Lyme Arthritis

Lyme Arthritis: What is it?

Lyme arthritis is a late sign of Lyme disease. It most frequently affects the knee and results in observable warmth, edema, and joint discomfort. Antibiotics can be used to treat Lyme arthritis.

Lyme disease is a bacterial infection transmitted through the bite of certain types of ticks. According to research, around 476,000 Americans receive a diagnosis and treatment for Lyme disease each year.

Lyme disease can cause several late signs and symptoms if treatment is not received. Lyme arthritis is one of these, and it can cause irreversible joint damage.

Causes of Lyme arthritis:

The bacteria Borrelia burgdorferi is the cause of Lyme disease. The saliva of some tick species, particularly deer ticks, that have contracted the infection contains this bacterium. Humans can contract it by being bitten by a tick.

Early on, the B. burgdorferi germs spread to the surrounding tissues and joints. However, Lyme arthritis develops later, usually after months have passed, whereas joint pains may appear during the early stages of illness.

Your joints get extremely inflamed when you have Lyme arthritis. This may eventually cause irreversible joint injury.

What Are the Lyme Infection Stages?

Three phases are involved:

• Early localized Lyme: Flu-like symptoms, including fever, chills, enlarged lymph nodes, headache, sore throat, and a bull’s-eye-shaped or circular, red rash that is at least two inches long.
• Early-stage Lyme disease symptoms include flu-like symptoms including numbness, discomfort, or weakness in your arms and legs; visual abnormalities; chest pain and heart palpitations; a rash (which may or may not be a bulls-eye rash); and Bells palsy, a kind of facial paralysis.
• Months, weeks, or even years after the tick bite, late-disseminated Lyme disease may develop. Severe exhaustion, headaches, disorientation, arthritis, and confusion are possible symptoms.

About 10% of people who receive treatment for Lyme disease are unaware that they have the illness. Three main symptoms might follow: exhaustion, soreness in the muscles or joints, and disorientation or short-term memory loss. Post-treatment Lyme disease syndrome is the term for this. Since its symptoms are identical to those of other disorders, diagnosing it can be challenging. Furthermore, there is no blood test to support it.

Experts are uncertain as to why Lyme symptoms don’t always go away. One theory is that your body continues to battle the illness, like an autoimmune condition, even after the germs have been relocated.

The symptoms of Lyme arthritis:

One or more joints may be impacted by Lyme arthritis. Although Lyme arthritis most frequently affects the knees, it can also affect other joints, such as the:

• shoulder
• hip
• elbow
• ankle
• wrist
• jaw

Early signs can include the following and are similar to a mild flu:

• Fever
• Headache
• Fatigue
• Chills
• Body aches
• Swollen lymph nodes
• Within a month following the bite, a bull’s-eye-shaped red skin rash may develop at the location.

Usually, Lyme arthritis develops in the months following Lyme illness. Among the symptoms are joints that are:

• swollen
• stiff or painful
• red
• warm to the touch
• Untreated Lyme arthritis may result in recurrent or chronic flare-ups of joint pain and swelling. The duration of these flares might range from weeks to months.

How does the Rash Appear?

Some Lyme rashes resemble a bull’s eye with a circle close to the middle. However, the majority are red, spherical, and at least two to two inches wide.

Over many days, the rash progressively gets larger. It may grow to a diameter of almost 12 inches. Although it could seem warm to the touch, it is usually not unpleasant or irritating. It might show up on any part of your body.

What is the tick’s size?

Depending on their stage of life, ticks come in three different sizes. They can be as little as an apple seed, a poppy seed, or a sand seed.

Who are at increased Risk of Lyme arthritis?

The risk of developing Lyme disease is highest in males aged 40 to 60 and in boys under the age of 15. This is due to their ability to play outside and move on to hiking, camping, and hunting.

Some people believe that because older adolescents and men in their 20s are more likely to be indoors and using computers, Lyme diseases are less common in these demographics.

Additionally, they could know older adults better since they can work in their backyards, which is where the majority of Lyme illnesses happen.

How will you know if you’ve been bitten?

Ticks are so small that you have to have very good eyesight to see them.

A tick bite might be the cause of a small, red patch on your skin that looks like a mosquito bite. It won’t be a problem if it goes out in a few days. Be aware that getting bitten by a tick does not always mean you have Lyme disease.

