Transverse myelitis all you need to know

Transverse myelitis is a neurological disorder that involves inflammation of the spinal cord. When the inflammation occurs across the width of the spinal cord, affecting the entire cross-section, it is referred to as “transverse myelitis” (TM).

Transverse myelitis can result from various causes, including infections (such as viral or bacterial), autoimmune diseases (like multiple sclerosis), certain vaccinations, and other inflammatory conditions. The immune system mistakenly attacks the spinal cord, leading to the inflammation that disrupts the normal functioning of nerve fibers.

Common symptoms of transverse myelitis include:

Sensory disturbances: This may include feelings of numbness, tingling, or burning sensations in the arms and legs.

Motor deficits: Weakness or paralysis of the limbs may occur, making it difficult to walk or perform daily activities.

Pain: Patients may experience severe back pain or pain in the affected area of the spinal cord.

Bowel and bladder dysfunction: Transverse myelitis can lead to problems with controlling bowel and bladder functions.

Coordination and balance issues: Some individuals may experience difficulties with coordination and balance, leading to unsteadiness while walking.

The severity of transverse myelitis can vary from mild to severe, depending on the extent of inflammation and the affected area of the spinal cord. In some cases, the symptoms may progress rapidly, while in others, they may develop more gradually.

Treatment for transverse myelitis often involves addressing the underlying cause, if known, and managing symptoms to promote recovery and reduce complications. Immunosuppressive medications may be prescribed to reduce inflammation, and other supportive therapies like physical therapy and pain management techniques can also be beneficial.

It’s essential for individuals with suspected transverse myelitis to seek immediate medical attention, as early diagnosis and treatment can improve outcomes and prevent further damage to the spinal cord. If you or someone you know is experiencing symptoms suggestive of transverse myelitis, please consult a healthcare professional for a proper evaluation and management.

Allopathic management of transverse myelitis

The allopathic (conventional Western medicine) management of transverse myelitis typically involves a combination of approaches aimed at reducing inflammation, managing symptoms, and promoting recovery. The specific treatment plan may vary based on the underlying cause, severity of symptoms, and individual patient needs. Here are some common components of the allopathic management of transverse myelitis:

High-dose corticosteroids: Intravenous administration of high-dose corticosteroids, such as methylprednisolone, is often the first-line treatment to reduce inflammation and halt the immune response attacking the spinal cord. Treatment with corticosteroids is typically initiated as soon as possible after the onset of symptoms.

Plasma exchange (plasmapheresis): In some cases, when corticosteroids are ineffective or not well-tolerated, plasmapheresis may be considered. This procedure involves removing and filtering the patient’s blood to remove harmful antibodies or other components of the immune system that may be attacking the spinal cord.

Immunosuppressive medications: If the inflammation persists despite corticosteroid treatment, or if there is an autoimmune component to the condition, immunosuppressive drugs like azathioprine, mycophenolate mofetil, or rituximab may be prescribed to further suppress the immune response.

Pain management: Pain is a common symptom of transverse myelitis. Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, and opioids, may be prescribed to manage pain effectively.

Physical therapy and rehabilitation: Physical therapy plays a crucial role in the management of transverse myelitis. It helps improve strength, balance, coordination, and mobility. A tailored rehabilitation program can help patients regain functional independence and adapt to any permanent disabilities.

Bowel and bladder management: Patients with transverse myelitis often experience bowel and bladder dysfunction. Doctors may recommend strategies such as catheterization, bowel training, and dietary modifications to manage these symptoms.

Treatment of underlying conditions: If transverse myelitis is secondary to another underlying condition, such as an infection or autoimmune disease, treating the underlying cause is essential for optimal management.

Psychological support: Dealing with a neurological disorder can be emotionally challenging. Patients may benefit from psychological support and counseling to cope with the emotional impact of the condition.

It’s important to note that transverse myelitis is a complex condition, and individual cases may differ. The management plan should always be tailored to the specific needs and circumstances of each patient. Patients with transverse myelitis require ongoing medical monitoring and follow-up care to track their progress and make any necessary adjustments to their treatment plan. If you or someone you know has been diagnosed with transverse myelitis, it’s crucial to work closely with healthcare professionals to ensure the best possible outcomes.

Acupuncture for transverse myelitis

Acupuncture can be used as a complementary therapy for individuals with transverse myelitis.

