent episodes (eculizumab, inebilizumab and satralizumab), and doctors sometimes use other immune-quieting medicines such as mycophenolate, rituximab or azathioprine, often long-term (NINDS).
  • MS: has its own long-term disease-modifying medicines (NINDS); see our MS guide.
  • MOGAD: a 2023 review said there were no FDA-approved treatments and that it was uncertain whether each person’s illness would stay a single episode or relapse (review, PubMed).
  • Autoimmune diseases such as lupus or Sjögren’s: in Sjögren’s, spinal cord involvement is often resistant to steroids, and in lupus a steroid plus cyclophosphamide combination may help if started promptly. Cyclophosphamide has a significant side-effect profile (review, PubMed Central).
  • In general, immunosuppression is often recommended for immune-mediated forms that carry a higher risk of coming back (review, PubMed).

6. Keeping the body working while it heals

After the first treatment it is critical to keep the body functioning (NINDS). Teams also work to prevent blood clots, lung collapse and pressure sores (review, PubMed Central).

7. Rehabilitation

Rehabilitation cannot reverse the physical damage, but it can help even people with severe paralysis become as independent as possible. Strength and function can improve even years after the first episode (NINDS).

  • Physical therapy helps keep muscle strength and flexibility, improve coordination, reduce stiffness, regain bladder and bowel control, and increase joint movement, and it teaches the use of wheelchairs, canes or braces (NINDS).
  • Occupational therapy teaches new ways to bathe, dress, prepare meals and clean house (NINDS).
  • Vocational therapy and counseling or talk therapy help with work and with the emotional impact (NINDS).
  • The evidence: in a study of 43 adults with acute TM, scores for neurological and functional recovery improved significantly between admission and discharge from inpatient rehabilitation, even for people with poor function at first. The study had no comparison group, and scan findings did not predict who would improve (rehabilitation study, PubMed).

What it costs

  • Physical therapy: per-session cost estimate being researched. Medicare Part B covers medically necessary outpatient physical therapy with no yearly limit; you pay 20% of the Medicare-approved amount after the deductible (Medicare.gov).
  • MRI: The Pricer reports that a self-pay MRI commonly costs about $250–$1,000 for many routine single-body-part scans, and notes that a scan of more than one body region, such as brain and cervical spine, may be billed as more than one study (The Pricer, MRI cost).
  • IVIG: The Pricer reports about $5,000–$15,000 or more per infusion before insurance adjustments, depending on coverage and where it is given (The Pricer, IVIG cost).
  • Plasma exchange: usually priced per session. In the hospital price files The Pricer reviewed, posted cash prices for the exchange procedure ranged from about $660 to $5,400, with supplies, labs and room charges often billed separately (The Pricer, plasmapheresis cost).
  • Hospital stay and spinal tap: cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic is a licensed health care profession whose treatment typically involves manual therapy, often including spinal manipulation (NCCIH). It has no role in diagnosing or treating TM. We found little research on chiropractic care for TM; our PubMed search turned up only case reports, which concern recognizing the condition rather than treating it.

Back or neck pain with new weakness, numbness or bladder or bowel changes needs emergency medical care first. Pain is often among the first signs of TM (NINDS), and a chiropractic case report describes a diagnosis delayed for months in a man with back pain and neurological symptoms (case report, PubMed). Another describes a person with acute TM who came to a chiropractic office with neck and upper-back pain; that patient was not treated with manipulation (case report, PubMed).

Later in recovery

If you later want help with ordinary aches, get your neurologist’s clearance, tell the chiropractor you have had spinal cord inflammation, and keep care gentle. NCCIH reports that serious problems from spinal manipulation, including serious spinal or neurological problems, are very rare but may be more likely in people with underlying health problems; neck manipulation has been linked to tears in neck arteries that can lead to stroke (NCCIH). As an MBHA caution (not a finding from a study), we advise against neck manipulation and against forceful manipulation of any area with weakness or numbness after spinal cord inflammation. Your physical therapist is the main guide for rebuilding strength.

