Fragments From Lyme Bacteria Persist In Joints Even After The Bacteria Are Killed Off
A new study published in Proceedings of the National Academy of Sciences sheds light on this medical mystery. To keep from spilling open, bacteria have rigid cell walls made of a matrix of protein and sugars, called peptidoglycan. Most bacteria recycle their peptidoglycan when they grow and divide, but the peptidoglycan of B. burgdorferi has a peculiar structure, and the bacteria is unable to reuse it. Instead, it dumps it into its immediate surroundings, like a microbial litterbug.
This peptidoglycan collects in the joints where B. burgdorferi is found. Almost all patients in the PNAS study with Lyme arthritis had peptidoglycan in their joint fluid. Most of them also had specific antibodies to peptidoglycan in the joint fluid, suggesting that the peptidoglycan was driving the inflammatory process. These antibodies were not found in fluid from people with other joint conditions, such as rheumatoid arthritis, osteoarthritis, or gout.
Patients with Lyme arthritis who did not get better with antibiotics still had peptidoglycan in their joint fluid. However, their joint fluid did not contain detectable B. burgdorferi DNA. This suggests that even after the bacteria were killed off, the peptidoglycan stayed behind, and stimulated further inflammation. This may explain why people with Lyme arthritis who do not respond to antibiotics may improve with medications that damp down the immune system, such as methotrexate or TNF inhibitors.
Recognizing Lyme Disease Causing Hip Problems In Children
Theres an old saying in medicine, If you hear hoof beats, think horses not zebras. It means to look for the obvious not search for strange, unusual causes of symptoms. But in the case of hip pain in children, it may be a zebra like Lyme disease. Most of the time, joint pain caused by Lyme disease affects the knee. But in a small number of cases, Lyme arthritis presents only in the hip.
Thats the conclusion of a group of pediatric orthopedic surgeons who studied their records of Lyme disease in children. Located in the northeastern region of the United States at the Childrens Hospital, this hospital is in an area where Lyme disease is very high.
Yet out of all the children treated at the hospital, only 73 cases of Lyme disease were reported between 1995 and 2009. And only eight of those cases were hip pain caused by Lyme arthritis. The children in the study ranged in ages from three to 20 years old. The symptoms presented included hip pain , refusal to put weight on that leg , and limp .
Fever was not a key feature for most of the children. None of the families were aware of any tick bites or unusual skin rashes. But lab values were suspicious with elevated white blood cell count and sed rate .
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.
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When Should I Go See My Doctor
Anyone who has been bitten by a black-legged deer tick is at risk for Lyme disease. The highest risk groups include those living in or visiting endemic areas, especially people who spend significant time outdoors such as gardeners, hikers, or outdoor workers.
Patients should seek advice from their doctor if they have a suspicious round expanding red skin lesion, and/or show signs of summer-flu, particularly during Lyme disease season, which is highest-risk late spring through July/August. If those circumstances apply or symptoms persist it is very important to go to a physician.
For the west coast and other more temperate regions Lyme disease can be a year-round concern.
In the later disseminated stages, Lyme disease can be a much more insidious and complex illness. An individual should seek medical care if experiencing symptoms such as prolonged fevers, unexplained fatigue, painful joints, new or unusual headache, or heart or neurologic symptoms. If unexplained viral-like symptoms last for more than 1-2 weeks, please seek the advice of a physician.
Lyme Disease & Plantar Fasciitis
A Lyme co-infection called Bartonella can cause the same foot and heel pain symptoms as plantar fasciitis:
- Painful inflammation along the bottom of your foot
- Pain is worst first thing in the morning
- Long periods of standing or sitting cause pain to flare up
Statistically, Americans are more likely to suffer from plantar fasciitis than Bartonella. No matter the cause of your foot pain, its important to learn the root cause for effective treatment. Our experienced surgical podiatrists will evaluate your foot and heel pain with a view to creating an effective and lasting treatment plan. Back to top
Milwaukee podiatrists treating all types of foot, heel & ankle pain
Our team of elite surgical podiatrists are committed to providing the highest level of care for every patient. Well take the time to listen as you describe your symptoms, and provide solutions for fast pain relief and long-term results.
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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
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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How To Diagnose Neuropathy
For most people, a diagnosis of neuropathy may be based upon a persons medical history, physical exam, lab work, and neurologic evaluation. The following tests can be useful to identify the condition, as well as rule out potential causes and contributing factors.
- Neurologic Exam: During a neurologic exam, your doctorusually a neurologistassesses reflexes ability to feel sensations like hot, cold, and pain coordination balance muscle strength and muscle tone.
- Blood Tests: Blood tests are run to assess nutritional deficiencies, organ function, toxins, and the presence of an atypical immune response.
- Electrodiagnostic Tests : EDX testing checks how well the muscles and nerves are functioning by measuring their electrical activity, which assists in determining the extent of nerve damage. Two commonly used procedures are electromyography and nerve conduction velocity . During an EMG, small needle electrodes are inserted through the skin into the muscle to measure the electrical activity while the muscle is at rest, during a mild contraction, and during a powerful contraction. Frequently, the NVC will be completed at the same time as the EMG, which helps further assess the amount and speed with which an electrical impulse moves through a nerve.
