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Physical Symptoms Of Lyme Disease


Unexplained Pain And Other Sensations

Diagnosing and treating Lyme disease

Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem 00090-7/abstract%20″ rel=”nofollow”> 27).

When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified musculoskeletal cause.

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Other symptoms have to do with cranial nerves.

  • Ear-ringing . Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as youre trying to fall asleep. About 10 percent of people with Lyme experience this (
  • Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing .
  • Jaw pain or toothaches that are not related to actual tooth decay or infection.


How Do People Get Lyme Disease

  • Lyme disease is normally carried in the blood of mice, squirrels, birds and other small animals. It is transmitted to ticks when they feed on infected animals and then to humans through the bites of the infected ticks.
  • It is not transmitted directly from person-to-person by touching or kissing.
  • Although dogs and cats can get Lyme disease, they cannot transmit the infection directly to humans. Pets can, however, carry infected ticks into your home or yard.
  • Deer hunting may increase exposure to ticks when tracking through high grass, shrubs and brush areas. Lyme disease cannot be contracted from eating deer meat.

What To Do If You Have A Blacklegged Tick Bite

Remove the tick by pulling it directly out with fine-tipped tweezers. Lift upward with slow and even pressure. Dont twist when removing it. Dont crush it or put soap or other substances on it. Dont apply heat to it.

Place the tick in a resealable container. See if you can identify what kind of a tick it is.

Immediately after removing the tick, wash your skin well with soap and water or with rubbing alcohol.

Not all ticks carry Lyme. The Lyme bacteria is transmitted only by blacklegged ticks in their nymph or adult stage.

Save the tick to show your doctor. The doctor will want to determine if its a blacklegged tick and if theres evidence of feeding. Ticks enlarge as they feed. Your risk of getting Lyme from an infected tick increases with the length of time that the tick fed on your blood.


Pull the tick out with tweezers and save it in a resealable container for identification.

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Diagnostic Tests/lab Tests/lab Values

Lyme disease is diagnosed based on symptoms, physical findings , and the possibility of exposure to infected ticks. Laboratory testing is helpful in the later stages of disease.

Diagnosis of any infectious disease requires a combination of clinical experience and assessment by the doctor and understanding of the lab tests and their limitations. Laboratory tests are rarely definitive and all tests have a proportion of results which are false-positive and false negative . When tests are done in places where the disease is rare or absent , many positive tests will be falsely positive.

The tests to diagnose Lyme disease are technically complex and require specialist expertise. It is important for people who want to be tested to make sure the laboratory that performs the test is reliable.

Lyme disease is most commonly diagnosed by a screening test called ELISA and this is then confirmed using a western blot test. Both of these tests detect antibodies that are produced by the immune system of someone with Lyme disease.

Lyme disease can also be diagnosed by testing a sample of the skin lesion by nucleic acid testing or culture.

Lyme Disease Symptoms Also Occur In Other Diseases

Lyme symptoms

Many Lyme symptoms, such as fatigue, cognitive impairment, joint pain, poor sleep, mood problems, muscle pain, and neurological presentations also occur in other diseases. Hence, the symptoms of Lyme disease significantly overlap those of chronic fatigue, fibromyalgia, rheumatoid arthritis, multiple sclerosis, Parkinsons disease, ALS, depression and Alzheimers disease. Many Lyme patients report being misdiagnosed with a different condition before being properly diagnosed with Lyme disease.

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Symptoms Diagnosis And Treatment


Symptoms of Lyme disease vary and may develop days or weeks after a person is infected from a tick bite. Early symptoms may include:

  • An expanding skin rash that looks like a bulls eye may develop at the site of the tick bite in 70 to 80 percent of infected persons. Some people may not develop a rash.
  • Fever, chills, headache, muscle and joint pain, fatigue or swollen lymph nodes.
  • Later symptoms may include more rashes, dizziness, abnormal heartbeat, arthritis, mental confusion or inability to think clearly , nervous system disorders .


Getting a diagnosis of Lyme disease can be difficult as your symptoms may be similar to other illnesses. Inform your health care provider of any travel outside of the province and whether you have developed a rash around a recent tick bite.

Prevention and early diagnosis of Lyme disease are important. Consult a health care provider as soon as possible if you are bitten by a tick and develop symptoms of Lyme disease. The earlier you receive a diagnosis and treatment, the better your chances to make a full recovery.

Your health care provider should:

  • review your symptoms
  • find out if you were in an area at risk of having Lyme-infected blacklegged ticks
  • do a physical examination and
  • order laboratory blood tests to see if you have certain antibodies that could indicate you have the disease.


Information on Lyme disease is also available on HealthLine Online by typing Lyme Disease in the health topic search.

