Is Your Joint Pain Caused by Lyme Disease?

The incidence of tick-borne disease in the United States, including Lyme disease, continues to rise as Lyme-carrying ticks move into more areas of the country, according to the U.S. Centers for Disease Control (CDC).

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Yet most cases of Lyme disease go unreported, said Dr. Lyle Petersen, director of CDC’s Division of Vector-Borne Diseases, during a recent telephone news briefing.

“We know that the number of Lyme disease cases that actually occur each year are approximately 300,000, or 10 times higher than what is nationally reported,” Petersen said.

For most people, Lyme disease will result in no lasting illness after some initial flu-like symptoms. But for others, it can become debilitating if left untreated. Older adults can be particularly vulnerable, and they may brush off the effects. Symptoms of Lyme disease that has progressed include short-term memory loss, joint pain or swelling, and fatigue — signs often attributed to aging.

“You might start thinking, ‘I'm just beginning to lose my memory a bit. And everybody does that as they get older,’” said Dr. Brian Fallon, a psychiatrist and director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.

Other long-term effects include chronic pain, irregular heartbeat, brain “fog,” shooting pains or numbness in the arms or legs, and severe headaches.

We often hear that a bull’s-eye rash is the classic Lyme marker. But the more common rash — if you have one at all — is a round or oval-shaped reddish or pinkish area that starts small and expands in size, said Fallon, author with Dr. Jennifer Sotsky of Conquering Lyme Disease.

Black-legged ticks, or deer ticks, are in the nymph stage when they spread Lyme disease. The size of a poppy seed, they can easily be overlooked. Many people don’t realize they’ve been bitten.

That uncertainty can lead doctors to discount the possibility of Lyme disease in their patients, although symptoms may point in that direction. Fallon said. And even when doctors test for the disease, the results can be inconclusive. For example, in the first four to six weeks after a tick bite, people with Lyme disease will likely test negative because antibodies have not yet had time to develop, according to the CDC.

If you feel your doctor is not taking your concerns seriously, Fallon said, “you should seek someone else, and perhaps someone who has more knowledge of tick-borne diseases.”

Of course, the best way to conquer Lyme disease is to avoid it in the first place, said Thomas Mather, a professor of public health entomology at the University of Rhode Island and director of the Tick Encounter Resource Center.

That has become harder to do. The dramatic increase in cases of Lyme disease is likely due to the movement of white-tailed deer into semi-urban settings, Mather said. The ticks need those deer to reproduce.

Mather urges these precautions:

• Be aware of which ticks are present in your geographical area. Also, what time of year they’re most active.
• Use tick repellent. The CDC says it should contain 20 percent or more DEET, picaridin or IR3535 on exposed skin.
• Use a permethrin spray on clothing, including shoes, socks and pants. (Keep cats away when spraying or treating clothes, as it can be toxic for them.) You can also buy clothing that has been pre-treated with permethrin.
• Do a daily tick check, even if you’re just out in your yard or garden. Ticks can attach to your shoes and crawl up the inside of your pants leg.
• Keep an eye on your pets. They can bring into your house ticks that may simply fall off and land on your rug or furniture.

If you find a tick and want to know what it is, you can email a photo of it to Mather’s team at TickSpotters.org. A staff person will get back to you with information.

Emily Gurnon is the former Senior Content Editor covering health and caregiving for Next Avenue. Her stories include a series of articles on guardianship abuse that was funded by the Journalists in Aging Fellows Program. She previously spent 20 years as an award-winning newspaper reporter in the San Francisco Bay Area and St. Paul. Reach her through her website. Read More