Potential benefits of acupuncture for transverse myelitis may include:

Pain management: Acupuncture has been known to help alleviate pain associated with various neurological conditions, including transverse myelitis. By stimulating specific acupuncture points, it may promote the release of endorphins and activate the body’s natural pain-relieving mechanisms.

Reduced inflammation: Some research suggests that acupuncture may have anti-inflammatory effects. By targeting certain acupuncture points, it is believed to help modulate the immune response and reduce inflammation, which could be beneficial in transverse myelitis cases with an autoimmune component.

Improved circulation: Acupuncture may enhance blood flow to the affected areas, which can promote healing and nourishment of tissues damaged by inflammation.

Nerve function support: Acupuncture is thought to influence the nervous system positively. It may help regulate nerve impulses and potentially aid in nerve regeneration and repair.

Stress reduction: Chronic conditions like transverse myelitis can cause emotional stress. Acupuncture may help reduce stress and anxiety, improving overall well-being.

Enhanced relaxation and sleep: Acupuncture sessions can promote relaxation, leading to better sleep quality, which is vital for the body’s healing and recovery process.

Remember that individual responses to acupuncture may vary, and its effectiveness in managing symptoms will depend on the severity of the condition and the patient’s unique circumstances.

Acupuncture treatments are typically tailored to the individual, considering their specific symptoms, constitution, and response to treatment. The acupuncturist will conduct a thorough assessment before designing a treatment plan that may involve selecting specific acupuncture points along the meridians (energy pathways) relevant to the patient’s symptoms.

Acupuncture points for transverse myelitis

Few of the acupuncture points that are commonly used in Traditional Chinese Medicine (TCM) for neurological conditions, including transverse myelitis. Acupuncture is an ancient practice that involves inserting thin needles into specific points on the body to stimulate energy flow and promote healing. Here are few of the acupuncture points that are often used for neurological conditions:

Baihui (GV20) – On the top of the head, at the midpoint of the line connecting the apexes of both ears.

Dazhui (GV14) – On the midline of the back, below the spinous process of the 7th cervical vertebra.

Fengchi (GB20) – On the back of the neck, in the depression between the upper portion of the sternocleidomastoid muscle and the trapezius muscle.

Hegu (LI4) – On the dorsum of the hand, between the first and second metacarpal bones, in the middle of the second metacarpal bone.

Taichong (LV3) – On the dorsum of the foot, in the depression distal to the junction of the first and second metatarsal bones.

Zusanli (ST36) – On the anterior aspect of the lower leg, one palm width below the kneecap, and one finger width lateral to the shinbone.

Quchi (LI11) – At the lateral end of the transverse cubital crease when the elbow is flexed.

Sanyinjiao (SP6) – On the medial aspect of the lower leg, three finger widths above the medial malleolus.

Shenshu (BL23) – On the lower back, 1.5 finger widths lateral to the lower border of the spinous process of the second lumbar vertebra.

Pishu (BL20) – On the lower back, 1.5 finger widths lateral to the lower border of the spinous process of the 11th thoracic vertebra.

Ganshu (BL18) – On the lower back, 1.5 finger widths lateral to the lower border of the spinous process of the ninth thoracic vertebra.

Shenshu (BL23) – On the lower back, 1.5 finger widths lateral to the lower border of the spinous process of the second lumbar vertebra.

Pangguangshu (BL28) – On the lower back, 1.5 finger widths lateral to the lower border of the spinous process of the fourth lumbar vertebra.

Huatuojiaji points – These are points located along the spine, corresponding to the affected area.

Yanglingquan (GB34) – On the lateral side of the lower leg, in the depression anterior and inferior to the head of the fibula.

Ashi points – Tender or trigger points found in the affected muscles or areas.

Bai Lao (BL32) – At the lower border of the sacrum, in the midline.

Yanglinquan (GB34) – On the lateral side of the lower leg, in the depression anterior and inferior to the head of the fibula.

Houxi (SI3) – On the dorsum of the hand, in the depression proximal to the head of the fifth metacarpal bone.

Weizhong (BL40) – Midpoint of the transverse crease of the popliteal fossa, between the two tendons.

Mingmen (GV4) – On the lower back, at the level of the second lumbar vertebra, about 3 finger widths away from the midline.

