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.
Lyme Disease And Joint Pain: Its Complicated
For starters, Lyme is complicated and every patient responds to the disease differently.
Approximately 30,000 new cases of Lyme are diagnosed each year, according to the CDC, and just over one-third of them develop arthritis as a symptom. The most common symptoms beyond the bullseye rash are chills, fatigue, headache/neck stiffness, fever. Painful and swollen jointsespecially in large joints such as the kneeare often considered a late-stage symptom of Lyme, but can appear even days after the tick bite.1-3 Some individuals may find out they have Lyme as a result of chronic joint painwithout ever knowing they had a tick bite.
Ticks rarely carry just one strain of bacteria. They usually deliver several different species of bacteria and parasites in one bite these are called co-infections. Co-infections are one reason Lyme disease diagnosis and treatment can be so complex and difficult.
To investigate why joint pain is a common symptom of Lyme disease, I spoke to Thalia Farshchian, ND, a naturopathic doctor practicing at Medical Options for Wellness, a clinic in Foster City, California. She specializes in treating patients affected by chronic and complex diseases, including Lyme disease.
It is estimated that about 70% of individuals presenting with bullseye rash do not recall a tick bite, she said. It is important to note that the absence of a rash does not rule out Lyme Disease as diagnosis, but may be supportive of the diagnosis.
Health’citizen Scientists’ Take On Tick
As for the new study, it leaves open the question of whether there are still bacteria in the joints of patients with Lyme arthritis, Lewis said. The authors think that the peptidoglycan remains in synovial fluid after the pathogen is gone. My guess is that the pathogen remains in the joints and sheds the antigen. It would be good to know how things really are.
When it comes to finding physical explanations for patient symptoms, its not necessary to determine whether PTLDS is caused by lingering bacteria or to a malfunctioning immune system, said Dr. Peter Novak, an assistant professor of neurology at Harvard Medical School and director of the autonomic laboratory at Brigham and Womens Hospital. Novak, who also was not involved in the new study, and his colleagues have discovered patients end up with damage to their small nerves and also diminished blood flow to certain areas of the brain.
He suspects that damage is due to changes in the immune system that were kicked off by the Lyme infection and remain after the bacteria have been obliterated. As for patients who experience improvement when treated with long courses of antibiotics, Novak believes this is because many antibiotics also have an anti-inflammatory effect.
So, while others look for ways to test for the presence or absence of the bacteria, Novaks strategy is to try to make patients feel better by treating their symptoms.
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Diagnosis Of Lyme Arthritis
Like all proper diagnostic workups, it is essential to start with the history of the patient. In the case of tick-borne infections, it is important to know if there is a possibility the person may have been exposed to a tick prior to the onset of their symptoms. As mentioned previously, it can take up to two years for the pain caused by Lyme disease to manifest, so it is essential to review the patientâs history. Does the person spend time outdoors? Some activities increase exposure risks such as hiking, horseback riding, and camping, but people can also be exposed to ticks in parks, sports fields, in their yards, and from their pets bringing ticks into the house.
When children experience pain, they are often taken to their pediatrician who may not consider the diagnosis of Lyme disease. The same can occur for an adult with pain who presents to an orthopedist or sports medicine doctor.
On exam, the lining of the affected joint may be inflamed â called synovitis. Synovitis not only occurs in rheumatoid arthritis but also Lyme arthritis. Lyme arthritis rarely causes symmetrical joint involvement like rheumatoid arthritis, which can be helpful in making the correct diagnosis.
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.
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Facts About Lyme Disease In Pa
Ticks thrive in the countryside of Pennsylvania in particular, and according to a study published in the Proceeding of the National Academy of Sciences of the United States of America , Lyme has a greater likelihood of occurring where suburban developments encroach on existing forest. This is thought to be because the white-footed mouse that is the most important animal in the Lyme disease transmission cycle can live without too many predators under these circumstances.
Notable statistics of Lyme disease in PA include:
- Swollen lymph nodes
For some people, a telltale sign of the disease is the red bulls eye-shaped skin rash that presents in some, but not all sufferers, within three to 30 days after being bitten by a tick.
