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Old 08-07-2006, 08:38 AM
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Harrison Harrison is offline
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Lyme disease is quite a problem -- especially in the (entire) northeast. Its many symptoms can be cardiovascular, neurological, myalgic and arthritic.

I found several articles that relate back pain to the naughty little bug – the Borrellia spirochete – that can tunnel into all parts of the body. It’s a very sophisticated bug that can change forms and elude the immune system as well as most diagnostic tests.
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Meningoradiculoneuritis mimicking vertebral disc herniation. A "neurosurgical" complication of Lyme-borreliosis.

Meier C, Reulen HJ, Huber P, Mumenthaler M.

University Department of Neurology, Inselspital, Bern, Switzerland.

We report on 3 patients with meningoradiculoneuritis (MRN) due to Lyme-borreliosis (LB), which presented clinically as vertebral disc herniation. In 2 cases the underlying infection was discovered only after unsuccessful neurosurgical treatment. In the differential diagnosis between MRN and disc herniation the following criteria are suggestive of MRN and should raise suspicion of a non-discogenic aetiology: History of tick bite or erythema chronicum migrans, fever or general malaise, mono- or oligoradiculopathy with absent or insignificant lumbar pain and complaints of a burning character of the radiating pain. In suspicious cases we recommend blood investigations including antibody determination against borrelia burgdorferi and CSF investigations including cell count and cytology, protein and glucose determination, nephelometry and isoelectric focusing to exclude MRN and other conditions that may mimic disc herniation.


Joint Bone Spine. 2004 Sep;71(5):433-7. Related Articles, Links

Sciatica, disk herniation, and neuroborreliosis. A report of four cases.

Dupeyron A, Lecocq J, Jaulhac B, Isner-Horobeti ME, Vautravers P, Cohen-Solal J, Sordet C, Kuntz JL.

Physical Medicine and Rehabilitation Unit, Strasbourg Teaching Hospitals, Avenue Moliere, 67098 Strasbourg cedex, France. arnaud.dupeyron@chru-strasbourg.fr

We report four cases of sciatica in patients with same-level disk herniation confirmed by computed tomography and a final diagnosis of acute radiculitis caused by Borrelia burgdorferi, with a favorable response to ceftriaxone therapy. The neurological manifestations of Lyme disease are protean, and a potential contribution of concomitant disk disease to sciatica can lead to diagnostic wanderings. Disk lesions and infectious conditions that can cause sciatica are discussed. Whether a favorable response to antibiotic therapy should be taken as proof of B. burgdorferi radiculitis deserves discussion. In practice, in a patient with clinical manifestations suggesting disk-related nerve root pain and residing or having traveled to an endemic area, B. burgdorferi infection should be looked for, as both etiologies can coexist.
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Old 08-07-2006, 10:15 AM
tisury tisury is offline
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Early on in my back pain journey when the doctors were telling me they could not locate the pain generators, I requested a Lyme test after reading quite a few articles that stated that Lyme disease could mimic neuropathic pain from DDD. I live in a rural wooded area in Pennsylvania - prime area for the deer tick and Lyme disease. The rheumatologist I saw refused, but my primary care doctor agreed it was an easy and inexpensive test. It did test negative though. Thank heavens. I know people with Lyme disease - and if not treated until the late stages of the disease - it can be truly horrendous in it's symptoms and controlling them.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
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Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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Old 08-07-2006, 01:19 PM
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Tisury, I heard that PA has some of the highest Lyme rates in the country. For what its worth, Lyme is a clinical diagnosis, NOT determined by the blood test as false negatives and false positives can occur for myriad reasons. Worse, most people that fear a Lyme condition go out of state (Mass.) because doctors here are not "Lyme literate."

More on seronegativity here:
http://www.lymeinfo.net/lymefiles.html
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Old 08-07-2006, 02:43 PM
tisury tisury is offline
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Thanks for the info Harrison. Wow.......that isn't a comforting thought though. I didn't realize that the blood tests were that inaccurate. What kind of testing do they use in Mass. - do you know?
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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Old 08-08-2006, 03:00 PM
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The testing question is simple, but the answer is not! E.g., this seven-year-old FDA bulletin on Lyme testing is quite misleading, as it points to a CDC test method that was designed for surveillance – not diagnostics. This crappy test often leads to false negatives, as it only tests a small number of “biomarkers” of the Lyme bug:

http://www.fda.gov/medbull/summer99/Lyme.html

If you are curious about the accuracy of the test, join the club. But to be fair, it’s a tricky test. For example, try this search and check out the results – there are many reasons why a patient’s results could be seronegative:

http://www.google.com/search?hl=en&q=reasons+for+lyme+s...y&btnG=Google+ Search

Again, most hospitals and clinics use this cheap, easy and crappy test. It’s hard to believe, but it’s the norm. At least in Taxachusetts.

There are some good labs out there, ones that test for an accurate number of Borrellia markers (Lyme bacteria) as well as other bacterial co-infections. Here’s one in CA (click on Lyme disease):

http://www.igenex.com/

Hope this helps.
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Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
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  #6  
Old 08-08-2006, 03:22 PM
annapurna annapurna is offline
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This is completely outside of the purpose of the post and the board, but it is worth pointing out that Lyme disease is easily treated if treated early. If you get bitten by a tick in an area where Lyme diesase is a reasonable concern, it's easy enough to go get your doctor to prescribe a short course of antibiotics to make sure you're not here talking about it in the future.

Sorry, I'll stick to backs from now on.
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  #7  
Old 08-10-2006, 06:05 PM
tisury tisury is offline
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Thanks Harrison. I will have to take a look at this stuff. At this point, I don't think I have Lyme disease or one would think I would have developed new symptoms after this amount of time.
You are definetely right about how easy it is to treat if caught right away using antibiotics. But at least around here, they will not prescribe antibiotics merely because you have been biten. My son has come in with deer ticks on him. Of course, not all deer ticks carry the disease either. When I found one that had attached, I removed it, saved it, and took him to the doctor. They would not prescribe any antibiotics, they just had us watch for the "tell-tale bullseye rash." I have read many articles and personally know two people though who have full blown lyme disease who never recall ever having the bullseye rash. We do use repellant when outside usually and check for them when we come in. The sooner they are removed, the less chance you have of getting the disease also. Another trick is to wear light colored clothing, because they are really tiny and hard to see.

I love the area we live in. It is truly beautiful here on the hill all year round. I guess we just have to deal with being cautious.
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May 2002 Degenerated disks at L3-4,L4-5, and L5-S1.
Feb 2004- Flexicore ADR - L5-S1
Jan 2005 - pinching pain in back and leg weakness is gone, but severe nerve pain in hips,legs, low back and backside has not improved. May 2006 Nucleoplasty L3-4 a
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