Zhongwan (CV12) – On the front of the abdomen, midway between the navel and the lower end of the breastbone.

Shuigou (GV26) – On the upper lip, in the philtrum.

Taixi (KI3) – On the medial aspect of the foot, in the depression between the medial malleolus and the Achilles tendon.

Xiajuxu (ST39) – On the lower leg, 8 finger widths below the kneecap, one finger width lateral to the anterior border of the tibia.

Self care strategies for transverse myelitis

Self-care is an essential aspect of managing transverse myelitis and can complement medical treatments provided by healthcare professionals. Here are some self-care strategies that individuals with transverse myelitis can consider to improve their overall well-being and quality of life:

Follow your doctor’s treatment plan: Adhere to the prescribed medications and treatment protocols recommended by your healthcare provider.

Manage pain: Use pain management techniques, such as relaxation exercises, heat or cold therapy, or gentle stretching, to help alleviate pain.

Physical therapy: Engage in regular physical therapy exercises to improve strength, flexibility, and mobility.

Balance and coordination exercises: Practice exercises to improve balance and coordination, which can help prevent falls and injuries.

Maintain a healthy diet: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins to support overall health.

Stay hydrated: Drink plenty of water to maintain proper hydration.

Rest and sleep: Ensure you get adequate rest and quality sleep to support healing and recovery.

Avoid stress: Practice stress-reduction techniques like deep breathing, meditation, or yoga to manage stress and anxiety.

Assistive devices: Consider using assistive devices like canes or braces to improve mobility and safety.

Adapt living spaces: Modify your home to accommodate your needs, such as installing handrails or grab bars.

Manage bladder and bowel function: Create a schedule for bathroom breaks and consider pelvic floor exercises to manage bladder and bowel function.

Monitor skin health: Check for pressure sores regularly and maintain good skin hygiene.

Stay socially connected: Engage in social activities and maintain a support network to prevent feelings of isolation.

Seek emotional support: Talk to friends, family, or a counselor to cope with emotional challenges.

Avoid smoking and alcohol: Refrain from smoking and limit alcohol consumption to promote better health.

Prevent infections: Take preventive measures like regular handwashing and staying up-to-date with vaccinations.

Monitor medications: Be aware of potential side effects of medications and inform your healthcare provider if you experience any adverse reactions.

Exercise caution in extreme temperatures: Avoid extreme hot or cold weather, as temperature changes may exacerbate symptoms.

Practice relaxation techniques: Incorporate relaxation practices, such as mindfulness or progressive muscle relaxation, into your daily routine.

Stay informed: Educate yourself about transverse myelitis, treatment options, and new developments in medical research.

Remember that every individual’s experience with transverse myelitis is unique, so tailor self-care strategies to your specific needs and preferences. Always consult with your healthcare provider before making any significant changes to your self-care routine or treatment plan.

20 foods & herbs which help in management of transverse myelitis

While there is no specific diet or herb that can cure transverse myelitis, certain foods and herbs may have potential benefits in supporting overall health and managing symptoms. It’s essential to remember that these foods and herbs are not a replacement for medical treatment but can be incorporated into a balanced diet to promote general well-being. Always consult with your healthcare provider before making significant changes to your diet or introducing new herbs, especially if you are taking medications or have underlying health conditions. Here are 20 foods and herbs that may be beneficial:

Foods:

Omega-3 fatty acids: Found in fatty fish (such as salmon, mackerel, and sardines), flaxseeds, and chia seeds, omega-3s have anti-inflammatory properties that may help reduce inflammation associated with transverse myelitis.

Colorful fruits and vegetables: High in antioxidants, vitamins, and minerals, fruits and vegetables can support overall health and provide essential nutrients for the body.

Whole grains: Foods like brown rice, quinoa, and oats are rich in fiber and can contribute to better digestion and gut health.

Nuts and seeds: These are excellent sources of healthy fats, protein, and minerals that support the nervous system and overall health.

Lean proteins: Include lean sources of protein, such as chicken, turkey, tofu, and beans, to support muscle health and repair.

Dairy or dairy alternatives: Choose low-fat or non-dairy options to maintain bone health and provide essential nutrients like calcium and vitamin D.

Healthy fats: Olive oil, avocados, and nuts contain healthy fats that support brain health and reduce inflammation.

Water: Stay well-hydrated to support overall health and ensure proper body function.