Which Areas Are More Likely To Have It

The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. Cases in California and Florida are on the rise. After a drop between 2017 and 2018, the numbers jumped a little bit in 2019.

But most Lyme cases in 2019 were in 15 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New

Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin. Washington, DC, is also a hotspot.

In 2019, Pennsylvania had the most Lyme infections, with 6,763. New York was next, with 2,847 cases.

In the Southern U.S., where itâs hotter, ticks stay under leaves so they don’t dry out. This means people donât get Lyme from Southern ticks very often because they don’t usually come out to bite.

Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.

Whoâs likeliest to get Lyme disease?

Boys up to age 15 and men between the ages of 40 and 60 are the most likely to get Lyme disease. Thatâs because they tend to play outside and go camping, hunting, and hiking.

Why are there more ticks now than there used to be?

There are several reasons why Lyme is spreading. Some of these are:

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What’s The Best Way To Prevent A Tick Bite

Ticks can’t fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:

  • Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
  • Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
  • For even more protection, use the chemical permethrin on clothing and camping gear.
  • Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
  • Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.

How do you know if you’ve been bitten?

Since ticks are so small, you’ve got to have pretty good eyes to see them.

If you have a small, red bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, itâs not a problem. Remember, a tick bite doesnât necessarily mean you have Lyme disease.

If you notice a rash in the shape of a bull’s-eye, you might have a tick bite. Talk to your doctor about treatment.

If you have an allergic reaction to ticks, you’ll notice a bite right away.

Study Shows Evidence Of Severe And Lingering Symptoms In Some After Treatment For Lyme Disease

Lyme Disease Symptoms and The First Month of Treatment

In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue…

In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing.

Post-treatment Lyme disease syndrome is a real disorder that causes severe symptoms in the absence of clinically detectable infection, says John N. Aucott, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Lyme Disease Clinical Research Center.

The findings, published in the December issue of Frontiers in Medicine, could spur further investigation into the cause of persistent symptoms, a source of medical controversy. As Lyme disease rates have steadily climbed in the United States since it was first recognized in the mid-1970s, so have reports of a collection of symptoms that patients commonly refer to as chronic Lyme disease. Experts in the field have questioned the validity of this term because of the lack of direct evidence in this group of patients of ongoing infection with Borrelia burgdorferi, the bacterium that causes Lyme disease.

Other Johns Hopkins researchers who participated in this study include Alison W. Rebman, Ting Yang, Erica A. Mihm, Mark J. Soloski and Cheryl Novak.

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Symptoms Of Early Stage Lyme Disease

According to the Centers for Disease Control and Prevention , early-stage Lyme disease symptoms crop up within 3 to 30 days after exposure and can include but are not limited to:

  • Joint pain and swelling
  • Swelling of the lymph nodes
  • Erythema migrans , a bulls-eye-shaped rash that appears at the site of the tick bite

Early Lyme disease does not always appear the same in all patients. For example, up to 30% of patients dont remember experiencing a bulls eye rash.

Late Lyme Disease Symptoms

  • Have you had any of the following symptoms typical of late or chronic Lyme disease?
  • New onset fatigue, widespread pain, sleep disturbance, and cognitive impairment are common symptoms of late Lyme disease. Many symptoms of late or chronic Lyme disease are non-specific and common among diseases. What sets Lyme patients apart is the severity of symptoms and the degree of functional impairment. Patients report pain at the severity of post-operative patients, fatigue at the level of patients with multiple sclerosis, and functional impairment comparable to those with congestive heart failure. Most patients with chronic Lyme disease report one or more of the following symptoms as severe or very severe: fatigue , sleep impairment , joint pain , muscle aches , other pain , depression , cognitive impairment , neuropathy , headaches and heart-related issues . Chronic Lyme patients generally report more than one symptom and average three severe or very severe symptoms.
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    Can Lyme Disease Be Prevented

    Most people with Lyme disease get the infection during the late spring, summer and early fall when immature ticks are out feeding. In warm climates, few tick bites take place during winter months.

    Deer ticks are most often found in wooded areas and nearby grasslands. Theyre especially common where the two areas merge, including neighborhood yards where deer occasionally roam. Ticks dont survive long on sunny lawns. They dry out quickly and die.

    Although only about 1% of all deer ticks carry Lyme disease-causing bacteria, there are areas in which over 50% of the ticks carry the bacterium. The diseased ticks are often found in the U.S. Northeast and upper Midwest areas. Ticks also live in coastal areas.

    Black-legged ticks can get the infection from animals other than deer. Mice, voles and some squirrels can carry the bacteria.

    How can I prevent tick bites?

