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.
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.
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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Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
What Are Signs And Symptoms Of The Third Stage Of Lyme Disease
Late stage Lyme disease can result when treatment is unsuccessful or started too late due to unrecognized symptoms or misdiagnosis. The late disseminated stage occurs months or years after initial infection and can have a major impact on a patients health and quality of life. Late Lyme arthritis is a third stage Lyme disease manifestation that involves fluid accumulation and pain in joints, particularly in the knee joints. Late neurologic disease is a 3rd stage condition that can also be debilitating and difficult to diagnose. Late disseminated Lyme disease symptoms include a variety of symptoms that are often neurologic in origin including: numbness in extremities, mental fogginess and concentration problems, and difficulty following conversations or processing information.
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Lyme Disease And Leaky Gut Syndrome
Small intestine inflammation more commonly known as leaky gut syndrome is a condition where the spaces between the cells that line the small intestine become enlarged. This allows bacteria and food particles to enter the bloodstream triggering the immune system to respond by releasing inflammatory cytokines. The outer layer of bacteria that enters the bloodstream contains fat and a carbohydrate called lipopolysaccharide that causes the immune system to react. Food allergies, alcoholism, stress, infections , toxicants, certain medications, and mast cell activation syndrome are some of the causes of increased intestinal permeability. Paradoxically, leaky gut syndrome also leads to an increase in food allergies since food proteins pass through the inflamed small intestine into the bloodstream creating an antibody response.
Leaky gut syndrome can lead to systemic inflammation which contributes to fatigue, headaches, joint pain, ADHD, and brain fog. Research has demonstrated leaky gut syndrome can contribute to autoimmune conditions. Since many of the symptoms related to Lyme disease are caused by inflammation, successfully treating leaky gut syndrome is crucial to reducing the systemic inflammatory burden.
How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
Is Your Back Pain Caused By Lyme Disease
Back pain can have a number of different causes. One potential cause that you may not immediately think about is Lyme disease. Lyme disease tends to be especially prevalent during the summer months when the weather is warm and people are more likely to be outside in nature. To learn more about how Lyme disease can cause back pain, we must first understand what Lyme disease is, how it spreads, and how it affects the body.
Lyme disease is a bacterial infection that is spread by infected ticks. It is most commonly spread by the blacklegged tick, which is commonly referred to as deer ticks. These ticks are found throughout the eastern United States and infect an estimated 329,000 individuals annually. Within that number, around 15% of people with Lyme disease can experience back pain.
Lyme disease affects the body in a few different ways. One of the first distinguishing signs of Lyme disease is a circular rash that forms on the skin surrounding the tick bite. Additionally, Lyme disease can also cause fatigue, fever, and pain in the muscles and joints. It can also cause a phenomenon known as Lyme arthritis.
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Types Of Peripheral Neuropathy
Lyme disease is an inflammatory disease that rapidly progresses. Transmitted by the bite of an infected deer tick, Lyme disease is most common in the Northeast section of the United States. However, the disease has also appeared in the upper East coast, in the upper Midwest, and along the coasts of northern California and Oregon.
Signs of Lyme disease include skin rash and painful inflammation of joints , accompanied by flu-like symptoms. The symptoms of Lyme disease increase in severity as the disease spreads though the body.
Early diagnosis and treatment are important to stop the progression of the disease. If untreated, the disease can result in neurological disorders such as peripheral neuropathy, including Bells palsy, as well as pain, numbness or weakness in the limbs. The onset of peripheral neuropathy typically develops weeks, months or years later, if the disease is left untreated.
While potentially serious, Lyme disease can be treated, especially in the early stages. It is important to take preventive measures when outdoors in areas known to have infected deer ticks. Some helpful steps include: wearing enclosed shoes and light colored clothing checking clothing and exposed skin frequently for ticks and using insect repellant containing DEET on skin or clothes.
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The Patient Who Suspects Chronic Lyme Infection
LD is so prevalent and well known that the public is well aware of its symptoms. Many patients, particularly those who have been diagnosed with fibromyalgia, degenerative arthritis, or neuropathies of unknown origin, believe they may have had unrecognized and undiagnosed LD. They may request recurrent LD testing and even antibiotic therapy, despite negative Lyme serologic tests.