Herbs:

Turmeric: Contains the compound curcumin, known for its anti-inflammatory properties.

Ginger: May have anti-inflammatory and pain-relieving effects.

Boswellia (Indian frankincense): Traditionally used for its anti-inflammatory properties.

Ashwagandha: An adaptogenic herb that may help manage stress and support the nervous system.

Ginkgo biloba: Known for its potential cognitive benefits and antioxidant properties.

Ginseng: Adaptogenic herb that may support overall well-being.

Skullcap: Traditionally used to support the nervous system and reduce inflammation.

Feverfew: May have potential anti-inflammatory properties.

Cat’s claw: An herb that has been studied for its potential immune-modulating effects.

Astragalus: Known for its immune-boosting properties.

Please note that individual responses to foods and herbs can vary, and some people may have allergies or sensitivities to certain ingredients. Always start with small quantities and monitor your body’s response when trying new foods or herbs. If you are considering using any of these herbs as supplements or in medicinal form, consult with a qualified herbalist or healthcare provider to ensure safety and appropriateness for your specific condition. Remember, a well-balanced diet, regular exercise, and adherence to medical treatments are crucial for managing transverse myelitis effectively.

Physiotherapy for transverse myelitis

Physiotherapy may help in management and rehabilitation process for individuals with transverse myelitis. It focuses on optimizing physical function, mobility, and quality of life by addressing the specific impairments caused by the condition. A physiotherapist, also known as a physical therapist,  designs individualized treatment plans to meet the unique needs of each patient. Here are some ways physiotherapy can benefit individuals with transverse myelitis:

Improving strength and flexibility: Physiotherapy includes exercises to strengthen weakened muscles and improve flexibility, which can enhance overall mobility and reduce the risk of secondary complications like joint contractures.

Enhancing balance and coordination: Balance and coordination exercises help patients regain control over their movements and reduce the risk of falls.

Gait training: For individuals experiencing difficulty with walking, physiotherapists can provide gait training to improve walking patterns, use assistive devices if necessary, and promote safe ambulation.

Range of motion exercises: These exercises aim to maintain or improve joint flexibility and prevent stiffness in paralyzed or weakened limbs.

Functional training: Physiotherapists work with patients to practice everyday activities like dressing, bathing, and transferring to promote independence and restore functional abilities.

Pain management: Physiotherapy may include techniques such as heat or cold therapy, manual therapy, and specific exercises to help manage pain associated with transverse myelitis.

Posture education: Correcting and maintaining good posture is essential to prevent secondary issues related to muscle imbalances and pressure sores.

Respiratory exercises: In severe cases of transverse myelitis affecting the upper spinal cord, respiratory muscles can be affected. Physiotherapists can provide breathing exercises to maintain optimal lung function.

Adaptive equipment and mobility aids: Physiotherapists can assess the need for and provide recommendations on using mobility aids and assistive devices to improve independence and safety.

Patient education: Physiotherapists educate patients and their caregivers about the condition, exercises, proper body mechanics, and strategies to manage day-to-day activities.

Home exercise programs: Creating customized home exercise programs allows patients to continue their rehabilitation independently between physiotherapy sessions.

Supportive care during acute phases: In the acute phase of transverse myelitis, physiotherapists work closely with other medical professionals to address immediate needs and facilitate the transition to rehabilitation.

Yoga for transverse myelitis

Yoga can be a beneficial complementary therapy for individuals with transverse myelitis, as it offers various physical, mental, and emotional benefits. However, it’s essential to approach yoga with caution and consult with your healthcare provider or a qualified yoga instructor before starting any yoga practice, especially if you have transverse myelitis or any other neurological condition. Here are some potential benefits of yoga for individuals with transverse myelitis:

Improved flexibility and mobility: Yoga poses (asanas) can help improve flexibility, range of motion, and joint mobility, which can be particularly beneficial for individuals with reduced mobility due to transverse myelitis.

Strength and balance: Yoga involves holding various postures that can help build strength in different muscle groups and improve balance, helping to reduce the risk of falls.

Stress reduction: The practice of yoga often incorporates breathing exercises and meditation, which can help manage stress, anxiety, and promote relaxation.

Pain management: Certain yoga poses and techniques can be used to alleviate pain associated with transverse myelitis through relaxation and increased body awareness.