You may have been bitten by a tick if you see a bull’s-eye-shaped rash. Discuss therapy with your physician or doctor.

You will notice a tick bite right away if you have an allergic reaction to ticks.

Diagnosis:

A doctor will begin by reviewing your medical history and performing a physical examination, which includes assessing the affected joints if you start to exhibit signs of Lyme arthritis.

A two-step antibody-based testing procedure can be performed to identify Lyme disease if your doctor believes you have Lyme arthritis. These tests are extremely sensitive in individuals with Lyme arthritis and need a blood sample.

Your doctor may prescribe tests to rule out other forms of arthritis, such as septic and rheumatoid arthritis (RA) because Lyme arthritis can be similar to these disorders. Here are a few instances:

• Analysis of synovial fluid.
• Examinations for indicators of autoimmune diseases such as antinuclear antibodies or rheumatoid factor.
• Blood tests for inflammatory indicators such as erythrocyte sedimentation rate and C-reactive protein.
• Complete blood count.
• Joint imaging with MRI or ultrasound.

Treatment of Lyme arthritis:

A 28-day regimen of oral antibiotics is used to treat Lyme arthritis. Adults may follow the following regimens, according to the Centres for Disease Control and Prevention (CDC):

• Doxycycline (100 mg, twice daily)
• amoxicillin (500 mg, three times daily)
• cefuroxime (500 mg, twice daily)

Children with Lyme arthritis may also be treated with the same drugs. However, body weight and age are taken into account while adjusting the dose.

Nonsteroidal anti-inflammatory medicines (NSAIDs) are an example of an over-the-counter medication that may be used to assist manage pain and inflammation during therapy. Physical therapy could be suggested as part of the healing process if there has been a significant joint injury.

Treatment of Lyme arthritis with physiotherapy:

Only antibiotics and other supplemental medications, such as analgesics, can treat early-stage Lyme disease. Some medical professionals will recommend physical therapy to patients with persistent Lyme disease symptoms that do not improve with medication. Physical therapy serves the following main purposes in the treatment of Lyme disease:

• lessen discomfort
• Prepare deconditioned individuals to begin an exercise regimen at home.
• Teach patients how to exercise properly, including the right frequency, duration, and resistance to attain fitness goals without exacerbating Lyme disease symptoms.

Interventions in physical therapy involve:

• Massage
• Range of motion
• Myofascial release
• Modalities include paraffin, ultrasound, and moist heat.
• Although there is no research to support this, electrical stimulation and cold packs are generally contraindicated.
• Strengthening and gradually increasing the patient’s level of activity—which may be minimally compromised due to a persistent Lyme infection—are the goals of exercise prescriptions. Stretching, gentle exercise, and light resistance exercises with low weights and high repetitions are common components of whole-body workouts.

Shoulder stretch

• Maintain it with your right arm while crossing your left arm across your body.
• Hold for almost 30 seconds.
• Switch arms and do it once again.

Knee to chest stretch

• With the backs of your heels flat on the floor, assume a supine posture on your back.
• As you feel a stretch in your lower back, slowly bring one knee joint up to your chest.
• Keep the other leg relaxed.
• Hold for almost 30 seconds.
• Switch legs and do it once more.

Neck stretch

• Just slightly bend your head to the right.
• Feel the left side of your neck extend comfortably as you gently lower your head with your right hand.
• Hold for almost 30 seconds.
• Switch sides and do it once more.

Rolling with a foam roller

Using a foam roller to roll tight tissue in your body is an effective at-home task. This helps your fascia, or connective tissue, to stretch and release tension. (The connective tissue that covers every muscle, including tendons and ligaments, is called fascia.)

Rollers may be purchased online and are reasonably priced. Use the roller only to gently move the muscles surrounding sore joints or joints, or any sore muscles at all.

Gentle strengthening

Mildly strengthening the muscles that support the joints affected by Lyme arthritis can help reduce pain and inflammation. Everybody is different when it comes to this kind of strength training. For example, if a patient has knee soreness and wants to strengthen the weak muscles that link to the knee joint in a way that reduces pain,

Although it takes time and patience, strengthening is almost always beneficial. Finding a qualified Pilates teacher or physical therapist to help you with this kind of work is worthwhile.

