Learn about Lyme disease and joint pain, including its symptoms, diagnosis, and treatment options. Find out how Lyme arthritis can affect your joints and how to prevent the disease.
Lyme disease is caused by the bite of a black-legged tick (also known as a deer tick) that is infected with the bacterium Borrelia burgdorferi. More than 476,000 cases of Lyme disease are reported in the United States each year. The tell-tale sign of Lyme disease is an erythema migrans rash, sometimes called a bulls-eye rash because of its shape. If you notice a rash and are diagnosed with Lyme disease right away, the infection can often be taken care of with a course of antibiotic treatment.
Unfortunately, not everyone gets a rash (nor do they all look like a bulls-eye). In its early stage, Lyme can cause flu-like symptoms such as fatigue, fever, muscle aches, chills, and swollen lymph nodes, which can mirror other illnesses. Moreover, labs tests for this tick-borne illness are notoriously faulty. Therefore, many cases of early Lyme disease are misdiagnosed or overlooked.
If early symptoms of Lyme disease are not caught right away, the Lyme disease bacterium can move into other parts of the body including the joints and nervous system, causing more severe symptoms like neck stiffness, brain fog, severe headache, joint swelling and joint pain. When Lyme moves into the joints, it causes Lyme arthritis. Let’s walk through what Lyme arthritis is and how it is treated.
Why Does Lyme Disease Affect Your Joints?
In early Lyme disease, your joints and muscles might feel achy. This is from the flu-like symptoms you get when your immune system initially responds to Lyme disease. At this point in infection, the Lyme disease bacterium is still localized. Untreated Lyme disease allows the bacterium to move to other parts of your body. When it gets to your joints, the bacterium causes inflammation, which results in joint swelling and pain, known as Lyme arthritis.
Lyme Disease Arthritis Symptoms
Lyme disease arthritis causes swelling or pain in one or more of the joints. Joints affected can include:
Swelling and pain can wax and wane. You might experience tenderness or pain in one joint one day and in another the next day. You might only get pain in one knee and not the other.
Migratory pain that comes and goes is a distinguishing characteristic of Lyme arthritis, unlike rheumatoid arthritis which causes symmetrical swelling and pain. Your joints may also feel warm to the touch.
When Does Lyme Disease Joint Pain Develop?
Early Lyme disease can cause achiness in your joints and other parts of your body, which you can feel shortly after becoming infected. Lyme disease arthritis is part of late-stage Lyme disease, which occurs once the bacterial infection moves into the joints. This usually happens between one to a few months after the initial infection.
How is Lyme Arthritis Diagnosed?
Lyme disease is a clinical diagnosis. It can be supported by a blood test such as ELISA (enzyme-linked immunosorbent assay) or Western Blot, but because those tests have a lot of false negatives, a doctor should diagnosis you based on your symptoms and your history of a tick bite or exposure to ticks. Lyme arthritis can also be diagnosed by testing the synovial fluid, which is the fluid located around your joints.
How is Lyme Arthritis Treated?
Lyme arthritis is treated with antibiotics, usually doxycycline or amoxicillin. Your health care provider will start you with one or two courses of antibiotics, but if you have persistent symptoms, you may need to be treated for longer. Lyme disease arthritis and other Lyme disease symptoms can relapse, so if you are treated and have recurring Lyme arthritis, you might need to be treated again. Your health care provider may also give you anti-inflammatory medication (prescription or over the counter) to help with swelling and pain. Treatment can vary from patient to patient depending on the severity of symptoms and other factors like whether you have co-infections.
Can Lyme Arthritis Cause Permanent Damage?
Yes. Without appropriate treatment, Lyme disease arthritis can cause permanent joint damage. If treated, Lyme disease arthritis can improve, but also can relapse.
Can Pets Also Develop Lyme Arthritis?
Yes, Lyme arthritis is actually one of the most common Lyme disease symptoms in pets, especially dogs. With early Lyme disease, a dog may experience lameness—limping with pain that shifts between legs and comes and goes. Lyme disease can spread through a pet’s body just as it does through a human, so the bacteria can eventually settle in the joints, causing the swelling and joint pain that comes with Lyme arthritis. Left untreated, Lyme arthritis can become chronic in dogs just as it can in humans.
How to Prevent Lyme Disease
The best way to avoid Lyme arthritis is to prevent tick bites. Black-legged ticks are found in every state in the U.S. except Hawaii, and in many parts of the world. Whenever you participate
in outdoor activities, from hiking to playing in your yard to walking in beach dunes, you should be Tick AWARE. Apply EPA-approved insect repellent such as DEET or picaridin before heading outside, especially to places where ticks like to live such as grassy areas, bushy areas, wooded areas, leaf litter, stone walls, and perimeters where the lawn meets the woods. Wear light-colored clothing to spot ticks more easily, and cover as much of your skin as possible with long sleeves, long pants (which can be tucked into high socks), closed-toed shoes, and a hat with your hair tucked in. You can also treat your clothing, shoes, and gear with permethrin.
When you come indoors, remove clothing and toss into the dryer on high heat for 10-15 minutes to kill live ticks (simply washing your clothes won’t do this; the ticks need to be exposed to high heat). Do a thorough tick check, feeling along your skin, hair, and scalp for any bumps. Pay special attention to behind the knees, the groin, the armpits, the belly button, and behind your ears. A lint brush can help you pick up ticks that you don’t see or feel.