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Dr. Miller often treats empirically. “Because early treatment of Lyme disease decreases the chance of chronic symptoms, we often treat empirically with doxycycline while awaiting results of antibody testing. Travelers to high-risk areas may return home and develop symptoms weeks later.”
Source: https://www.ncbi.nlm.nih.gov/pubmed/31259503
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References:
- Miller R. Lyme Disease As Possible Contributing Factor for Knee Pain. Am Fam Physician. 2019;100(1):4.
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was bitten in May. experiencing knee pain in right knee that came on sudden and has not gone away. Could it be related Dr. Cameron?
How would I explain to owcp that it May be connected? Are Lymes blood tests accurate? – Charlie
I often see knee pain early in Lyme disease. The tests are not as reliable as I would like.
Hello. I feel pain in both knees for several months and I was bitten in May. Would that be possible that it is Lyme or is it always only one knee?
I have often seen patients in my practice with both knees affected.
I developed side of knee pain diagnosed as MCL sprain and substituted walking for my usual running but when pain persisted and got worse and seemed to spread all around knee with difficulty bending after two months, had an MRI, which showed MCL and ACL sprains, torn meniscus, bone contusions, partly ruptured Baker’s cyst, chondromalacia and bursitis in two places. Blood work showed Lyme antibodies (but had LymeRix 20 years ago) and presence of 4 rather than required 5 Borrelia bands so was deemed inconclusive. Took doxy for 30 days and finished about 5 weeks ago. Knee slightly better but still hurts. Did I have Lyme? No other symptoms except skin abnormalities (not rash). What to do next? BTW– my husband was also diagnosed with Lyme about a month before my knee problems began and is recovered after doxy. We are in NJ.
I find it more difficult to diagnose Lyme disease in my patients if there are only a few symptoms. I am not sure how many bands persist after the LymeRx vaccine. The 31 and 34 bands were not included in the current test as they are often positive from LymeRx. I have to use clinical judgement.
Doctor Cameron. I’m 35 years old, super active, jiu jitsu black belt and professor. Always training and teaching classes. Last july out of nowhere my knee got swollen out of a sudden. No trauma, no injury… went to my orthopedic and he thought it was a bacteria from the mats. Days after, with the swelling not progressing…. Decided to go to the ER. They ended up admitting me to the hospital which I stayed for 5 days taking IV antibiotics for something they thought it I got from training mats. I heard staph, MRSA, baker cyst ruptured… i never got any answer. Got out of the hospital and was told to take linezoid for 2 weeks as a follow up. My knee was still swollen full of fluids. My friend is a nurse and drained it for me. After draining and on linezoid I got better and eventually got 100%.
Last week, the exact same thing happened again. This time on my elbow. As soon as I woke up I knew exactly what was going on. Nobody ever mentioned to me the possibility of lyme. The hospital staff didn’t, my orthopedic didn’t. After doing research I found out your videos and your description of lyme arthritis matches with everything I feel and been through. Took a test last friday and still waiting for the results. Do you think even if I test negative I should start lyme treatment?!
Lyme disease can lead to inflammation in the joints. The condition is called synovitis in the knees, bursitis in other joints and sacroiliitis in the back. The tests may be negative from the first antibiotic treatment.
Interesting. Elbow is very swollen and the sweeling is going down the forearm and a bit on the hands. Well if the test come negative would you recommend being treated for lymedisease with proper antibiotics like doxycycline or amoxicillin?! The thing is so far none of the people thought it could be lyme so I’ve been given antibiotics for other bacterial infections which has not been helping at all. Thanks doc
There are so many causes of joint swelling. I have had to complete a careful evaluation to look for any evidence of a tick borne illness. I have had to treat some of patients for a month using clinical judgement.
I have IGG 41, 23 32. I couldn’t put my foot down. Now I’m limping in constant pain. Hip and back MRI fine. I’m going for a knee MRI. I had Lyme 3 times. But this is old Lyme. But says reactive. My doctor put me on doxycycline. Its been day 2 no real improvement.
Is it Lyme? I’m in constant knee pain.
There are so many causes of knee and foot pain. The bands could be left over from an earlier illness with Lyme disease. I advise my patients to also look for underlying knee problems. I have some patients with knee problems that are exacerbated by Lyme disease. BTW I do not see gains in 2 days.
There are so many causes of knee and foot pain. The bands could be left over from an earlier illness with Lyme disease. I advise my patients to also look for underlying knee problems. I have some patients with knee problems that are exacerbated by Lyme disease. BTW I do not see gains in 2 days.
