Link between Lyme disease and arthritis

Dear Dr. Roach: What is known about arthritis later in life for someone who had early treatment for Lyme disease?

I had it as a teenager in the late 1980s and was told by my doctor that arthritis could be an issue later. I was treated with an IV antibiotic, which I believe was the go-to treatment at the time. — J.A.

Lyme disease, a bacterial infection transmitted by the deer tick, causes arthritis in about half of people with untreated Lyme disease. Among those who are recognized and treated early, joint and muscle pains are common, but inflammation of the joints, along with the possibility of joint damage, is unusual.

So, if you were recognized and treated early, the likelihood of developing any joint problems should be no different from your risk if you had never had Lyme disease.

Lyme arthritis most commonly affects one knee, but it can affect other joints, such as the shoulder, ankle, elbow or jaw (TMJ). Eleven percent of untreated Lyme disease patients developed permanent joint damage, but only 2% developed permanent joint disability.

This study comes from a time when Lyme disease frequently went unnoticed and untreated.

Diagnosing Lyme disease can be a challenge, especially when a rash has gone unnoticed or was never present at all.

A doctor needs vigilance and appropriate laboratory testing to find undiagnosed Lyme disease.

Conjunctivitis, damage to the nerves of the face or eyes, Lyme meningitis and abnormal electrocardiograms (including heart block) all are occasional manifestations of Lyme disease and should prompt a clinician to consider the diagnosis.

Early treatment of Lyme disease was, and is still, most commonly oral doxycycline.