About 30,000 cases of Lyme disease are reported to the Centers for Disease Control and Prevention every year.
Rates of infection vary by state, with the Northeast a particular hotbed of Lyme disease — but all U.S. states are home to the ticks that cause the infection. Rates of Lyme disease are growing.
Clemson University’s Lyme disease forecast map indicates the presence of ticks that carry various bacterial strains linked to Lyme. Once considered a northeastern condition exclusively, the Borrelia Burgdorferi bacteria is appearing in higher concentrations along the East Coast into the Carolinas, across the upper Midwest, upper Great Plains and into pockets of the Smokey Mountains of Tennessee.
Craig Prior, president of the Companion Animal Parasite Council, said, “As mice and other animals that ticks feed on move into new habitats, the ticks and Lyme disease move with them. Awareness is the key, and forecasting helps people and veterinarians know the potential risk in their county.”
Anyone can become infected, once bitten by an infected tick. With Lyme disease on the rise, there is a good chance at least one of your clients might suffer from this condition.
This article provides general information about Lyme disease; it does not replace medical advice and any client presenting with untreated Lyme disease should be referred to an appropriate health care professional.
Signs and Symptoms of Lyme Disease
According to the Lyme Light Foundation, Lyme disease is called “the great imitator” as condition manifestations often mimic fibromyalgia, chronic fatigue syndrome, multiple sclerosis or systemic lupus.
Symptoms of Lyme disease include:
• Erythema migrans (bullseye rash)
• Pain (joint or muscular)
• Joint swelling
• Swollen lymph nodes
• Sleep disorders
• Sore pockets in the arms, knees or thighs
• Cognitive challenges
Classically presented, there are four stages of this condition:
Stage 1: The first stage is termed Early Localized Lyme, which may feature flu-like symptoms that manifest anywhere from three to 21 days upon infectious entry. The presence of a bullseye rash was once considered commonplace; however, recent research presented by the National Center for Health Research suggests less than 50% cases witness an initial rash. Stage 1 may be asymptomatic for some patients.
Stage 2: The second stage of this condition is termed Early Disseminated Lyme and features many classic signs and symptoms. Fatigue, more pronounced flu-like symptoms, swollen lymph nodes or glands, sore throat, vision challenges and sensations felt in the bite region may be experienced.
Stage 3: The third stage of this condition is termed Late Disseminated Lyme and features more extreme symptoms including brain fog, temporary amnesia, apraxia, ataxia, heart palpitations and arrhythmias, arthritis onset, extreme fatigue, Bell’s Palsy with accompanying neuritis and stroke-like symptoms.
Stage 4: The fourth stage may be confused with other chronic illness. Chronic Lyme features many complications, including chest pain, cardiac arrest sensation, edema, hepatitis, paresthesia into the extremities, cranial and cervical pain, seizures, encephalitis and headaches. Many co-infections may result, including chlamydiae class diseases, mycoplasms and Epstein-Barr.
Lyme diseases is a bacterial infectious disease. Spirochete bacteria, mycoplasms and other pathogens may all be carried by ticks. Other causes include blood transfusions, mother-to-fetus transmission, or by a variety of bugs (ticks, bed bugs, mosquitos and fleas).
There is discussion in the medical field if Lyme disease can be either considered an autoimmune disease or contribute to the onset or exacerbation of an existing autoimmune potential within the body.
Daniel Cameron, MD, a nationally renowned authority with more than 25 years’ experience working with adults and adolescents suffering from Lyme Disease, suggests Adult-onset Still’s Disease (AOSD) is strikingly similar to Lyme Disease. Dr. Cameron highlights a case in AOSD was triggered by the presence of Lyme within a 61-year-old patient.
The two main allopathic treatment options are oral or intravenous antibiotics. Some patients seeking a non-Western medicine approach are utilizing Bismacine (Chromacine), which is not approved by the FDA.
Some Lyme disease patients experience symptoms that mildly linger beyond treatments. Post-Treatment Lyme Disease Syndrome (PTLDS) is a condition confirmed by Dr. John Aucott, an infectious disease specialist in Maryland, who acknowledges “PTLDS is a real condition, although nobody really knows what is happening.”
The Role of Massage
“How important is massage therapy for the Lyme disease patient?” posed Lyme disease sufferer Wende Teague of Phoenix, Arizona. “With the bacteria’s ability to hide in the tissues, massage therapy becomes crucial in healing. My joints ached, the muscle spasms could be unbearable, and the headaches were debilitating.
“The key to dealing with Lyme patients in massage therapy is slowing down,” she added. “Fast strokes can feel like constant stimulation to an already stressed sympathetic nervous system.”
Keeping in mind Teague’s comments, here are recommended massage and bodywork techniques and considerations to incorporate into treatment sessions. Assimilating various modalities into session is indicated as long as these are performed slowly and mindfully.
The primary question to consider is determining which stage of Lyme disease is presented.
The early stage is often asymptomatic, yet if symptoms do present, be sure to keep the massage treatment less intense for the client — which involves lessening duration, pressure and speed of strokes.
With disseminated stages, massage is contraindicated in the period of time symptoms acutely manifest. When these symptoms subside, some modalities offering relief of pain and discomfort include:
• Lymphatic drainage to move lymphatic fluid carrying metabolic and other waste.
• Thai massage including stretching to keep limbs mobile and joints healthy. The Southern approach to Thai will be better received typically with more mild gentle movements offered. Avoid extreme Northern style Thai movements and stretches.
• Stability of joints is key. Ensure joints are well cared for when mobilizing limbs and performing frictions within joint fibrous membranes.
• Shiatsu to provide overall mind-body balance. Performing medium pressure compressions upon the 12 main meridian pathways can be relaxing to the client.
• Cranial sacral therapy can greatly alleviate conditions involving the cranium, including the Lyme client’s headaches and neuritis.
Other general bodywork considerations include postponing sessions if systemic inflammation arises and avoiding skin lesions and rashing seen upon the client.
Also, in general when offering Swedish massage, keep strokes slower than normal to overly tax the patient’s body.
An important clinical note to remember: Some health professionals archaically maintain an opinion that Lyme may have psychogenic elements.
Be sensitive to this notion as you converse and listen actively to the Lyme client. Many Lyme disease sufferers are used to their condition being discounted, and even dismissed, by many health professionals.
A compassionate, open-minded approach will be appreciated by the massage client.
Jimmy Gialelis, LMT, BCTMB, is owner of Advanced Massage Arts & Education in Tempe, Arizona. He is a National Certification Board for Therapeutic Massage & Bodywork-approved provider of continuing education, and teaches “Working with Pathologies—Arthritis” and many other classes. He is a regular contributor to MASSAGE Magazine. His many articles include “6 Principles of Professional Ethics in the Therapeutic Relationship.”