Detailed, evidence-based help for common painful problems

Yet another sneaky pathological pain culprit

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

You can “win” the battle with an infection and still lose the war, suffering for long after, because some pathogens pollute our biology in a way that does lasting harm. For instance, the Borrelia burgdorferi bacteria causes Lyme disease, but many people continue to struggle even when all the burgo-bastards are dead — a previously unexplained phenomenon called post-Lyme disease syndrome. The cause is probably a lingering molecule produced by the bacteria during their campaign.

Borrelia burgdorferi — tiny spiral joint-poisoning demons.

In 2019, researchers discovered that B. burgodorferi sheds a lot of peptidoglycan molecules while it grows — analogous to a snake molting — which collects in joints especially and continues to provoke the immune system, causing ongoing inflammation and malaise. Although “just one study” of a controversial topic, this study was highly persuasive. Especially the part where they actually induced acute arthritis in mice by injecting them with peptidoglycan. Sorry, mice!

If correct, then this study has not only solved one of the gnarliest puzzles in medicine — truly a big deal — but also demonstrateed an important general principle: immunity is a double-edged sword with many, many complications that are impossible to guess. If this can happen, and avoid detection for decades, you can be damn sure there’s more like it. •shudder•

So let’s add this to the long list of chronic pain causes that are definitely not “all in your head” in any way whatsoever.

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