Without insurance, The Pricer reports about $55–$100 for a follow-up visit and about $90–$200 for a first appointment (The Pricer, chiropractic cost).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

We found little research on acupuncture for TM itself, and what exists is small and uncontrolled.

  • Bladder and bowel, 16 people: in a Chinese observational study, 16 people with TM had electroacupuncture, which uses a mild electrical current, five days a week and then three, for 8 weeks. Afterward, 5 of 16 had normal voiding, 6 partly normal and 5 no change; of 8 people with stool retention, 4 had normal bowel movements. There was no comparison group, and the authors call for randomized trials (observational study, PubMed).
  • Case reports: a 2008 report describes a woman with TM whose pain, sleep and mood improved with acupuncture added to inpatient rehabilitation (case report, PubMed); a 2024 report describes a woman who regained walking and bladder and bowel function after 36 electroacupuncture sessions (case report, PubMed). One person’s story can’t show that acupuncture caused the change.

Related evidence in spinal cord injury (not TM): a 2022 meta-analysis of six small trials found that acupuncture lowered nerve pain after spinal cord injury, but the authors saw signs of publication bias and said its role remains to be determined (meta-analysis, PubMed). A Cochrane review of non-drug treatments for chronic pain in spinal cord injury found two acupuncture trials with no evidence of benefit, and judged the overall evidence too weak for firm conclusions (Cochrane review, PubMed).

In short: it is not known whether acupuncture helps TM. If you want to try it for pain or sleep, use it only alongside — never instead of — hospital treatment and rehabilitation, and tell your neurologist.

Safety

When not delivered properly, acupuncture can cause serious problems including infections, punctured organs and injury to the central nervous system (NCCIH). Choose a licensed practitioner who uses sterile, single-use needles, and tell them about reduced feeling or any bleeding or infection risk.

Cost: The Pricer reports about $90–$185 per follow-up visit and about $125–$230 for a first private visit, with community clinics around $50–$90, and notes that Medicare Part B covers acupuncture only for qualifying chronic low back pain (The Pricer, acupuncture cost).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement has been shown to treat transverse myelitis. We found little research on herbal remedies for TM. The medicines that are used are described in the conventional medicine section.

Tell your neurologist and pharmacist about every supplement. Supplements can interact with medicines or pose risks with some medical problems (NCCIH). Many people with TM take steroids or other immune-calming medicines, and some herbs affect how those work.

Cautions from NCCIH

  • Asian ginseng may worsen autoimmune disorders and interfere with blood clotting (NCCIH).
  • Cat’s claw might make the immune system more active, which could increase symptoms of autoimmune diseases, and it may interact with immunosuppressants (NCCIH).
  • St. John’s wort has a high overall risk of drug interactions, including documented interactions with the immunosuppressant cyclosporine, and can cause potentially serious serotonin-related side effects with certain antidepressants (NCCIH); some antidepressants are used for nerve pain (NINDS).

Vitamin D

A review of TM notes that low vitamin D levels have been linked to TM and to repeated attacks, and that vitamin D deficiency is common after spinal cord damage and can affect bone health (review, PubMed Central). That is a link, not proof that supplements prevent attacks. Ask your doctor whether to have your level checked. We list no doses.

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Gentle massage may ease muscle tightness and aches during rehabilitation. We found little research on massage in transverse myelitis itself, but two small studies in people with spinal cord injury give some clues:

  • In a randomized feasibility trial of 40 people with chronic spinal cord injury, five weekly sessions of upper-body Swedish massage reduced pain and fatigue; so did a guided-imagery relaxation comparison group, so massage was not clearly better (randomized trial, PubMed).
  • In an exploratory study of 30 people with nerve pain after spinal cord injury, massage and acupuncture both improved some pain ratings after 6 weeks of treatment, but the improvements within each group were no longer significant at a follow-up two months later (exploratory study, PubMed).

These are small studies of a different condition, so they cannot show that massage works for TM.

