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Is it Rheumatoid Arthritis or Lyme Disease?


Is it Rheumatoid Arthritis or Lyme Disease

Lyme disease is frequently misdiagnosed because its symptoms are similar to those of so many other diseases, irrespective of whether they are tick-borne or not. Rheumatoid arthritis (RA), a chronic disorder with a less apparent etiology than Lyme disease, is one of the most common Lyme disease misdiagnoses.

Although there are numerous fundamental differences between these two disorders, Lyme disease-related arthritic pain can sometimes resemble RA. Lyme disease was first found and reported in part as a result of a group of youngsters in Lyme, Connecticut, who presented with arthritis symptoms.

So, how can you tell the difference if you're having joint pain or Lyme disease? If you've been bitten by a tick or believe you're at risk for a tick-borne disease, seek medical help right away, and don't overlook any arthritic pain that could be caused by Lyme disease. Continue reading to learn more about the distinctions and similarities between Lyme disease and arthritis.


Differences between Lyme disease and rheumatoid arthritis

Lyme disease is a tick-borne infection caused by Borrelia burgdorferi, a spiral-shaped bacteria. Lyme disease is treatable with medications, but if not identified and treated promptly, it can worsen, change symptoms, spread to the nervous system, develop a chronic condition, and even become life-threatening.

When screening for Lyme disease, the Centers for Disease Control and Prevention (CDC) recommends that clinicians assess the likelihood that a patient has been exposed to infected blacklegged ticks. The CDC's risk maps show where Lyme disease is most common, with the majority of cases occurring in the Northeast and Upper Midwest. However, it's crucial to remember that these maps are based only on the number of Lyme disease cases reported. Every year, a large number of cases of Lyme disease go unreported because of diagnostic errors and misdiagnoses, missing diagnoses, or simply a lack of data.

Lyme disease is widespread in all 50 states and at least 60 nations worldwide. If you're suffering from Lyme disease symptoms but don't live in the Northeast or Upper Midwest, it doesn't mean you're immune to the disease.

Lyme disease symptoms are similar to those of many other tick-borne and nontick-borne infections, making diagnosis difficult. The symptoms of Lyme disease can develop in different ways, with early-stage symptoms occurring anywhere from 3 days to weeks following a tick bite.

Symptoms of Lyme disease in the early stages

  • Fatigue
  • Headache
  • Erythema migrans (EM) or "bull's eye" rash (note: many patients with Lyme disease don't get a rash, so just because you don't remember getting one doesn't indicate you don't have Lyme disease.)
  • Fever
  • Sweats
  • Chills
  • Muscle ache
  • Joint discomfort
  • Neck ache
  • Problems with sleep


Symptoms of Lyme disease in the late stages

  • Fatigue
  • Joint discomfort
  • Muscle ache
  • Problems with sleep
  • Symptoms of the mind
  • Neuropathy
  • Depression
  • Abnormalities in the heart
  • Headaches
  • Bell's palsy (facial drooping)


Patients who present with arthritic discomfort in the knee are frequently misdiagnosed with rheumatoid arthritis.

However, one important distinction between Lyme disease and arthritis is that Lyme arthritis usually affects larger joints and only one side of the body—for example, one knee. Rheumatoid arthritis, on the other hand, affects the hands, fingers, feet, and toes more frequently and is usually bilateral (showing up equally on both sides of the body).

Finally, Lyme arthritis is typically sporadic, whereas RA joint discomfort occurs on a daily basis and tends to be persistent.


RA is a chronic inflammatory illness that affects the lining of the joints, most commonly in the hands and fingers or the feet and toes. The cause of RA, unlike Lyme illness, is unknown. RA is a chronic disease for which there is no cure at present.

Many people think of RA as an autoimmune disease, and it can even be a side effect of Lyme arthritis; however, not all RA cases are caused by Lyme, and not all arthritis cases are RA. While Lyme disease is a risk factor for RA and other types of inflammatory arthritis, doctors will consider any of the other risk factors for RA when making a RA diagnosis.

An immune reaction that affects healthy tissues in the body releases a high quantity of IgM antibodies, often known as "rheumatoid factors."

