Lyme Disease Vs Juvenile Idiopathic Arthritis
Lyme arthritis is most common in 7- to 10-year-olds, so it tends to be confused with juvenile idiopathic arthritis , a type of inflammatory arthritis that affects young children, says Dr. Lewandowski. If a child lives outside the areas where Lyme is common New England, the Mid-Atlantic, Wisconsin, and Minnesota its more than likely JIA, not a tick-borne disease.
To answer the JIA vs. Lyme arthritis question, doctors can test patients for signs of Lyme disease. The first step is to test for antibodies with an enzyme-linked immunosorbent assay test. If that comes back positive, a doctor will likely order something called a Western blot test, which will show certain darkened bands if there are antibodies fighting a Borrelia burgdorferi infection.
Prevention Of Lyme Arthritis
Preventive measures to avoid or minimize tick bites are important and may include landscaping measures, removal of deer from specific areas, wearing appropriate clothing such as pants tucked into socks, and tick repellants. In areas where ticks are common, its important to check your child frequently and remove any ticks. Ticks may remain on your childs skin for hours before attaching themselves, so checking for ticks after coming inside may help remove them before they attach.
How To Prevent Tick
High-risk regions for infection include the Atlantic coast from Maine to Virginia, as well as Minnesota, Wisconsin, and Michigan. Lyme disease was once rare in Canada, but has been steadily ratcheting its range northward as a result of climate change.
If you live in an area where Lyme disease is common, some simple steps can minimize the risk of tick bites:
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How Is Lyme Arthritis Diagnosed
When Lyme disease is suspected as the cause of your childs arthritis, its important to be diagnosed by a pediatric rheumatologist who can distinguish Lyme arthritis from juvenile arthritis. Your physician will conduct a full medical exam and may ask questions about where and when your child may have been exposed to ticks. To diagnose Lyme disease, your physician will order blood tests.
There are two blood tests to diagnose Lyme disease:
- Enzyme-linked immunosorbent assay test. The test detects antibodies to B. burgdorferi. False-positive results are not uncommon, so it is used in conjunction with the Western blot test if results are positive.
- Western blot test. If the ELISA test is positive, this test can help confirm the diagnosis. In this two-step approach, the Western blot detects antibodies to several proteins of B. burgdorferi.
Signs Of Arthritis After Lyme Disease
Joints are complex structures that connect bones to each other. These structures also make it possible to twist, bend and move your body. Arthritis happens when inflammation affects joint functioning.
The symptoms of arthritis after Lyme disease often come on suddenly and may include:
- Brief periods of joint pain, swelling and stiffness
- Pain that occurs in just one joint, typically a large one like your knee
- Difficulty performing once simple activities, like standing from a seated position or climbing stairs
- A popping sensation when you use the joint. Find out more about crepitus .
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Diseases That Mimic Rheumatoid Arthritis
A number of diseases can be similar to rheumatoid arthritis . There is notable overlap between symptoms of RAjoint pain, stiffness, fatigueand those of RA-like rheumatic or autoimmune diseases, other types of arthritis, and some viral and bacterial infections.
Ruling out other conditions that mimic RA, such as Lyme disease, lupus, and fibromyalgia is part of diagnosing RA. This process relies on a combination of your physical examination, medical history, laboratory test results, and imaging studies.
Even after you’ve been diagnosed with RA, your healthcare providers may consider other conditions if your symptoms are still not improving, despite treatment with disease-modifying anti-rheumatic drugs .
Research published in the Annals of the Rheumatic Diseases found that more than 40% of people who were diagnosed with RA actually had a different condition.
It’s also possible that you could have RA and another condition.
Verywell Health / Hilary Allison
How Is Lyme Arthritis Treated
Most children with Lyme arthritis recover after 28 days of antibiotic treatment. The most common antibiotics prescribed for Lyme disease are:
- Doxycycline for children eight years of age or older
- Amoxicillin for children under eight years of age
If the symptoms persist after a course of antibiotics, a second course of antibiotics may be prescribed.