Safety

  • The risk of harm from massage appears low, but rare serious problems, including a blood clot, nerve injury or bone fracture, have been reported, some with vigorous deep-tissue massage (NCCIH).
  • Reduced feeling and weakness. When sensation is reduced, skin can break down from friction (review, PubMed Central). Ask the therapist to use light pressure, check your skin afterward, and never press hard over numb areas.
  • Early recovery. Long periods of immobility call for blood-clot prevention (review, PubMed Central), so ask your care team before any massage in the first weeks.

Cost: one national chain, Massage Envy, advertises memberships of about $70–$90 a month, according to The Pricer (The Pricer, Massage Envy cost). Rates elsewhere vary.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Recovery from TM can take many months, and for some people it involves lasting changes (NINDS). An MBHA Wellness Coach can help you turn your rehabilitation team’s advice into daily habits — always alongside medical care, never instead of it.

Building routines for bladder, bowel and skin

Bladder dysfunction is one of the most common and disabling consequences of TM and often persists even after strength returns; urinary tract infection is the most common medical complication (review, PubMed Central). A coach can help you keep the toileting, catheter, fluid and bowel routines your team prescribes.

Heat, infection and “pseudo-relapses”

One review explains that a rise in body temperature (fever, hot weather, hot baths, exercise), dehydration, stress or any infection, especially a urinary tract infection, can cause temporary worsening of old symptoms, and that this does not automatically mean a new attack (review, PubMed Central). Because you cannot tell the difference at home, MBHA advises calling your neurologist promptly rather than guessing. The review suggests drinking enough fluid and exercising during cooler hours (review, PubMed Central).

Pacing and safe movement

Your physical therapist decides what exercise is right. A coach can help you stick to that plan, build in rest and keep a log of what helps or worsens symptoms. Fatigue, mood changes and thinking problems are recognized after MS and other autoimmune disorders (review, PubMed Central). Occupational therapists can recommend ways to make bathing, dressing and cooking safer (NINDS). See our Balance guide and Chronic Fatigue guide (a different condition, but its tips on planning energy may help).

Emotional recovery

Losing independence, plus bladder, bowel and sexual changes, can affect mood and expectations. The review suggests seeing a clinical psychologist or psychiatrist early, and notes that in one study almost 90% of parents of children with TM perceived a need for psychiatric care but only about a quarter received it (review, PubMed Central). NINDS lists counseling and talk therapy as part of rehabilitation (NINDS). See our Anxiety and Depression guides. If you have thoughts of suicide, call or text 988; the Lifeline is available 24/7/365 and conversations are free and confidential (988 Lifeline).

Connect with others

NINDS lists these sources of information: the Christopher and Dana Reeve Foundation, the National Organization for Rare Disorders, the National Multiple Sclerosis Society, the Siegel Rare Neuroimmune Association and the Guthy-Jackson Charitable Foundation (NINDS). NINDS also invites people with TM to consider joining clinical trials (NINDS). MBHA coaching cost estimate being researched.

Another approach

Recovery, recurrence and follow-up

Most people with TM have at least partial recovery, with most of it in the first three months after symptoms begin. Healing can take many months, some people have permanent effects on daily tasks, and some have only one episode while others have a recurrence, especially when an underlying illness such as MS caused the inflammation (NINDS).

  • How well do people do? Older reviews describe roughly thirds: about one third of people with idiopathic acute TM recover with little or no lasting problems, one third keep a moderate disability and one third a severe one; spinal shock at presentation predicted a poor outcome (review, PubMed Central). Other reviews say up to two-thirds are left with moderate to severe disability (review, PubMed) and that residual disability splits about equally between severe, moderate, and minimal or none (MRI review, PubMed). These numbers come from mixed groups and older studies; your own outlook depends on the cause, severity and how fast treatment started.
  • Bladder problems linger. Bladder dysfunction often persists despite complete motor recovery (review, PubMed Central). In a mixed series of children (TM, flaccid myelitis and Guillain-Barré), 5 of 14 with sphincter problems still needed intermittent catheterization at last follow-up (pediatric study, PubMed).
  • Will it come back? TM with no cause found is usually a single episode, but it recurs in about one quarter to one third of cases in reviewed studies; risk factors reported include male sex, age over 50, severe weakness with sphincter problems, and negative spinal fluid and antibody tests (review, PubMed Central). NINDS says recurrence is more likely when an underlying illness such as MS is behind it (NINDS).
  • Watching for MS. A review reports that MS-like lesions on a brain MRI in people with partial TM carry about an 80% risk of progressing to MS over 3 to 5 years, while the risk is under 10% when the brain MRI and spinal fluid are normal (review, PubMed Central). Follow-up MRI and neurology visits are how this is tracked.
  • Worse again later? Do not assume. Worsening of old symptoms with fever, infection or heat is not automatically a relapse (review, PubMed Central), but new weakness, numbness or bladder or bowel changes still deserve a same-day call to your neurologist or an ER visit.

