One of the most disabling symptoms for the patient with Lyme-MSIDS is chronic pain. Over the counter medications only provide minimal really. By the time they seei lyme aware physicians some of the patients are on high dose narcotics to control pain. These patients frequently have seen rheumatologists and, depending on the clinical presentation, they may have been told that they suffer from sero-negative rheumatoid arthritis or from a non-specific auto immune disease. They are then placed on steroids such as prednisone, or disease modifying antirheumatic drug regimens, such as methotrexate. These agents might give temporary relief but can have significant side effects.Pain can be so debilitating that some people lose their ability to function in a meaningful and productive way. Many turned the pain management specialist, who then often prescribe multiple drug regimens to provide pain relief. Despite these physicians best attempts, patients may still have pain, and as the narcotics wear off, higher and higher doses are required to control and discomfort.-the end result is that pain sufferers and up on disability, and are unable to work or go to school.
Lyme disease can cause pain in every part of the body. Although this pain may be limited to one of two areas, and be more or less constant, one particular hallmark of tick areborne disease, and particularly Borrelia Bergdorferi , is that pain comes and goes and migrates.
This includes arthritis pain, myalgia’s (Muscle pain), and neuropathic pain (nerve pain), all of which normally do not tend to migrate. In women the pain is also influenced by hormonal cycles, since women usually flare several days right before, during, and after the Menses.We can also suspect a tick-borne disorder when antibiotic use increases pain (From a Jarisch-Herxheimer reaction) or decreases pain. This will occasionally happen in patients treated for a unrelated bacterial infection such as sinusitis or urinary tract infection, who are unaware that they have lime disease.If pain is associated with multiple systemic symptoms, especially the ones listed in the Horowitz questionnaire, then it is quite likely that it is cause by lyme –MSIDS. A patient who just presents with neck pain or an isolated pain in a joint might simply have a herniated disk with neuropathy, or osteoarthritis.If the patient circles many of the symptoms on this sheet one should suspected tick-borne disorder and order the appropriate tests. Establishing a proper pain aetiology can be difficult, because as we have seen above Lyme – MSIDS can mimic most common pain syndromes.
Simultaneously treating the three I’s of lyme disease- infection inflammation and immune dysfunction may be the key to alleviating chronic pain. Finally inadequate phase I and phase II liver detoxification, with inadequate production or over utilisation of glutathione, and the subsequent inability to remove Neuro toxins and cytokines often seen with lyme– MSIDS, will also result in pain. Many different medical problems that are listed on the MSIDS Map can cause pain, and may be contributing overlapping factors. Each of these different factors can increase free radical production and increase cytokines, and may need to be simultaneously addressed to achieve adequate pain control in both lyme– MSIDS and non-lyme– MSIDS.
These will include
1. Detoxification problems
2. endocrine abnormalities
3. food allergies
4. heavy metals and environmental toxins
5. nutritional and enzyme deficiencies
6. other infections including bacteria parasites viruses and opportunistic infections(Candida)
7. sleep disorders
Psychological disorders may also increase discomfort, as the amygdala is the part of the brain deals with the emotions and pain sensation when patients suffer from depression and anxiety, their pain thresholds can be lowered, leading to increased perception of pain.
Early diagnosis and treatment are important to stop the progression of the Lyme disease. If untreated, the disease can result in neurological disorders such as peripheral neuropathy, including Bell’s 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 (Diethyl-meta-toluamide) on skin or clothes.
(Not all symptoms and signs may be present.)
Lyme disease progresses in three stages of severity:
• Fever and chills
• Muscle and joint pain
• Red circular rash
• Stiff neck
• Swollen lymph nodes
• Facial paralysis (Bell’s palsy)
• Irregular heartbeat
• Meningitis (fever, stiff neck, severe headaches)
• Numbness and pain in arms and legs
• Stiff neck
• Poor coordination
• Chronic arthritis and swelling in large joints, especially the knees
• Chronic pain in muscles
• Problems with sleeping
• Numbness and pain in arms and legs
• Nervous system problems
• Difficulty concentrating
• Memory loss
• Numbness and tingling
• Peripheral neuropathy
• Pain, numbness and tingling in limbs
• Paralysis of facial muscles (Bell’s palsy)
EVALUATION AND TESTS
(Not all evaluation and tests may be necessary.)
• Neurological exam
• Nerve conduction velocity test
• Blood tests, including tests for antibody against the agent that causes Lyme disease and tests to detect the agent itself.
TREATMENT AND THERAPY
(Not all treatments and therapies may be indicated.)
• Intravenous therapy For Bell’s palsy (facial paralysis)
• Eye drops for affected eye
• Medications such as steroids to reduce inflammation of nerve and decrease
• Surgery (in rare cases to improve appearance)
• Treatment of underlying inflammatory condition, if present
If experiencing weakness, pain, or inflammation (in limbs or knees)
• Ask your doctor about special therapeutic shoes or a knee brace (which may be covered by Medicare and other insurance)
• Take safety measures to compensate for loss of sensation
• Lyme disease is curable, if treated early
Lyme Pain treatment: see Lyme disease treatment.