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Severe Back Pain or Fingertip Numbness May Signal Transverse Myelitis: The Silent Killer

Back pain or numbness in the fingertips might seem minor at first, but it could be an early warning sign of Transverse Myelitis—a severe condition that impacts spinal cord function. If left untreated, symptoms can escalate, leading to severe complications, including paralysis or death.

Dr. Kitidate Boonchai, a spine surgeon at Vejthani Hospital, explained that Transverse Myelitis is a condition caused by inflammation of the spinal cord, which plays a vital role in transmitting nerve signals between the brain and the body. This inflammation can affect the nervous system, causing patients to experience numbness and weakness in both feet, which gradually spreads to both legs. In some cases, a sudden back pain may occur first, followed by progressive weakness in the legs until it results in paralysis, making walking and defecation impossible. These symptoms tend to become more severe within a few hours to several days. Patients may also experience fever, loss of appetite, headache, and neck pain.

The causes of Transverse Myelitis can affect people of all ages and are not commonly related to genetics or family history. There are several causing factors:

Immunologic diseases such as Multiple Sclerosis (MS) or Systemic Lupus Erythematosus (SLE), or patients with a history of receiving vaccines.
Viral infections such as HIV, herpes virus, herpes simplex, Epstein-Barr virus (EBV), or poliovirus.
Bacterial infections such as syphilis
Parasitic or fungal infections

Diagnosing Transverse Myelitis starts with a detailed discussion about your symptoms and medical history and a thorough evaluation of your neurological function through various tests. These may include MRI scan, which helps doctors detect inflammation in the spinal cord, damaged nerve sheaths, and other abnormalities affecting the spinal cord or blood vessels. A lumbar puncture may also be performed to check for infection or assess elevated protein levels and white blood cells. Additionally, a blood test can help identify the pathogen responsible for causing Transverse Myelitis.

The treatment for Transverse Myelitis varies based on the underlying cause and the severity of symptoms. If an infection causes the condition, antiviral medications are prescribed. In cases linked to an autoimmune disorder during the acute phase, high-dose intravenous steroids are typically administered. If symptoms persist, plasmapheresis may be considered. Blood test results guide long-term treatment strategies, and if a relapse occurs, the risk of recurrence remains high. Patients in this group need to undergo immunosuppressive therapy for at least 3-5 years.

Currently, there is no known method to prevent Transverse Myelitis. However, maintaining overall good health through a balanced diet, regular exercise, and minimizing the risk of infections may help reduce the likelihood of developing the condition.