Thoracic Outlet Syndrome or Lyme Disease?
Correct diagnosis equals effective treatment
By Michael P. Mansfield AAS, L.M.T., CNMT
Summer is upon us and it is time to enjoy the great outdoors! For many, camping, hiking, and experiencing what nature has to offer are typical summertime activities. Most people are aware of the inherent risks of overexposure to the sun, dehydration, and protecting oneself from venomous creatures, and biting and stinging insects. For the latter, awareness of surroundings and the use of insect repellant are essential.
Summertime is also a prime time for humans to become host to ticks. Tick bites, while usually innocuous, can become debilitating if bitten by a deer tick (or blacklegged tick, Ixodes scapularis) carrying the bacterium responsible for Lyme disease, Borrelia burgdorferi. The tick must be attached to its host for 36-48 hours or more in order to transmit the bacterium.
A tell-tale symptom of Lyme disease infection may or may not include a red, expanding rash called erythema migrans (EM).
- 70-80% of infected persons show signs of a rash, beginning at the tick bite, 3-30 days after being bitten.
- Parts of the rash may be clear, giving the appearance of a “bull’s-eye”, and can expand up to 12 inches in diameter
- Rarely itchy or sensitive, the rash may be warm to the touch.
- Erythema Migrans lesions may on any area of the body.
Other symptoms 3-30 days post tick bite may include headache, fever, chills, fatigue, muscle and joint aches, and swollen lymph nodes. An untreated Borrelia burgdorferi infection may spread throughout the body producing specific symptoms that may come and go. Symptoms include severe neck stiffness and headaches due to meningitis, pain and swelling in the large joints, Bell’s palsy (partial paralysis of the facial muscles), additional EM lesions on other parts of the body, heart palpitations, vertigo, chronic fatigue, and fibromyalgia.
Long term infection of the Borrelia burgdorferi bacterium may lead to further neurological complaints such as shooting pains and peripheral neuralgia (numbness in the hands and feet), arthritis accompanied by severe pain and swelling (particularly in the knees), chronic fatigue, and memory loss.
Lyme disease is the most commonly reported vector borne illness in the United States. 94% of all cases reported in 2010 were in the following states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Hampshire, New York, Pennsylvania, Virginia, and Wisconsin.
Several years ago I had a client with the chief complaint of chronic neck stiffness and peripheral neuralgia. The symptoms had persisted for over 10 years, with a variety of diagnosis provided by health professionals. One such diagnosis was Thoracic Outlet Syndrome (TOS), made by doctors at an unnamed University Medical Center. My client was convinced TOS was a rare musculoskeletal condition and removal of a neck muscle (scalenus anterior) would relieve her symptoms. Although some relief was achieved, symptoms continued to persist after time.
Discouraged but not defeated, she hired a new doctor. Upon review of her history, the doctor noticed she was originally from Connecticut, leading to a round of questions regarding outdoor habits in CT, and if she had ever experienced the initial symptoms of Lyme disease.
As it turned out, she loves the outdoors and had experienced the initial symptoms (sans EM lesions) while in Connecticut 10 years prior. A blood test confirmed a chronic Borrelia burgdorferi infection. Treatment with antibiotics is now the correct course of action.
If you suffer from chronic symptoms aforementioned, and have visited or previously lived in a high risk geographical area for Lyme disease, it is entirely possible you may be suffering from a chronic Borrelia burgdorferi infection. Laboratory tests may confirm the infection and put you on the road to recovery. Have fun this summer and be safe. Stop, Breathe, and Be Well!