Often, these first signs are missed when youre infected with Lyme disease and are dismissed as the flu or some other virus. This is very worrying because if antibiotic treatment isnt begun when the first signs of the disease present, your condition can become more serious.
Joint pain is another issue that can occur with Lyme disease. In the worst cases, over several weeks, nervous system and heart issues can develop. If left untreated, you may suffer from arthritis and neurological issues. In fact, according to the Arthritis Foundation, when Lyme disease is untreated, more than half of all sufferers will develop sporadic arthritis bouts.
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
- Severe headache and neck stiffness
- Pain and swelling in the large joints
- Heart palpitations
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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
Early Lyme Disease Symptoms
- Bulls eye rash, or Erythema Migrans
Late Stage Lyme Disease Symptoms
- Facial drooping
Can Lyme Disease Cause Multiple Rashes
The most common early sign of Lyme disease is a skin rash that has a bulls eye appearance. It begins as a reddened area near the tick bite. As the rash increases in size, it clears in the middle and develops a red ring around the outside. A person may experience multiple rashes, such as you see here.
What can mimic Lyme disease?
Chronic Lyme disease, for instance, has symptoms very similar to those of several other chronic illnesses, such as juvenile idiopathic arthritis, fibromyalgia, and myalgic encephalomyelitis/chronic fatigue syndrome. Multiple sclerosis and arthritis also have symptoms similar to Lyme disease.
Are Lyme disease symptoms constant?
Chronic Lyme disease can cause symptoms of early Lyme disease such as fatigue and muscle aches to recur, but it can also cause new symptoms that affect different parts of the body.
What are Lyme disease flare ups?
Chronic Lyme Disease causes continuing, low-grade symptom flare-ups, and can occur when a patient has been infected for more than a year before seeking treatment or when steroids have been prescribed prior to the Lyme diagnosis.
Does caffeine affect Lyme disease?
No Role for Stimulants Here. Caffeine is not the answer to increasing energy levels in Lyme because it doesnt provide any nutrients needed for energy production. When youre feeling lethargic and drowsy, your go-to may be a caffeinated beverage such as coffee, tea, chocolate or a cola drink.
Can a bacterial infection cause petechiae on skin?
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Drugs That Block Excess Tnf
Having the right amount of tumor necrosis factor in your body is important. If you’re healthy, your body naturally takes care of this: It blocks any extra TNF you might have. That doesn’t always happen in diseases like RA, so you end up with too much TNF in your blood. That leads to inflammation and painful symptoms.
Fortunately, there are drugs that block excess tumor necrosis factor. They’re part of a group called biologics, and you might hear your doctor call them one of these names:
Rheumatoid arthritis patients who have not responded sufficiently to TNF inhibitors may be prescribed baricitinib or tofacitinib . They are a class of drugs known as Janus Kinase Inhibitors. JAKs work by interrupting the signal pathway from inside the cell involved in the inflammation.
Doctors are studying the effects of a TNF inhibitor on type 2 diabetes, but there are no conclusive results. Some studies show it improves insulin resistance, others don’t. More work is needed.
Is It Lyme Arthritis Or Jia
A Lyme arthritis diagnosis requires a two-step testing approach. False positives are complex and common.
The authors of a review article on the differentiating factors of Lyme arthritis in children recommend that patients suspected of having juvenile idiopathic arthritis in endemic regions for Lyme disease, may have Lyme arthritis and should be screened for Lyme disease.
Two-tier testing is advisable when a patients history suggests a possibility of potential tick bite, writes Elübieta Smolewska this month in the journal Pediatric Rheumatology. The development of consistent worldwide guidelines would simplify the diagnostic process in everyday pediatric practice.
In the absence of such guidelines, Dr. Smolewska and colleagues reviewed the scientific evidence for Lyme arthritis in children.
