Physical Therapy for Lyme Disease

What is Lyme Disease?

Lyme disease is caused by a bacteria transmitted through tick bites. In the mid-atlantic region it is typically transmitted through the bite of a deer tick. Diagnosis of Lyme disease is done by a medical doctor, through use of a blood test. These blood tests are not perfect, and therefore symptoms and presentation are also important in the diagnosis process. 

What are the symptoms of Lyme disease?

Lyme disease can have variable presentation, and as a result, can often be difficult to diagnose. The typical presentation often begins with a red rash, presenting 3-30 days after a tick bite. This rash can be present in the region of the bite, or elsewhere on the body. Less than 20% of Lyme cases show the typical “bull’s eye” style of rash presentation. Many people are often unaware of a tick bite, and often do not develop a known rash in early stages. Early stage Lyme infection can also present with a flu like illness. Less commonly, facial nerve dysfunctions can be seen in early stages of infection. Lyme disease may cause symptoms of muscle pain, or joint pain; often, the joint pain seems to move from one joint to another. The bacteria that causes Lyme disease often targets nervous system tissue, skin, muscle, joints, and/or eyes. Arthritis is a common symptom of later stages of Lyme disease. 

Why is it so hard to diagnose? Why are symptoms so variable?

Lyme disease has been called “the great imitator” due to its variable presentation and how the presentation is often similar to other diagnoses such as chronic fatigue syndrome, rheumatoid arthritis, fibromyalgia, lupus, multiple sclerosis and other diseases. The presentation of the disease will vary depending on the stage, as well as the tissues or organs impacted by the bacteria. The bacteria that causes Lyme disease can efficiently travel through the body, and can therefore affect many different organs and tissues. Symptoms are often migratory, they may come and go, and may change to various locations. Both nerve and joint pains can be migratory. There are many different diseases and bacteria that can be transmitted by tick bites, and often people may have more than just one of these infections. Co-infections such as babesia, bartonella, ehrlichia, rocky mountain spotted fever, tularemia, anaplasma, and mycoplasma can all have different symptoms, and can be present in any combination. 

What is the treatment? How can physical therapy help?

Treatment of Lyme disease and any co-infecting tick borne diseases will require a multi-disciplinary approach. A medical doctor can provide diagnosis and initial antibiotic treatment, and may direct you to an infectious disease or lyme disease specialist. A consultation with a dietician or nutritionist may be beneficial in managing the effects of strong antibiotic use. Physical therapy can help to restore good joint mobility, manage the effects of arthritis from later stage lyme disease, and to aid in pain control from nerve, muscle, or joint pain associated with lyme disease. Additionally, physical therapy can assist in managing cardiovascular symptoms, and fatigue symptoms.