Another approach

Living with TM: bladder, bowel, spasticity, pain and more

Many lasting problems can be treated even when strength does not fully return. Your team will tailor this; we list drug classes only and no doses.

  • Bladder. TM can cause failure to store urine, failure to empty, or both together. Urodynamic tests and a bladder ultrasound are often needed to sort out which, and options include medicines, clean intermittent catheterization, and other devices or procedures (review, PubMed Central). See our Bladder Problems guide.
  • Bowel. Bowel dysfunction can mean constipation or leakage. Reviewed measures include a high-fiber diet, fluids, exercise, a regular toileting routine, laxatives, and for some people transanal irrigation (review, PubMed Central). See our Bowel Problems guide.
  • Spasticity (stiffness and spasms). Physical therapy, stretching, orthotics and aquatic therapy are used for mild cases; medicine classes include baclofen, tizanidine and dantrolene, botulinum toxin injections and, if oral medicines cause too much sedation, baclofen delivered through a pump into the spinal fluid (review, PubMed Central). NINDS lists muscle relaxants such as baclofen, tizanidine and cyclobenzaprine (NINDS). The review warns that the pump needs careful evaluation because of serious risks if baclofen suddenly stops.
  • Pain. TM pain can be muscle or joint pain or nerve pain. Treatment classes include certain antidepressants and anticonvulsants, anti-inflammatory pain relievers, and topical products; biofeedback, physical therapy, acupuncture and electrical nerve stimulation are listed as non-drug options. A pain specialist may be needed (review, PubMed Central).
  • Autonomic dysreflexia. In people whose spinal cord lesion is high (at about the mid-back or above), a trigger below the lesion, such as a full bladder or bowel impaction, can set off a sudden surge in blood pressure with a pounding headache, sweating above the lesion and flushing; severe cases can be very dangerous. Ask your team for a written plan so you and your family know the triggers and what to do (review, PubMed Central).

Another approach

Children and teens

TM is much less common in children than adults, with peaks in toddlers under 3 and in ages 5 to 17, and boys and girls are equally affected. It often follows a respiratory infection. Children more often have a longer lesion and a better recovery than adults, and conversion to MS is less common; the most frequent long-term complication in children is bladder dysfunction. A review cautions that findings in adults and children should not be assumed to apply to each other (review, PubMed Central).

Plasma exchange is used in children mostly when steroids are not enough, but the evidence comes from retrospective hospital series (pediatric study, PubMed, pediatric study, PubMed). A pediatric neurologist should lead care.

Member stories

Living with Transverse Myelitis? Share your experience

Real experiences help others choose. Tell us what you tried — conventional medicine, chiropractic, acupuncture, herbs, massage or coaching — what it cost and what changed.

No stories have been published for this condition yet. Yours could be the first.

Which approaches have you tried?

What did you try, what did it cost, and what changed for you? Please leave out anything you’d rather keep private.

We read every story before it’s published and may shorten it. Stories describe one person’s experience; results vary. See our Privacy Policy.

Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

Find the right practitioner

Search MBHA’s Health Directory for doctors, chiropractors, acupuncturists and massage therapists across the Monterey Bay.

Search the Directory All Health Conditions

The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)(3) organization and does not endorse any particular products or practices. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. We strongly recommend that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition. MBHA provides administrative support, education and navigation — not medical, legal or tax advice — and cannot guarantee claim, billing or fundraising outcomes. MBHA is not an emergency service: in an emergency, call 911 or go to the nearest emergency room.