Risk factors for RA:

  • Anti-cyclic citrullinated peptide (anti-CPP) antibodies in the blood
  • Obesity
  • A history of autoimmune illness in the family
  • Dust and fiber exposure in the workplace
  • Genes are a type of genetic material (RA is not heritable but is linked to genetic susceptibility).
  • Infections and trauma, as well as hormones and environmental factors
  • In addition, women are two to three times more likely than men to have RA.


Signs and symptoms of rheumatoid arthritis

To adequately evaluate your risk for either disease, you must first understand the similarities and differences between Lyme disease and RA. The following are some of the most prevalent early RA symptoms:

  • Joint stiffness on both sides, especially first thing in the morning or after periods of inactivity
  • Smaller joints, such as the hands and fingers, or the feet and toes, may be stiff or painful
  • Joints that are swollen, painful, or heated
  • The range of motion is restricted.
  • Fatigue\weakness
  • Appetite loss
  • In addition to joint symptoms, some patients with RA experience issues with their eyes, skin, heart, and lungs.

As previously stated, arthritis on one side of the body or in larger joints could indicate Lyme disease.


How are Lyme disease and rheumatoid arthritis diagnosed?

Physicians use lab test findings and a patient's physical and reported symptoms to diagnose Lyme disease. However, as previously said, this can be difficult because of both the vast range of symptoms associated with Lyme and the limitations of the blood tests.

Many Lyme disease tests only identify antibodies produced in response to bacteria rather than the bacteria themselves. Patients who are checked too soon may have negative test results but still be infected with Lyme because it takes time for the body to build enough antibodies to show up in a test. If a patient is infected with a bacterial species that the test isn't designed to identify, they may test negative.

Such scenarios can lead to a misdiagnosis if the patient exhibits symptoms that are similar to those of another disease, such as RA.

RA, like Lyme disease, is a challenging condition to diagnose. There is no one blood test that can be used to rule out RA. Instead, doctors will examine a patient physically, examining for swelling, redness, or warmth in the joints, as well as reflexes and muscle activity. They may also use X-rays and MRIs to look for the antibodies ("rheumatoid factors") and proteins listed above in the blood.


How are Lyme disease and rheumatoid arthritis treated?

Antibiotics are the only way to treat Lyme disease. The majority of Lyme disease cases will be cured if treated promptly. It can, however, cause lifelong difficulties and even death if not discovered early. If it is misdiagnosed as RA, it might waste your money on unnecessary tests and treatments, as well as complications from the untreated infection, not to mention long-term health and quality-of-life consequences.

RA, like Lyme, can be debilitating if not treated promptly. Doctors, on the other hand, cannot easily cure RA with a therapy regimen; instead, they must treat symptoms over the course of a person’s lifetime. Without correct treatment, RA can cause chronic, irreversible damage to the cartilage and bones, which can worsen over time.

Nonsteroidal anti-inflammatory drugs, steroids, and conventional or biologic disease-modifying anti-rheumatic therapies are among the most popular treatments for RA, according to the Mayo Clinic. Physical therapy is commonly used to address RA symptoms, and in rarer situations or cases that do not respond to medication or therapy, doctors may consider surgery.



To conclude, the main distinguishing factors between Lyme disease and RA include:

Lyme disease

  • Tick-transmitted bacterial infection
  • A wide range of symptoms that are similar to those of other disorders
  • Large joints (such as the knee) on one side of the body are frequently affected by joint discomfort.
  • If the condition is not addressed, joint problems can become chronic.
  • Antibiotics were used to treat it.
  • When and if it progresses and worsens, it can be a risk factor for RA.


Rheumatoid Arthritis

  • Unknown causes for a chronic inflammatory disease
  • Generalized malaise accompanied by specific joint pain, stiffness, and impaired mobility
  • Joint stiffness and soreness are most common in small joints (hands and feet) and are bilateral.
  • Regular (typically in the mornings or after lengthy periods of idleness) and chronic joint symptoms
  • Anti-inflammatory medications, steroids, DMARDS, physical therapy, and antibiotics or surgery are used to treat it.