Myelitis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Myelitis?
A neurologist, a doctor who treats diseases of the brain, spinal cord and nerves, usually leads care for myelitis. Myelitis means inflammation of the spinal cord. Treatment targets the cause and the swelling. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is myelitis?
Myelitis means inflammation of the spinal cord. The details below are about transverse myelitis, the form that patient sources describe.
Transverse myelitis is a nervous system disorder caused by inflammation of the spinal cord. The swelling can damage myelin, the covering around nerve fibers. This disturbs the signals between spinal nerves and the rest of the body.
The disorder is rare. A person with transverse myelitis will often feel a band-like sensation across the trunk of the body.
Symptoms
Symptoms may develop within a few hours or days, or over 1 to 4 weeks. They can quickly become severe. They tend to occur at or below the damaged area of the spinal cord. Both sides of the body are often affected, but sometimes only one side is affected.
Common symptoms include:
- Weakness in the legs that worsens quickly. If the upper spinal cord is affected, the arms are weak too.
- Pain, often lower back pain or sharp, shooting pain that spreads down the legs or arms or around the torso.
- Abnormal feelings such as burning, tickling, pricking, numbness, coldness or tingling.
- Bowel and bladder problems. These include needing to go more often or urgently, leaking, not being able to urinate, or constipation.
Some people have breathing problems, sexual problems or long-term pain. Trouble breathing is an emergency, as explained in the "When to see a doctor" section.
Causes and who gets it
In many cases, the cause is unknown. When doctors cannot identify a cause, they call it idiopathic.
Possible causes include:
- Immune system disorders, such as multiple sclerosis (MS) or neuromyelitis optica spectrum disorder. In some people, transverse myelitis is the first sign of one of these diseases.
- An immune reaction after an infection or, rarely, a vaccine, when the immune system mistakenly attacks the body's own tissue.
- Infections from bacteria, viruses, parasites or fungi, such as HIV, syphilis, shingles, West Nile virus and Lyme disease.
- Other inflammatory disorders, such as sarcoidosis and lupus.
Transverse myelitis 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.
How doctors diagnose it
Doctors diagnose it with your health history and a full nerve exam. These tests can help:
- An MRI (magnetic resonance imaging) scan of the spine. It will almost always show a damaged area, called a lesion, in the spinal cord. An MRI of the brain can give clues to other causes, especially MS.
- Blood tests, which can find or rule out other problems, including HIV infection and vitamin B12 deficiency.
- A lumbar puncture, also called a spinal tap, which tests the spinal fluid. It can find infections.
Treatment
Treatment aims to treat an infection that caused the condition, reduce inflammation of the spinal cord, and relieve symptoms. Common first treatments include:
- Steroid medicines (corticosteroids) given through a vein. They may decrease swelling in the spinal cord.
- Plasma exchange therapy (plasmapheresis) for people who do not respond well to steroids. It swaps the liquid part of the blood for special fluids.
- Intravenous immunoglobulin (IVIG), a treatment that can help reset the immune system. It is an injection of antibodies from many healthy donors.
- Antiviral medicines. They may help if a virus has infected the spinal cord.
In rare cases, when breathing is greatly affected, a person may need a respirator, a machine that helps with breathing. This is usually temporary.
Rehabilitation can help too. Strength and function can improve even years after the first episode. Physical therapy can help keep muscle strength and flexibility and help regain bladder and bowel control.
When to see a doctor
Contact your provider if you have sudden, sharp back pain that shoots down your arms or legs or wraps around your trunk. Symptoms can quickly become severe. Also call right away if you have bladder or bowel problems. Call if you get worse, even with treatment.
Call 911 or go to the emergency room if you have sudden weakness or numbness of an arm or leg, trouble breathing, or you cannot speak. Also go if you have a sudden change in mental state, such as confusion.
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. A direct primary care doctor can see you early, send you to a neurologist, and help with follow-up care.
Common questions
Can people recover from myelitis?
Most people with transverse myelitis have at least partial recovery. Most recovery happens within the first three months after symptoms begin. About a third of people recover completely. Others have lasting disability and need help with daily activities.
Can myelitis come back?
Usually not. It may come back in some people with an underlying cause, such as MS.
Does myelitis run in families?
No, it does not appear to.
Sources
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.