Yoga

You’ve heard that countless times if you’ve been there once: Yoga is a great cleanse! as well as for those who are not very energetic. Start with easy or beginner lessons, and if you feel confident, mix it up as your energy levels increase! Since you are the one who knows your body the best, avoid doing hot yoga unless you are certain that the heat won’t get to you. I had trouble controlling my body temperature, so I didn’t attempt hot yoga until two months following treatment when I was drinking a lot of water.

Light Weight Lifting

Muscles might weaken and shrink as a result of chronic Lyme disease. Additionally affected were the liver, lungs, heart, and nerves. My body worked together more and then began to recover, the transition went more smoothly, and I was able to keep some muscle and strength with mild weightlifting/toning and light fitness programs.

Walking

Walking doesn’t sound like a show if you’re in your 20s or 30s. However, if it is all you are capable of doing throughout therapy, then do it! Start with 15 minutes each day and work your way up to a standard 30-minute session. Any exercise will be beneficial, but don’t push yourself too hard.

Bicycling

low-impact method of encouraging positive activities. Cycling has been an excellent substitute for cardio.

Stair-Stepping

It helped the legs build strength.

Differential Diagnosis

• Acute memory disorders
• Ankylosing spondylitis and rheumatoid arthritis
• Atrioventricular nodal block
• Cellulitis
• Contact dermatitis
• Gout and pseudogout
• Granuloma annulare
• Prion-related diseases

Risk factors of Lyme Arthritis:

Living in a region where Lyme disease-carrying ticks are common puts you at higher risk for both Lyme illness and Lyme arthritis. This encompasses the northeastern, mid-Atlantic, and north-central regions of the United States as of 2022.

Outdoor workers, such as those in the construction, gardening, or forestry sectors, are more vulnerable. Tick bites are also more likely to occur in those who spend a lot of time outside, whether it be gardening, hiking, or camping.

Generally speaking, spring through autumn is when infected tick bites occur most often. Tick activity peaks at these periods.

Possible side effects of Lyme arthritis:

Permanent joint deterioration is the primary consequence of Lyme arthritis. Joint discomfort and decreased range of motion may result from this, affecting day-to-day activities and overall quality of life.

Other health issues that might result from untreated Lyme disease include:

• Late-stage Lyme disease is linked to acrodermatitis chronica atrophicans, a skin disorder.
• Heart symptoms, such as Lyme carditis.

Neurological issues such as:

• Numbness and tingling sensations
• nerve pain
• Bell’s palsy
• symptoms similar to meningitis, including fever, stiff neck, and unbearable headache
• vision problems

Living with Lyme disease:

Most Lyme disease patients have a very good prognosis after receiving treatment. Antibiotics help remove the infection, lower inflammation, and halt further joint damage.

However, it’s crucial to remember that Lyme arthritis can cause long-term joint damage. Your quality of life may suffer, joint function may be affected, and you may be less able to perform specific tasks.

This is why it’s critical to consult a physician if you’re exhibiting signs of Lyme arthritis. Even while Lyme disease might not be the cause of your symptoms, it could be caused by another illness that requires medical attention.

Summary

The bacterial infection known as Lyme disease is the cause of Lyme arthritis. It usually affects the knee and can produce warmth, discomfort, and edema in the affected joints. Lyme arthritis can result in irreversible joint damage if treatment is not received.

An antibiotic course is an excellent way for a doctor to treat Lyme arthritis. Taking precautions to reduce your risk of tick bites is another way to avoid Lyme illness.

FAQs

References

• Seladi-Schulman, J., PhD. (2024, April 19). Overview of Lyme arthritis. Healthline. https://www.healthline.com/health/lyme-arthritis#takeaway
• Lyme Disease | Arthritis Foundation. (n.d.). https://www.arthritis.org/diseases/lyme-disease
• Mexico, L. (2020, May 20). Lyme arthritis: Symptoms, diagnosis and treatment. Lyme Mexico Clinic. https://lymemexico.com/lyme-arthritis-symptoms-diagnosis-treatment/
• Hirpara, D. (2023a, December 13). Lyme arthritis – Cause, symptoms, diagnosis, treatment. Mobile Physiotherapy Clinic. https://mobilephysiotherapyclinic.in/lyme-arthritis/