I have IGG 41, 23 32. I couldn’t put my foot down. Now I’m limping in constant pain. Hip and back MRI fine. I’m going for a knee MRI. I had Lyme 3 times. But this is old Lyme. But says reactive. My doctor put me on doxycycline. Its been day 2 no real improvement.
Is it Lyme? I’m in constant knee pain.
Hello Dr Cameron, I found a tick biting me on the back of my head/neck on Thursday, June 23, then I woke up sweaty and feeling sick 2 days later. I went to the ER and was given 21 days of Doxycycline. The tick bite was very sore for a good week plus. Now, after 7 days on Doxy, I woke up on Saturday July 2 with pain in my right knee for no particular reason. I can’t sleep very well with this knee pain, no position seems to be comfortable. What do you recommend as a pain treatment? Also, should I go on intravenous antibiotics right away, continue taking the Doxy, both, or wait and see how I feel after 3 weeks? Thank you. Tim Wheelock, Gardiner Maine.
I have patients in my practice whose symptoms can flare up during treatment. I do not find antiinflammatory medications all that helpful. I have had to refer to an orthopedist to rule out another cause or to find a treatment approach. I do not typically go to IV during a flare up. The decision will have to be made by your doctors. Finally, I look for Babesia as Babesia is not treated with doxycycline.
The correlation between knee pain and Lyme disease, especially in some rural regions, underscores the complexities of diagnosis. Often, patients might overlook seemingly unrelated symptoms like a past tick bite, making the clinician’s role pivotal in connecting the dots. Understanding such nuances can lead to more timely and accurate interventions, emphasizing the need for continuous education and awareness among patients and healthcare providers.
I was bit by a tick over 9 years ago. I became ill with a summer “flu” and also reproductive system issues. Since then, I’ve been diagnosed with sacroilitis and patellar tendonitis and bursitis (one knee doubled in size) in 2020, post concussion syndrome, and mostly recently no diagnoses for systemic illness for over a yearyear: multiple joint pain, muscle pain, chest pain, abdominal pain, debilitating fatigue, neurological and cognitive issues such as numbness and tingling in intermittent extremities, difficulty swallowing, brain fog, dizziness, vertigo, tinnitus, and memory, concentration, delayed response, and difficulty with word recall to name a few. The only abnormal finding thus far is lyme antibodies and a reactive but negative western blot, depleted iron stores, and insufficient vitamin d. I was treated with 30 days of amoxicillin and had a severe reaction with worsening symptoms and new ones emerging like tremors that I went to urgent care for because I didn’t know what was happening. I still don’t know why it happened. After the treatment, I am significantly better but still have knee pain, stiff neck and shoulder pain, and some neurological and cognitive issues. I have no diagnoses. I was told that the worsening of symptoms and the ones I have left are psychosomatic. I was told that I don’t feel better due to antibiotic treatment. The health care providers tell me nothing is wrong. I don’t know what to do.
I have patients who flareup due to a Herxheimer reaction when starting treatment for Lyme disease. I find gains after antibiotics worth a second look in my patients.
Thank you. That’s more validation than I’ve had from my entire care team. I’ve been left to do extensive research on my own, support myself through it, and just assert that this is what happened to me. The fact that I’m doing 90% better after antibiotics is proof to me. I asked for a new lyme test to see if there was a change in antibodies but was denied even though the language on the test results itself recommends testing a future sample due to the reactivity to multiple bands. I will have to seek out a new doctor. I never thought I’d find myself sick and treated so inhumanely. An infectious disease provider has gone to great lengths to deligitimize me, and it’s so surreal. I saw the politicization of covid, but I never thought I’d get sick and become part of a “political” science circus. I’m just trying to get better. I appreciate you taking the time out of your busy day to say a few words. Thank you, again.
You mentioned “politicization of covid.” The Lyme disease community has seen “politicization of Lyme” for decades.
I have learned this the hard way. It’s a shame, and I don’t understand the debate. I would’ve been better off contracting syphilis. It’s insanity. I never could have imagined that healing and feeling better would be turned into something scandoulous and taboo or I would be attacked by health care providers because I asserted what when on inside my body. I am deeply sorry for anyone that has been through this and continues to go through it. Keep up the good fight, doc. Patients need healthcare providers like you!
Thanks for your encouragement.
I tested positive for Lyme in June of 2023. Took 2 weeks of antibiotics. Had flu like symptoms for a week or so. Everything seemed to calm down. February of 2024 tested positive with Covid. A week after testing positive I’ve been having numbness and tightness in my right knee. Could this be a possible flare up of Lyme.
I have seen patients who thought they had long covid but turned to have a flareup of Lyme disease.