Body awareness: Yoga encourages mindfulness and body awareness, helping individuals become more attuned to their body’s signals and needs.

Posture improvement: Yoga emphasizes proper alignment and posture, which can help prevent secondary issues related to poor posture.

Enhanced circulation and lymphatic flow: Yoga poses and breathwork can stimulate blood circulation and lymphatic flow, supporting overall well-being.

Neuromuscular re-education: Yoga practices may help retrain the nervous system and muscles to work together in harmony, potentially benefiting individuals with neurological conditions.

When practicing yoga with transverse myelitis, it’s crucial to keep the following considerations in mind:

  • Start Slowly: Begin with gentle and modified poses that suit your abilities and comfort level. Avoid overexertion or pushing yourself too hard.
  • Adapt Poses: Modify yoga poses to accommodate any physical limitations or restrictions you may have due to transverse myelitis.
  • Focus on Breathing: Pay attention to your breath during the practice. Deep, mindful breathing can promote relaxation and better oxygenation.
  • Avoid Strain: Avoid poses that cause pain or discomfort. Listen to your body and adjust as needed.
  • Supervision: If you are new to yoga or have specific concerns related to your condition, consider practicing under the guidance of an experienced yoga instructor who has knowledge about neurological conditions.

Yoga can be a valuable addition to a comprehensive treatment plan for transverse myelitis. However, always consult with your healthcare provider to ensure that yoga is safe and appropriate for your specific condition and health status. They can provide personalized guidance and recommendations based on your individual needs and abilities.

Ayurvedic management of transverse myelitis

Ayurveda, the traditional system of medicine from India, offers a holistic approach to health and well-being. It aims to balance the body, mind, and spirit to promote overall health and manage various conditions, including neurological disorders like transverse myelitis. However, it’s essential to understand that Ayurveda should be used as a complementary therapy alongside conventional medical treatment and under the guidance of qualified Ayurvedic practitioners. Here are some Ayurvedic principles and therapies that may be considered for managing transverse myelitis:

Panchakarma: Panchakarma is a set of detoxification and rejuvenation therapies that aim to remove accumulated toxins from the body and restore balance. Specific Panchakarma therapies may be selected based on the individual’s constitution (Prakriti) and the nature of the disease.

Herbal Medicines: Ayurvedic herbs with anti-inflammatory and neuroprotective properties may be prescribed to help reduce inflammation and support the nervous system. Some commonly used herbs in neurological conditions include Ashwagandha, Brahmi (Bacopa monnieri), and Guggulu.

Abhyanga (Ayurvedic Massage): Abhyanga involves full-body massage with medicated oils, which can help improve circulation, relax muscles, and promote overall well-being.

Swedana (Herbal Steam Therapy): Swedana involves steam therapy with herbal decoctions or oils, which can aid in relaxing muscles and relieving pain.

Dietary Recommendations: An Ayurvedic diet, tailored to the individual’s constitution and imbalances, may be suggested to support healing and nourishment.

Yoga and Pranayama: Gentle yoga asanas and pranayama (breathing exercises) can be beneficial in promoting flexibility, relaxation, and overall well-being.

Meditation and Mindfulness: Ayurveda places great emphasis on mental well-being. Meditation and mindfulness practices can help manage stress and promote emotional balance.

Nasya: Nasya involves administering herbal oils or powders through the nostrils, which may have a beneficial effect on the nervous system.

Lifestyle Recommendations: Ayurvedic practitioners may provide lifestyle guidance to promote healthier habits and routines that support the body’s natural healing processes.

Rasayana Therapy: Rasayana refers to rejuvenation therapy that aims to enhance vitality and overall health. Specific Rasayana formulations may be recommended for neurological conditions.

Remember that Ayurvedic treatments should be individualized to each person’s unique constitution and health status. The management of transverse myelitis requires close collaboration between Ayurvedic practitioners and conventional healthcare providers to ensure safe and effective treatment.

It’s crucial to consult a qualified Ayurvedic practitioner who has experience in treating neurological conditions. They will perform a thorough evaluation and create a personalized treatment plan based on your specific needs and medical history. Always inform your conventional healthcare provider about any complementary therapies you are considering to ensure comprehensive and coordinated care.

Dr Neeraj Kaushik Founder Kaushik Acupuncture & Complementary Medicine

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