Angel Ouitan Chen, DO

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

• Blacklegged (deer) ticks, which spread Lyme disease in the Northeastern, North -Central, and mid-Atlantic United States.
• Western blacklegged ticks, which spread Lyme disease in the Pacific and Coastal regions of the United States.
• A mother infected with Lyme disease may pass it onto a fetus.

As background, ticks lay on the tops of grass and brush, clutching onto leaves with their legs and with their arms outstretched. This formation is called "questing" and allows ticks to quickly latch onto passers-by. Within two hours of biting a person's skin, the tick slowly begins to feed from the blood of its host, which can transmit the bacteria that causes Lyme disease. This tick activity generally occurs seasonally and tick bites mostly occur during the springtime.

After being infected, people with Lyme disease may develop symptoms like fever, exhaustion, headache, joint aches, and skin rash, usually three to thirty days after the tick bite. Lyme disease is characterized by a particular skin rash called erythema migrans, which is an enlarged red rash that starts at the site of the tick bite and expands outwards. The rash is a strong indicator that someone has developed or is at risk of developing Lyme disease.

In the following few months, symptoms may worsen and progress to include:

• Facial palsy (facial droop)
• Headache and neck pain
• Arthritis
• Nerve pain and numbness
• Spinal and brain inflammation
• Abnormal heart rhythm (Lyme carditis)

Most cases of Lyme disease dissipate over a few months. Lyme disease may be cured by a course of oral antibiotics, such as amoxicillin or doxycycline. Other treatments may include:

• Nerve blocking drugs for pain, such as gabapentin
• Topical ointments for rashes

People can take action to prevent Lyme disease by exercising caution when in environments with ticks. Using insect repellant and wearing long socks and protecting clothing can help prevent tick bites. Outdoor enthusiasts should regularly perform "tick checks," evaluating their skin for small ticks, especially in areas where ticks may easily burrow. Showering within two hours of returning indoors also can reduce the likelihood of developing Lyme disease.

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.