    The following tips can help you avoid tick bites:

    Symptoms Of Lyme Disease

    Could Your Chronic Pain Be From Lyme Disease?

    Signs and symptoms of Lyme disease can vary from person to person after being bitten by a tick.

    Lyme disease occurs in stages. The signs and symptoms of each stage can overlap. In some people, Lyme disease may present in a later stage without a history of prior signs or symptoms.

    The most commonly reported sign of Lyme disease is an expanding skin rash that typically begins at the site of the tick bite. This rash is called erythema migrans. It slowly grows to more than 5 cm in diameter over several days, and can sometimes:

    • be circular or oval-shaped
    • look like a target or bull’s eye
    • go unnoticed, especially if it’s on:
    • a part of the body that’s difficult to see

    Some people may not develop a rash.

    Other early signs and symptoms include:

    If left untreated, the infection could spread to the joints, heart and nervous system.

    Images of erythema migrans rash

    Image 1Footnote a: A rash that looks like a bull’s eye at the site of a tick bite.

    Image 2Footnote a: An oval-shaped red rash.

    Image 3Footnote a: A red rash that has expanded across the width of a limb.

    Image 4Footnote a: A red rash and blisters on a forearm.

    Image 5Footnote b: A rash on a shoulder.

    Image 6Footnote c: A rash on the back of a knee.

    Footnote a

    Later symptoms of Lyme disease can appear days to months after an infected tick bite, and may include:

    • migratory pain that spreads in the:
  • thinking and reasoning symptoms, such as:
  • Other later stage symptoms include:

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    Key Points For Healthcare Providers

  • In patients with facial palsy who are unable to close one or both eyes, eye drops or an eye patch may be needed to prevent dry eyes.
  • Neurologic symptoms do not necessarily indicate central nervous system infection in a patient with Lyme disease.
  • Two-step serologic testing for Lyme disease is the recommended diagnostic test for neurologic Lyme disease.
  • Cerebral spinal fluid analysis is not necessary to diagnose Lyme meningitis, but can help exclude other causes of illness, such as bacterial meningitis.
  • Consider Lyme radiculoneuritis in patients who report severe limb or truncal radicular pain without preceding trauma who live in or who have traveled to Lyme-endemic areas.
  • Chronic Lyme Disease Vs Acute And Late Stage Lyme

    One reason chronic Lyme disease is harder to detect and treat than Lyme at earlier stages is that chronic Lyme disease symptoms are more wide-ranging and varied. Chronic Lyme disease can cause symptoms of early Lyme disease such as fatigue and muscle aches to recur, but it can also cause new symptoms that affect different parts of the body.

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    The Role Of Physical Therapy For Lyme Disease

    At Arrow Physical Therapy & Rehabilitation, we have placed a growing focus on treatment for those who struggle with Lyme disease. According to the Centers for Disease Control and Prevention , in 2011, 96% of Lyme disease cases were reported from 13 states: one of them is New Jersey.

    Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system.

    People are most likely to be infected with Lyme disease in the summer months. The disease is fairly easy to cure with a course of antibiotics in the early stages, but if left undetected or untreated, can cause problems in the later stages, when the heart and nervous system are affected. Finally, late or chronic Lyme disease also causes arthritis. .

    PTLDS, or late stage Lyme disease, results in musculoskeletal impairments, which is a primary area of treatment in physical therapy. At Arrow Physical Therapy & Rehabilitation, we offer individualized treatment designed for patients to cope with and lessen the symptoms of Lyme disease.

    At Arrow Physical Therapy & Rehabilitation, in addition to a prescription for an exercise program, treatments for Lyme disease may include:

    You Have A Fever And Chills But It’s Not The Flu Or Covid

    Longer-Term Therapy for Lyme Disease

    Other common symptoms of Lyme disease include fever, chills, and body aches.

    If that trio sounds familiar, it’s because the symptoms can appear after any infection, such as COVID-19 or the flu. You can get tested at a doctor’s office to rule out other illnesses, but antibodies for Lyme disease typically don’t show up on tests for weeks after infection, according to the CDC.

    Fredericks recommended checking for the bull’s-eye rash to set early Lyme disease symptoms apart from something like the flu.

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    What Is Lyme Disease And Where Does It Occur

    • Lyme disease is an illness caused by the bacterium, Borrelia burgdorferi. It is spread through the bite of certain types of infected ticks.
    • It can cause serious illness in humans but can be effectively treated with antibiotics.
    • Cases have been reported in parts of Europe, Asia and throughout much of North America.
    • In British Columbia, the western blacklegged tick transmits Lyme disease while, in other parts of Canada, the disease is spread by the blacklegged tick, sometimes called the deer tick.