- Other Tests: The need for other testing will depend on the severity of your symptoms and could include specialized sensory testing, genetic testing, or a biopsy with tissue samples from a nerve, muscle, or skin.
How Does Lyme Disease Affect The Joints
Lyme disease is an infection caused by Borrelia burgdorferi bacteria transmitted from the bite of an infected blacklegged tick . A bulls-eye shaped rash is an easily recognizable sign of this tick borne disease however, if the rash doesnt appear or goes unnoticed, Lyme disease is often confused with other conditions due to the common nature of its flu-like symptoms.
Lyme disease can typically be treated with a course of antibiotics however, if left untreated, the infection can develop into a chronic disorder affecting the heart, joints, and nervous system. Once the disease reaches this stage, the infection may be managed, but the damage it has caused can be irreversible. .
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Symptoms Of Lyme Disease
A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.
The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.
The rash can have a darker or lighter area in the centre and might gradually spread. It’s not usually hot or itchy.
The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.
Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:
- a high temperature, or feeling hot and shivery
- tiredness and loss of energy
Some people with Lyme disease develop more severe symptoms months or years later.
This is more likely if treatment is delayed.
These more severe symptoms may include:
- pain and swelling in joints
- nerve problems such as pain or numbness
- heart problems
- trouble with memory or concentration
Life With Lyme Disease: A Woman’s 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.
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Could Your Knee Pain Be Caused By Lyme Disease
Lyme disease is a complex disease, with many of the symptoms often found in other conditions, making diagnosis difficult. Brian Hollenbeck, Chief of Infectious Disease at NEBH, explains that Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. It is transmitted when an infected tick bites a person, with typical initial symptoms including fever, headache, fatigue, and a skin rash that may look like a bullseye. If left untreated, infection can spread to joints, the heart, and the nervous system.
If Lyme disease is untreated, some patients will develop Lyme arthritis, which includes painful swelling, warmth and redness of the joint, most commonly affecting the knee. Lyme arthritis differs from other forms of arthritis in that the pain isnt constant. It is usually limited to one side and typically only effects one joint. The swelling and pain will usually get better without treatment, but can recur intermittently until the disease is treated with antibiotics. With time and proper antibiotic treatment, Lyme arthritis symptoms resolve completely in 97% of patients.
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.
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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Three Diseases That Cause Hip Pain
Your hip joint is one of the largest in your body, and the responsibility it bears isnt insignificant: Its one of your primary weight-bearing joints, so when theres a problem, your mobility and overall quality of life are greatly affected.
Countless people are affected by hip pain, whether from a sports injury, sitting at an office desk for too long, or because of a chronic condition. There are some diseases that are responsible for a disproportionate amount of hip pain, and its important to learn about them so you can practice preventive self-care and be well-informed when you talk with your doctor.
The expertise of the Advanced Spine and Painteam benefits you whether you visit us with hip pain, or youre trying to avoid it. Dr. Thomas Raley, Dr. Randy Davis, Dr. Brian Lee, and Dr. Alfred Correa are all concerned with keeping your joints in tip-top shape, educating you about self-care, and ensuring that youre pain-free.
Lyme Disease Joint Pain And Arthritis
Lyme disease and joint pain unfortunately go hand in hand, as Lyme-related arthritis is commonly found in Lyme disease sufferers. If you have Lyme arthritis, you have swollen, painful joints that cause stiffness and pain. It is found in people who are in the late stages of Lyme disease. According to an article in Science Daily, approximately 60 percent of patients with untreated Lyme disease will develop related arthritis.
Lyme arthritis is caused by the bacteria that causes Lyme disease getting into your joints and causing inflammation of your tissues. Over time, this can cause damage to your cartilage. Most cases of Lyme arthritis are short-lasting and affect only one large joint.
Lyme arthritis can affect your:
In the U.S., its estimated that about 60 percent of untreated Lyme disease patients will experience intermittent episodes of swelling and lyme disease joint pain for months to years after they are infected by a tick bite.
Thankfully, most Lyme arthritis cases can be treated with antibiotics and NSAIDs, although some people may require surgery to remove some diseased tissue. Around ten percent of untreated patients may go on to develop chronic arthritis, reports Johns Hopkins Arthritis Center.
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Constipation In Lyme Disease
It is estimated that up to 25% of the worlds population struggles with constipation. Not only is constipation uncomfortable and can affect daily activities, but it can also predispose individuals to develop more severe health issues. What about people who are doing all the right things to prevent constipation drinking plenty of water, eating plenty of fiber, and exercising regularly but still experience constipation?
Constipation in Lyme has been referred to as Bells palsy of the gut. Just like facial paralysis that can occur in Lyme disease, the nerves that innervate the intestines can be affected causing a decrease in the muscular wave of contractions that usually move the contents of the intestines downstream. Chronic constipation ensues, and people end up taking magnesium, Dulcolax, or other laxative medications for long periods because the underlying cause of their constipation was never identified. Nerve dysfunction can occur elsewhere in the gastrointestinal tract, including the esophagus, which leads to difficulty swallowing.
When constipation or difficulty swallowing is related to nervous system dysfunction from Lyme disease, treating the infection also helps to improve nerve signaling. Prokinetic medications help with bowel movements but also serve as physical therapy for the large intestine by increasing the activity of intestinal muscular contraction.