In persistent cases of Lyme arthritis, your rheumatologist may prescribe non-steroidal anti-inflammatory drugs , disease-modifying antirheumatic drugs , or intra-articular corticosteroids.
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Managing Lyme Arthritis Pain: Can Herbs Help
Stephen Harrod Buhner is a well-known herbalist and author who specializes in the treatment of Lyme disease and co-infections. His book, Healing Lyme, Natural Healing of Lyme Borreliosis and the Coinfections Chlamydia and Spotted Fever Rickettsioses, is based on extensive research on Lyme disease and was the first book I bought after my Lyme diagnosis.4 It offers an exhaustive description of what occurs during Lyme infection, as well as a detailed herbal protocol that Ive been following for the past 3 years.
Buhner writes that Lyme joint pain is caused by the way Borrelia burgdorferi interacts with joint spaces in the body. According to Buhners book, The most important thing to understand about Lyme disease is that the bacteria have an affinity for collagenous tissue. This is at the root of every symptom they cause… Wherever feed on those tissues is where the symptoms occur.
Joints are largely composed of collagen both cartilage and synovial fluid are collagenous structures. Lyme bacteria break down and eat collagen wherever they lodge. As you can imagine, this leads to inflammation and pain.
Lyme can plant itself into any collagenous tissue in the body meaning it can infect any joint space. It can also choose the myelin sheaths around nerve tissue in the brain or spinal cord, also made of collagen. This results in neurological symptoms, and is another reason Lyme patients symptoms and pain are so different.
Arthritis After Lyme Disease
Lyme disease is an illness spread through ticks saliva. If an infected tick bites you, bacteria in the saliva enters your bloodstream, increasing your risk of Lyme disease.
When there is a delay in treatment, the bacteria may settle into the joints, leading to a special type of arthritis. In fact, six out of 10 people who do not receive timely treatment for Lyme disease develop arthritis.
At Aurora Health Care, our experts quickly and accurately diagnose arthritis after Lyme disease using blood tests and a physical exam. In most cases, youll receive care from a primary care doctor or arthritis expert . But if the arthritis is advanced, an orthopedic specialist may be involved in your care. Learn more about how orthopedics and primary care work together for your care at Aurora.
Most people can make a full recovery after simple treatments, like antibiotics. But if your body needs help to heal, we offer treatments like physical therapy and minimally invasive surgery if others dont work.
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Incidence Of Autoimmune Disease Development After Lyme Disease
Patients may develop new-onset systemic autoimmune joint diseasesincluding rheumatoid arthritis , psoriatic arthritis , or spondyloarthritis following Lyme infection, according to research published in Arthritis & Rheumatology.
Shelia L. Arvikar, MD, of the division of rheumatology, allergy, and immunology at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital and Harvard Medical School, Boston, MA, and colleagues conducted a medical record review of all adult patients seen at a single specialty rheumatology clinic between 2003 and 2015. The researchers also analyzed records of patients enrolled in the Lyme arthritis cohort over a 2 year period for comparison.
Dr Arvikar and colleagues identified 30 patients who had developed new-onset systemic autoimmune joint disease a median of 4 months after Lyme disease 15 patients with RA, 13 with PsA, and 2 with peripheral SpA. Patients diagnosed with PsA or SpA were found to have had a past medical history significant for psoriasis, axial involvement, or enthesitis.
The number of patients that we have evaluated has steadily increased over the past 13 years, Dr Arvikar and colleagues wrote. Moreover, during the most recent 3-year period, the proportion of patients in whom we diagnosed a systemic autoimmune joint disease following Lyme infection increased even more.
Lyme Disease And Rheumatoid Arthritis: Similarities Differences And Why A Misdiagnosis Can Be Deadly
Because its symptoms mimic those of so many other diseases both tick-borne and otherwise Lyme disease is often misdiagnosed. One of the most common Lyme disease misdiagnoses is Rheumatoid Arthritis , a chronic condition with less clear causes than Lyme disease.
