Lyme Arthritis and Rheumatoid Arthritis: Impact on Quality of Life

Patients with both Lyme arthritis and rheumatoid arthritis may experience worse joint pain, reduced mobility, and poorer quality of life compared with those who have rheumatoid arthritis alone. A recent study found that infection with Borrelia burgdorferi, the bacterium responsible for Lyme disease, can worsen both the physical and psychological burden of arthritis.

Study Examines Quality of Life in Lyme Arthritis and Rheumatoid Arthritis

In the study “Assessment of quality of life in patients with Lyme arthritis and rheumatoid arthritis,” Yuskevych and colleagues surveyed 90 patients with rheumatoid arthritis who were treated at their rheumatology clinic.¹

Nearly 50% of the patients with rheumatoid arthritis also tested positive for Lyme disease.

Survey results indicated, “The presence of Borrelia burgdorferi [the causative agent of Lyme disease] in patients with arthritis not only significantly reduced the motor activity of patients, but also complicated the mental adaptation to their own disease.”

The patients had high and moderate disease activity, significantly reduced physical activity, and body pain.

Greater Functional Impairment and Joint Pain

The quality of life of patients with Lyme arthritis and rheumatoid arthritis was worse due to severe joint pain and a greater degree of functional disorders compared to patients with only rheumatoid arthritis.

The authors found that patients with both conditions had worse physical functioning and greater limitations than those with rheumatoid arthritis alone.

Mental Health Burden

The authors considered depression as one explanation for the reduced quality of life in patients with rheumatoid arthritis.

“Depression imposes a significant burden on the health-related quality of life, disability, and mortality of individuals with arthritis,” wrote the authors.

They also noted that patients with Lyme arthritis had significantly lower mental component scores (MCS), suggesting more severe psychological adaptation to their disease.

“Patients with [Lyme arthritis] have significantly lower MCS (mental component score) values, which is explained by the patients’ severe psychological adaptation to their own disease, given the prevalence of [Lyme disease] at the present and its tendency towards chronicity.”

The authors suggested that active infection itself might contribute to these mental health difficulties.

“We can speculate that the conscious that joints disease may be connected with infection not with the autoimmune disease caused a more depressive reaction.”

Clinical Insight

Clinical Perspective

Editor’s note: I often see patients with both a rheumatologic condition and Lyme disease. I have had patients with Lyme disease whose symptoms were initially thought to be from a flare-up of the rheumatologic condition.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

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