Clinical features
In the United States, Borrelia burgdorferi sensu stricto is the main cause of Lyme arthritis, while in Europe, two other genospecies of Borrelia burgdorferi have been implicated in Lyme disease: B. garinii and B. afzelii. The two are different in that an infection of the latter occurs within a short period of time from a tick bite, as opposed to a Borrelia burgdorferi sensu stricto infection which can manifest months later any month of the year, not only during summer months.
Diagnostics
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Sorting Out Your Symptoms Seeking A Diagnosis
Rheumatoid arthritis and lupus also known as systemic lupus erythematosus are both autoimmune diseases that can affect many parts of the body. Lyme disease is an infectious disease with some similar symptoms, caused by tick-borne bacteria.
Rheumatoid arthritis, lupus and Lyme disease can all cause severe, disabling joint pain, and the three diseases are frequently mistaken for each other during diagnosis.
Other symptoms that may indicate one or more of these diseases include skin rashes, kidney disease, fever, headaches, fatigue and depression. There are a number of tests that can be done to determine whether you suffer from rheumatoid arthritis, lupus or Lyme disease.
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What Are The Signs And Symptoms Of Lyme Disease
Early symptoms usually appear within 3 to 30 days after the bite of an infected tick. In 60-80 percent of cases, a circular bulls eye rash about two inches in diameter, called erythema migrans, appears and expands around or near the site of the tick bite. Sometimes, multiple rash sites appear. One or more of the following symptoms usually mark the early stage of Lyme disease: chills and fever, headache, fatigue, stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is unrecognized or untreated in the early stage, more severe symptoms may occur. As the disease progresses, severe fatigue, a stiff aching neck, and tingling or numbness in the arms and legs, or facial paralysis can occur. The most severe symptoms of Lyme disease may not appear until weeks, months or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems.
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Can Lyme Disease Cause Skin Problems
When a tick that causes Lyme disease bites you, it infects you with bacteria. Without treatment, the bacteria can spread to other areas of your body. Stage 2 begins when the bacteria spread to other parts of your body. During this stage, you may see small, oval rashes on your skin.
Can Lyme disease cause red spots?
Rash. From three to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center, forming a bulls-eye pattern. The rash expands slowly over days and can spread to 12 inches across.
What skin lesions are associated with Lyme disease?
The three characteristic cutaneous manifestations are erythema migrans, borrelial lymphocytoma, and acrodermatitis chronica atrophicans. Erythema migrans occurs in acute Lyme borreliosis, lymphocytoma is a subacute lesion, and acrodermatitis is the typical manifestation of late Lyme borreliosis.
Lyme Disease: Why Does Joint Pain Persist
Researchers have found clues that might lead to a treatment for Lyme arthritis. The secret may lie in the walls of the bacterium that causes the condition.
Lyme disease occurs when a person becomes infected with a tick-borne bacterium called Borrelia burgdorferi.
Initial symptoms typically include general fatigue, fever, skin rashes, and headaches.
Although doctors can often treat Lyme disease with antibiotics, if they do not catch it early, the bacteria can cause long-term issues with the individuals joints.
In fact, following infection with B. burgdorferi, about 60% of people develop a condition called Lyme arthritis, the hallmarks of which are inflamed and painful joints.
Lyme arthritis can persist for months or even years in some cases.
Researchers are still unsure why joint symptoms can continue long after antibiotics have destroyed the bacteria.
30,000 cases of Lyme disease among the United States population.
However, the true number of cases is likely to be much higher. In fact, the CDC estimate that there might be up to 300,000 cases each year.
According to the CDC, reports of Lyme disease have tripled since the late 1990s, and overall, tick-borne diseases are becoming more prevalent. This increase is due, at least in part, to rising global temperatures.
Due to the steady growth in the number of cases, scientists are keen to uncover more effective ways of treating the long-term symptoms.
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Expert Care For Joint Pain From Lyme Disease
At, Aurora Health Care, our team of more than 80 orthopedic specialists has years of experience and training caring for people with joint pain and other problems, like arthritis. This has led to fast and accurate diagnoses for the people we treat so they can return to their busy lifestyles.
Highlights of our program also include: