by Jenny Lelwica Buttaccio
Posted 6/24/20

Painful joints and swollen knees have remained a common manifestation of Lyme disease since it was first diagnosed as a separate condition in the mid-1970s. In fact, a study in Arthritis and Rheumatism recounted the first cases of what would come to be known as Lyme arthritis (LA) in 1977.

In this historical study, the authors examined 51 residents from three neighboring communities near the town of Lyme, Connecticut. The individuals affected by the mystery illness included 39 children and 12 adults. The residents experienced pain and swelling in larger joints of the body, with the most typical presentation occurring in the knee.

Film x-ray knee joint with arthritis and blank area at left side

The incidences of pain and swelling tended to develop in an “asymmetric” fashion, meaning the symptoms occurred on one side of the body. About 25% of the patients involved in the study also described the appearance of a unique skin lesion resembling a bull’s-eye approximately four weeks before the onslaught of arthritic symptoms.

Remarkably, all of the cases surfaced in people who lived in rural, wooded areas with the peak rate of incidence happening in June through September. In contrast, other arthritic diseases, such as rheumatoid arthritis, had never occurred among groups of community members or during specific months of the year before, making the novel mystery illness distinct from those with similar symptomatology.

deer tick on human finger

The seasonal nature of the illness, combined with the bull’s-eye rash, gave rise to the suspicion that an infectious etiology might be the cause of the symptoms. And, the mode of transmission was likely a tick bite.

As we fast-forward to the present, we now know that LA is a chief, debilitating complaint among many patients with acute and chronic Lyme disease, the tick-borne infection caused by the bacteria Borrelia burgdorferi. Below, we’ll examine some of the contributing factors to LA and share solutions to ease discomfort and improve joint health.

What Does Lyme Arthritis Look Like?

When Lyme disease is diagnosed in an acute stage with symptoms occurring soon after a tick bite, oral or intravenous antibiotic therapies (doxycycline, amoxicillin) may be sufficient for the majority of people to recover from LA. However, if treatment is delayed, due to circumstances like inadequate testing or misdiagnosis, arthritic symptoms caused by Lyme disease may develop weeks to months after initial exposure to infection. Additionally, research suggests that approximately 10% of people treated in the acute stage will continue to experience arthritis as well. But is that estimation really accurate?

“In actuality, 10% percent is a ridiculously low number,” says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan. “With poor testing measures for Lyme disease, we have no way to accurately evaluate patients, so that figure isn’t correct. It’s likely much higher.”

Doctor's working on laptop computer, writing prescription clipboard with record information paper folders on desk in hospital or clinic, Healthcare and medical concept. Focus on stethoscope

Though there are discrepancies in the prevalence of LA, there are some frequent characteristics that can be seen in many patients. They include:

  • Lyme arthritis affects one or more joints in the body. While knees are a hallmark manifestation, other joints like the wrist, ankle, elbow, and shoulder can be affected, too.
  • Symptoms can occur in connective tissue. Patients may note pain and inflammation in connective tissue like tendons, ligaments, and bursae.
  • The pain may come and go. For many people, the discomfort associated with LA isn’t constant. They may cycle through periods of feeling better, then feeling worse.
  • The inflammation doesn’t occur symmetrically. LA is different from other inflammatory diseases of the joints (such as rheumatoid arthritis) because it doesn’t impact both sides of the body the same.
  • Symptoms can happen in any age group. LA can develop in both children and adults who contract Lyme disease.

Why Does Lyme Arthritis Happen?

After Borrelia invades a human host, its corkscrew shape allows it to migrate throughout the body, including the joints. Infected joints may present with visible swelling and pain. In many cases, the initial symptoms of a Lyme infection, such as fever, flu-like symptoms, or a rash, will have disappeared by the time LA develops.

As we’ve so often come to expect when sifting through information about Lyme, there’s some controversy in the medical community as to whether LA is caused by an overabundance of inflammatory chemicals, an autoimmune response, or chronic, low-grade infections. Patients who have dealt with LA tend to fit into one of three categories:

  1. People who have resolution of LA after antibiotic therapy for an acute Lyme infection
  2. People who receive treatment for an acute infection, but remain symptomatic with LA
  3. People who are undiagnosed for months or years and develop persistent symptoms of LA

Though we may not have all the answers as to why LA occurs in some people and not in others, Dr. Rawls believes the immune system plays a crucial role in combating the distressing symptoms.

Split image. Doctor's handing prescription pills packet, Healthcare and medical concept. Borrelia microbes on black background.

“There’s good evidence that antibiotics don’t eradicate Borrelia from the body,” says Dr. Rawls about the stealth pathogen. “The microbe wants to quietly set up shop in nutrient-rich tissues like collagen and joints until it can move to another host via a tick bite. The only thing that keeps bacteria in check is your immune system.”

But if your immune system becomes disrupted, microbes like Borrelia can flourish again, wreaking havoc, degrading collagen, and causing arthritic-type symptoms. Furthermore, Borrelia isn’t the only microbe with the capacity to degrade collagen — both Mycoplasma and Chlamydia are close runners up in contributing to arthritic pain, states Dr. Rawls.

Regardless of the source of symptoms, the end goal is to feel better. Medical interventions with antibiotics, antimalarials (hydroxychloroquine), non-steroidal anti-inflammatory drugs (NSAIDs), or other medications may be of benefit to some people.

But if you don’t fit the diagnostic criteria for LA, or if the current available treatment options have failed you, is there still hope for a future with less pain? In short, yes! There are several natural solutions that can help you address the factors that drive up inflammation and make you feel miserable.

5 Natural Solutions for Lyme Arthritis

Pain medications and other drugs don’t always do an adequate job at mitigating symptoms and quelling inflammation over the long haul, not to mention they can come with a host of unwanted side effects. Consequently, patients often look for other means to relieve pain and discomfort. The following suggestions can help you get things back on track:

1. Herbal Therapy

herbs graphic. cats claw knotweed reishi skullcap turmeric boswellia

“Really, all herbs provide benefits,” says Dr. Rawl. “Many herbs provide antimicrobial properties that are important for suppressing Borrelia, Mycoplasma, and other microbes, along with reducing inflammation.” Dr. Rawls’ preferred herbs for supporting healthy joints and lessening inflammation include:

  • Cat’s Claw: Native to the Amazon, cat’s claw has immune-modulating properties, which means it works to bring calm to an overactive immune system and mitigate inflammation. It’s commonly used in Lyme disease protocols, and it has historical use in alleviating arthritis pain.
  • Japanese Knotweed with Resveratrol: Used for centuries in traditional Asian medicine, Japanese Knotweed is a potent antioxidant with antimicrobial and anti-inflammatory properties.
  • Reishi: Reishi is a medicinal mushroom known for its antimicrobial and immune-modulating properties. It helps to mitigate inflammatory cytokines and support the immune system’s ability to deal with threatening microbes.
  • Chinese Skullcap: This herb works synergistically with other herbal remedies, meaning it enhances their effectiveness. Chinese skullcap also has antimicrobial properties, it dulls cytokines, and it supports immune health.
  • Turmeric: A staple in the traditional Indian medical practice of Ayurveda, turmeric is well-known for its ability to dampen a harmful, inflammatory cytokine response. Additionally, turmeric is an impressive antioxidant and helps to neutralize free radicals in the body.
  • Boswellia: Also used for centuries, boswellia works well alone or in combination with turmeric to ease systemic inflammation, minimize inflammatory cytokines, and support joint health.

2. Exercise

Exercise with chronic illness can be a catch-22. You need movement to lubricate your joints and stimulate mechanisms that help your body repair itself, but you can easily overdo it and cause an exacerbation of joint discomfort from the additional wear and tear.

To avoid pushing past your limits, follow Dr. Rawls’ 70% rule: Never exceed 70% of your maximum ability, even if you feel you can tolerate more activity. Low impact exercises like yoga, Pilates, tai chi, qi gong, walking, and swimming can be useful for getting you moving gently without bringing further harm to your joints.

3. Detox

If you’re undergoing Lyme treatment, you may experience Herxhemier reactions (Herx) whenever you change or increase antimicrobial therapies. What’s a Herx?

As Borrelia or coinfections are killed off, toxic substances known as endotoxins are shed. These endotoxins circulate throughout the entire body, causing a significant inflammatory reaction and worsening symptoms of pain. While pain can occur anywhere in the body, it’s not unusual to notice a spike in joint pain and inflammation, specifically.

To up your detox game and rid your body of endotoxins, stick with simple strategies. Options like alkalizing lemon water and juice, anti-inflammatory teas, or toxin binders like activated charcoal or chlorella are a great place to start.

4. Heat Therapies

Heat therapies like infrared sauna sessions and hot baths raise your body temperature, increasing healing blood flow to stiff, painful joints. Heat therapies can also induce sweating, which further assists in toxin removal and stimulates the release of feel-good chemicals like endorphins.

The goal of any heat therapy is to raise your body temperature by 1 to 2 degrees for 10-20 minutes each day,” explains Dr. Rawls. “Keep track by measuring body temperature using a thermometer in your mouth or under your arm.”

Heat therapies can be a powerful tool on your road to recovery, but the trick to avoid overtaxing your body is to start low and go slow: Begin with as little as five minutes a day. If you can handle that, gradually work your way up to a longer duration.

5. Sleep

Joint pain from any cause can play a role in keeping you awake at night. But sleep is one of the body’s most crucial requirements to repair itself.

To get the recommended seven to eight hours of sleep per night, allow for time to relax, unwind, and get comfortable before bed — which may mean tweaking your nighttime routine to factor in the amount of time it takes you to fall asleep. “I try to allot eight to nine hours for sleep every single night, so even if I have trouble falling asleep, I get at least the minimal amount that I need to function every day and reduce pain,” says Dr. Rawls.

Other ways to get the necessary shut-eye you crave? Some people might find that they sleep better when they schedule their heat therapies in the evening. Both the heat from the infrared rays and a warm bath may help to bring on the calm. Plus, gentle, restorative yoga before bed may lessen tension and quiet pain levels.

Living with LA can be challenging to endure. However, joint pain and inflammation don’t have to be insurmountable obstacles. By using a range of natural therapies, most people are able to alleviate discomfort, increase activity levels, and improve their quality of life.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.


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