Though there are many fundamental differences between these two conditions, its true that arthritic pain stemming from Lyme disease can often look like RA. In fact, Lyme was first discovered and documented in part because of a group of children presenting with arthritis symptoms in Lyme, Connecticut.
So, if youre experiencing joint pain, how can you tell the difference? If youve been bitten by a tick or think youre at risk for a tick-borne disease, its extremely important not to delay seeking medical attention or ignore any arthritic pain that might be associated with Lyme disease. Continue reading to better understand the differences and similarities between Lyme disease and arthritis.
Lyme Disease: Causes and Risk Factors
Lyme disease is a tick-borne infectious disease caused by the spiral-shaped bacteria Borrelia burgdorferi sensu lato. Though Lyme is treatable with antibiotics, it can worsen, change symptoms, spread to the neurological system, become a chronic condition, and even become life-threatening if not diagnosed and treated right away.
Common Symptoms of Lyme Disease
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When To Consider Testing For Lyme
You might be wondering if your joint pain could be related to Lyme disease, especially if youve had a blacklegged tick bite in the past.
The CDC estimates that a staggering 90% of cases of Lyme disease may go undiagnosed in the US each year. So while approximately 30,000 reported cases of Lyme reported annually, as noted, the actual number of cases may be closer to 300,000.
Lyme disease is often called the great imitator, because it mirrors many other diseases. These include, but are not limited to, osteoarthritis, rheumatoid arthritis, and multiple sclerosis. Unfortunately, unless you live in an area considered Lyme endemic, such as the northeastern United States, most conventional doctors may not think to test you for Lyme.
If your symptoms include waxing and waning flu-like symptoms, brain fog, fatigue, or joint pain, and if you think you may have had a tick bite in the past, consider asking your doctor for a test for Lyme disease. Remember that some people with Lyme experience have all of the above symptoms and more, while some experience just one. Also be aware that the ELISA test commonly given by conventional doctors is not always accurate, as it tests for antibodies that may or may not be present at the time of testing. My initial ELISA test came back negative it had been a year since my initial tick bite but my symptoms were in full force.
Treatment Of Lyme Arthritis
Infection with the tick-borne spirochete Borrelia burgdorferi leads to an estimated 300,000 new cases annually of Lyme disease in the United States. The northeastern United States is the most affected region, but the infection is also found in mid-Atlantic states, the upper Midwest, and in California, and it now extends into Canada. Lyme borreliosis in also endemic in parts of Europe and Asia. In untreated patients, the infection generally occurs in stages, with different manifestations at each stage. The disease usually begins with an expanding skin lesion, erythema migrans, accompanied by flu-like symptoms. Weeks later, untreated patients may have neurologic involvement, characterized by lymphocytic meningitis, cranial neuropathy, or radiculoneuropathy, or they may develop carditis, frequently manifested as atrioventricular nodal block. These manifestations of the disease can usually be treated successfully with appropriate antibiotic therapy for 24 weeks.
This range of outcomes leads to a conundrum. Do LA patients with little or no apparent response to oral antibiotic therapy still have active B. burgdorferi infection requiring IV antibiotic therapy, do they have postinfectious LA requiring therapy with disease-modifying antirheumatic drugs , or do they have another form of chronic inflammatory arthritis? Either IV antibiotics or DMARD, given inappropriately, might be harmful.
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What Are The Symptoms Of Lyme Arthritis
Lyme arthritis usually occurs during a later stage of Lyme disease that has not been treated. For many children, arthritis is the first symptom of Lyme disease they experience, and most do not remember being bitten by a tick.
