While reading some of my email in my study this morning, I came across an article on a disease that can cause diffuse joint pain, resembling arthritis. Now, it is true that a number of diseases can do that. Even some episodes of flu can cause diffuse joint pain, as part of the complex of symptoms.

Some new cases of rheumatoid arthritis can first present as a swelling of one single joint. I saw this personally happen to my wife’s niece, who developed swelling of her ankle, after a sprain. But the swelling continued long after a simple sprain should have disappeared.

Sure enough, once she was tested, she was found to have a form of inflammatory arthritis called JRA (Juvenile Rheumatoid Arthritis). Fortunately, it’s not too common. But I have seen some cases that are so rapidly destructive that you have the situation of a young girl with multiple joint replacements, before she’s out of her teens.

Obviously, this is not good, as man made parts have a finite life span-they don’t last forever. And their revision is a much more challenging surgery than the initial replacement. It’s a heart breaking condition, no question about it.

However, the condition I’m talking about is endemic to the Northeast of the USA, specifically around New England and parts of Long Island, New York, though it has since spread far and wide.

I’m talking of course about Lyme Disease, a form of arthritis that results from an infection by a spirochete bacterium, related to syphilis, called Borrelia burgdorferi, which is responsible for most of the cases in the US, while Borrelia afzelii and Borrelia garinii (different species of the same genus, Borrelia) cause the disease in Europe. The disease got its name from Lyme, Connecticut, where it was identified in 1975. However, it has since spread all over.

The bacteria are carried by deer ticks, very tiny arachnids, which are about the size of the period at the end of this sentence. They are so small that the victim often does not even feel the bite and is unaware that he’s been exposed. The bacteria are passed on to the host (that would be you), when the host is bitten by the tick. They then migrate all over the body and set up shop in your joints, where they cause the pain and swelling.

A single deer can harbor hundreds of ticks and a single female tick can lay a couple of thousands eggs, that become the next generation of ticks.

In the classic case, you may develop a characteristic “bulls-eye” rash at the site of the tick bite, but usually a while after the tiny bite has disappeared, if you ever knew it was there. But sometimes, that diagnostic sign just doesn’t develop, or is unnoticed by the patient.

That makes the disease difficult to identify, so again, the doctor must think of this disease whenever he sees an atypical case of knee pain and swelling, without another obvious cause.

This is just one of the less common causes of knee pain and swelling that I discuss for you in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN:

http://www.drbillsclinic.com/eliminate_knee_pain.html

Now, Lyme Disease can be treated and cured, in most cases, by an aggressive and prolonged course of antibiotics. But you have to know that this is the cause of the pain, so you know to treat for it. And that means having a very high index of suspicion, if you’re the examining physician.  

Unfortunately many times, no one thinks of it and the symptoms continue, on and on, tick…tick…tock…and the patient develops a progressive arthritis, often of the knee. Luckily, the old rule in Medicine remains true: “when you hear hoof beats, don’t think of zebras.”  

Standard treatments should be tried first, including rest, local heat, anti-inflammatory medication and/or omega-3 fatty acids, which have a natural anti-inflammatory effect, like those in my premium, enteric coated, deep arctic water, pharmaceutical grade fish oil, POWERHOUSE OMEGA FORMULA and my JOINT HEALTH FORMULA, with its unique Green Lipped Mussel extract.

http://www.favoriteformulas.com

http://www.favoriteformulas.com/jointhealth

They work in conjunction with NSAID medications, but without the adverse side effects. But they are so potent that in Europe, fish oil is a first line treatment for RA. So they are ideal for the treatment of standard knee joint inflammation.

When the pain and swelling recede, it’s time to begin rehabilitation, with strategic knee pain exercises like those in my newly revised PAIN-FREE PROGRAM: DVD & Manual.

http://www.drbillsclinic.com/exercise_eliminate.html

If it’s a garden variety joint inflammation, from injury, or degeneration, it should respond to these conservative measures.

But if it should persist, despite faithful adherence to this proven regimen, then other diagnoses must be entertained: more severe osteoarthritis, inflammatory arthritis (like rheumatoid, or lupus), gout, pseudogout, or a low grade infectious arthritis. (High grade arthritis makes the patient sick as a dog, with a high temperature and the knee is so glowing red, it looks incandescent; so there’s no mistaking that.)

Blood tests will usually tell the story, but sometimes, aspiration (sticking a needle into the joint to draw out fluid, for microscopic examination) is necessary. However, even with the absence of the usual history of a tick bite, or that diagnostic bulls-eye rash, the doctor must think of Lyme Disease, or the diagnosis will often be missed.

If you ever find yourself in this situation, don’t be bashful-ask your doctor if Lyme is a possibility. The doc is only human and it’s YOUR knee, so don’t hesitate to remind him. Something to think about, the next time you see those cute deer munching on your shrubs.

Til next time, my friend, be well.

Yours for a pain-free tomorrow and your optimal health,

Dr. Bill

“The Wellness Warrior”             TM