When you see a patient with vague aches, pains and fatigue you may think ‘inflammatory condition’ or ‘Fibromyalgia’ or ‘long Covid’. Would you think ‘Lyme disease’?
Lyme disease sneaks around acting like an MSK condition with its joint and muscle aches and pains, or a Spondyloarthropathy with its fatigue, or a Fibromyalgia with the brain fog or a Long Covid with its wide array of symptoms. It’s not an exotic disease you pick up on a jungle trek, nor is it confined to the most remote corners of Scotland. It is in all areas of the UK at varying risk levels.
My journey with Lyme disease started through my husband who was an ultra-marathon runner. In December 2021 he became unwell with a mild flu. We thought nothing of it but as the months went on he didn’t fully recover and he developed widespread aches and pains. For three months the aches worsened as did his energy levels and brain fog. Blood tests were normal and the GP suggested Fibromyalgia. He then remembered he had been bitten by a tick whilst on holiday on the Isle of Mull a month prior to his symptoms. The GP did a Lyme disease (borreliosis) test which was positive. He improved with a three-week course of antibiotics, then relapsed. He improved again with the second course but relapsed when they finished. He is currently on an extended course of multiple antibiotics, has recently returned to work and is slowly improving but is unable to exercise.
A third of people don’t know they have been bitten by a tick
It was scary to think of how quickly Fibromyalgia was suggested in a person who had barely gone to the GP before. Lyme disease is curable but 10-20 per cent of people don’t make a full recovery and chances are improved with earlier diagnoses. I am passionate about raising awareness and feel physios are well placed to spot it and have it as a differential diagnosis. Blood tests are unreliable, up to a third of people don’t know they have been bitten by a tick as they can be the size of a poppy seed and not everyone gets a rash. If a person has an occupational risk, such as working in the military or agriculture, or a recreational risk, for example hill running, then consider Lyme disease. Signpost them to the Lyme Resource Centre and get them to the GP.
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