In reality, some of these patients may be correct. The authors have encountered several patients who presented with a chronic pain syndrome such as fibromyalgia who were later found to have disseminated LD or PTLDS. At this juncture, we are not prepared to set out any specific diagnostic or treatment protocols. We do, however, believe that pain practitioners must consider LD as an underlying cause of pain in patients who present without a clear event or cause of chronic muscle, nerve, or joint pain. In addition to diffuse musculoskeletal and joint pathologies, cranial neuropathy , and radiculoneuritis are 2 of the most common presentations of acute, early neurologic LD. Given what appears to be an epidemic of LD, we will carefully monitor the situation and bring you updates through Practical Pain Management.
Life With Lyme Disease: A Womans 15
Scientists estimate that 10 to 20 percent of patients diagnosed and treated for Lyme continue to suffer symptoms such as arthritis, brain fog, pain and fatigue.
While Jutrass work focused on Lyme arthritis, its entirely possible that the findings may apply to other lingering Lyme symptoms.
Whenever and wherever the bacteria grow, they shed peptidoglycan, so it seems plausible that it may be important in other late-stage Lyme manifestations, Jutras said.
The new findings could be an important new insight into Lyme arthritis and maybe other outcomes of infection with Borrelia burgdorferi, said Mark Soloski, an immunologist and a professor of medicine at the Johns Hopkins School of Medicine and co-director for basic research for the Johns Hopkins Lyme Disease Research Center, who like Alaedini was not involved in the new study.
Soloskis own research points to immune system malfunctions. Our patients showed inflammation in unique regions of the brain, which suggests an immune process may be driving the symptoms, Soloski said.
Preventing Tick Bites
Minimizing your exposure to ticks is the best defense against Lyme disease. The following measures are recommended to reduce your likelihood of tick bites:
For more information on Lyme disease and prevention, visit cdc.gov.
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Gastrointestinal Symptoms Of Lyme Disease
The spirochete that causes Lyme disease Borrelia burgdorferi and the associated tickborne infections such as Bartonella and Babesia can directly affect any organ system in the body, including the gastrointestinal tract. About 80% of the immune system is located around the digestive tract, so digestive health influences the immune response. Gastrointestinal symptoms of Lyme disease range from food intolerances to constipation.
Rarely does acute Lyme disease cause gastrointestinal symptoms, but occasionally nausea, vomiting, heartburn, and abdominal pain can occur. More commonly, digestive symptoms such as constipation, gas/bloating, and abdominal discomfort occur in chronic or late-stage Lyme disease. Lyme bacteria can directly infect the gastrointestinal tract causing inflammation that creates digestive symptoms. In turn, digestive issues can cause immune dysregulation increasing susceptibility to chronic infections. Whether digestive problems are a result of Lyme disease or increase the susceptibility to chronic infections, it is essential to address the underlying issues to restore health more quickly and effectively.
Imaging For Lyme Arthritis
X-rays are a helpful diagnostic tool to identify the cause of arthritis and pain. Joint space narrowing is the hallmark finding on X-ray in osteoarthritis, and not seen in other causes of joint pain. Lyme disease rarely causes changes of the bones on X-ray.
Soft tissue swelling will be seen with Lyme disease and trauma, not in other conditions.
An MRI of a joint is useful at differentiating Lyme arthritis from septic arthritis or structural damage. In Lyme disease, an MRI will demonstrate joint effusion, synovitis, and muscle edema .
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The Problem Of Being Successfully Treated For Lyme Disease And The Continuation Of Symptoms
This is a frustration we often see in our cervical spine instability patients. They have been declared recovered, yet symptoms persist.
In December 2017 research paper, lead by Alison W Rebman at Johns Hopkins University School of Medicine published in the journal Frontiers in Medicine these observations:
Although a physical exam and clinical laboratory tests showed few objective abnormalities, standardized symptom questionnaires revealed that patients with post-treatment Lyme Disease symptoms are highly and clinically significantly symptomatic, with poor health-related quality of life.
Post-treatment Lyme Disease symptoms patients exhibited levels of fatigue, musculoskeletal pain, sleep disturbance, and depression which were both clinically relevant and statistically significantly higher than controls.
As the prevalence of post-treatment Lyme Disease symptoms continues to rise, there will be an increased need for physician education to more effectively identify and manage post-treatment Lyme Disease symptoms as part of integrated patient care.
A second paper published in 2021 , and again lead by Alison W. Rebman at Johns Hopkins University School of Medicine made many observations into the symptoms of Lyme Disease. Some of these findings included neck pain of unknown origin. Here are some brief learning points from this paper.