Symptoms of Lyme arthritis include:
- Joint pain, usually in the knees
- Joint swelling, usually in the knees
- Limping or inability to put weight on a limb
Early symptoms of Lyme disease may include:
- Enlarging, warm rash at the site of the bite that can last days to weeks, often with a partial central clearing so that it looks like a bulls eye
If left untreated, later stage symptoms of Lyme disease can include:
- Rash on other parts of the body
- Bells palsy
- Severe headache and neck stiffness
- Pain and swelling in the large joints
- Heart palpitations
The Lyme Bacteria Compound That Targets Your Joints
Brandon Jutras, a biochemist from Virginia Tech, just figured out why the bacteria behind Lyme disease causes arthritis and other problems
As this bacteria spreads, it releases something called peptidoglycan. Peptidoglycan is found in the cell walls of many bacteria. Unfortunately, peptidoglycan triggers an inflammatory response in the body. This response could be what causes Lyme arthritis, according to Jutras.
In his research, Jutras found peptidoglycan in the joint fluid of people who were exposed to Lyme disease but didnt have an active, detectable Lyme disease infection anymore. They did, however, have inflamed joints and other symptoms of Lyme disease arthritis.
Like I mentioned above, peptidoglycan triggers an inflammatory response in the body. Thats because the immune system knows it comes from bacteria, so it tries to eradicate it. How severely the body responds to peptidoglycan varies from individual to individual.
Why is this discovery important?
For two reasons first, researchers could work on Lyme disease treatments that target peptidoglycan. Second, peptidoglycan could be a way to diagnose chronic Lyme conditions like arthritis. If doctors detect peptidoglycan in your joint fluid, theres a good chance your arthritis symptoms are the result of chronic Lyme.
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Is Your Arthritis Chronic Lyme In Disguise
If you develop joint pain and stiffness as you get older, its easy to assume you have osteoarthritis, a common condition among middle-aged and older adults thats caused by regular old wear and tear.
But before you write off a sudden case of stiff, achy joints as a sign youre not the spring chicken you once were, ask yourself a question Whats my tick exposure like?
Ticks are sneaky little freeloaders. They hide out in grasses and on trees just waiting for the chance to hitch a ride and a meal. And if you spend a lot of time outside, youve probably found more than a few ticks on you over the years.
Hopefully, you found them before they had a chance to sink their fangs into you. But lets face it theyre easy to miss. Sometimes you find one a week later, fat and happy after feasting on your blood. Sometimes you never find them. They hide in your armpit or behind your ear. They fill up on your blood, fall off and go their merry way, while youre none the wiser.
The problem is, these ticks could be carrying Lyme disease bacteria. Now, I know everyone thinks that if youre exposed to Lyme disease bacteria, youll develop symptoms that make it very easy to catch right away, like a bulls eye rash or flu-like symptoms.
It pops up in around 60 percent of people with untreated Lyme. The question is how do you know if your arthritis is caused by Lyme or not?
Lucky for us, researchers may have just discovered a way
Diet & Targeted Exercise Can Help Lyme
If you have Lyme disease, discuss a protocol for killing the bacteria with your doctor. Of course, this is imperative for eliminating symptoms.
That said, most Lyme protocols take time, and there is much more you can do during treatment to mitigate symptoms of pain.
For instance, Dr. Farshchians clinic advises people with Lyme arthritis to decrease any environmental factors that may contribute to inflammation, such as mold exposure or mast cell activation . Addressing common comorbidities often makes a significant improvement in symptoms, she says. In addition, her clinic aims to help patients reduce inflammation organically through diet, lifestyle, anti-inflammatory herbal supplements, medications, light therapy, Epsom-salt baths, and exercise.
In my experience and that of my clients, all these approaches can be helpful. Below are a few of my favorite strategies.
1. Rolling with a foam roller
One thing you can easily do at home is to roll tight tissue in your body with a foam roller. This helps to lengthen and release tension in your fascia, or connective tissue.
Rollers are inexpensive and available online. Just play with gently rolling the muscles surrounding painful joints, or really any sore muscles at all, with the roller. If you need ideas for how to experiment with this, this video demonstrates my favorite ways to roll.
2. Gentle strengthening
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