The Lyme Disease And Digestive Symptom Connection
Since Lyme disease is a systemic infection, the bacteria can affect any organ or tissue in the body. The gastrointestinal symptoms of Lyme disease and its associated infections are related to inflammation, nerve damage, and mitochondrial dysfunction. These digestive symptoms or conditions may occur in isolation, but if systemic symptoms are present or the digestive disorders are challenging to treat, Lyme disease should be considered as the underlying culprit. In addition, treating digestive disorders improves the outcome of treating Lyme disease by reducing intestinal-mediated immune dysregulation.
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Severe And Lingering Symptoms Occur In Some After Treatment For Lyme Disease
- Johns Hopkins Medicine
- In a study of 61 people treated for the bacteria that causes Lyme disease, researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing.
p> In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing.
“Post-treatment Lyme disease syndrome is a real disorder that causes severe symptoms in the absence of clinically detectable infection,” says John N. Aucott, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Lyme Disease Clinical Research Center.
Efforts to better understand patients with these symptoms have largely failed, says Aucott, because patients grouped under the umbrella term “chronic Lyme disease” could belong to one of various subgroups.
“People have been comparing apples to oranges by grouping all of those with chronic Lyme disease together,” he says. “Our study was designed to compare apples to apples.”
Other Johns Hopkins researchers who participated in this study include Alison W. Rebman, Ting Yang, Erica A. Mihm, Mark J. Soloski and Cheryl Novak.
Unexplained Pain And Other Sensations
Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem 00090-7/abstract%20″ rel=”nofollow”> 27).
When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified musculoskeletal cause.
You can also have strange sensations like skin tingling or crawling, or numbness or itchiness 00090-7/abstract%20″ rel=”nofollow”> 27).
Other symptoms have to do with cranial nerves.
- Ear-ringing . Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as youre trying to fall asleep. About 10 percent of people with Lyme experience this (
- Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing .
- Jaw pain or toothaches that are not related to actual tooth decay or infection.
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Lyme Disease: Ankle Pain
Undiagnosed & untreated Lyme disease can progress to Lyme arthritis and cause joint pain, including stiff, swollen and painful ankles .
Lyme arthritis occurs when the bacteria responsible for the Lyme infection enter the joints and inflame the tissues. In many cases Lyme arthritis episodes are short-lived, and can recur for months to years after the initial tick bite.
Lyme disease is only one possible cause of swollen or painful ankle joints. Whatever the cause, effective & lasting treatment starts with an expert evaluation by a foot and ankle specialist. Back to top
Lab Tests To Determine The Cause Of Arthritis
If a tick-borne infection such as Lyme disease is a possible cause of pain, a comprehensive tick-borne infection panel at a Lyme-specific specialty laboratory should be ordered. Traditional rheumatology tests will provide insight into the underlying cause of pain and arthritis.
A positive low-level ANA is not specific to lupus or rheumatoid arthritis and can also be elevated in Lyme disease. Anti-CCP antibodies are specific to rheumatoid arthritis and rarely positive in Lyme arthritis, so are helpful in distinguishing Lyme arthritis from rheumatoid arthritis.
An erythrocyte sedimentation rate can demonstrate the degree of inflammation in the body, but is only significant above 50 mm/hr. The test creatinine phosphokinase tests for inflammation in the muscles, called myositis. Myositis is rare in children, except in Lyme disease and polymyositis, so CPK may be a useful test.
Synovial fluid from the affected joint can provide valuable information. In Lyme arthritis, the fluid will be yellow, have thin viscosity, be cloudy or turbid, and have a white blood count from 5,000-50,000. The white blood count in septic arthritis will be much higher. Lyme tests like PCR can be performed on synovial fluid.
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Signs And Symptoms Of Lyme Disease
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Lyme disease is an underreported, under-researched, and often debilitating disease transmitted by spirochete bacteria. The spiral-shaped bacteria, Borrelia burgdorferi, are transmitted by blacklegged deer ticks. Lymes wide range of symptoms mimic those of many other ailments, making it difficult to diagnose .
The blacklegged ticks can also transmit other disease-causing bacteria, viruses, and parasites. These are known as coinfections . These ticks that transmit Lyme are increasing their geographical spread. As of 2016, they were found in about half the counties in 43 of 50 states in the United States .
Lyme is the fifth most reported of notifiable diseases in the United States, with an estimated 329,000 new cases found annually . Some studies estimate that there are as many as 1 million cases of Lyme in the United States every year .
Most people with Lyme who are treated right away with three weeks of antibiotics have a good prognosis.
But if youre not treated for weeks, months, or even years after infection, Lyme becomes more difficult to treat. Within days of the bite, the bacteria can move to your central nervous system, muscles and joints, eyes, and heart .
Here is a list of 13 common signs and symptoms of Lyme disease.