Overview of Lyme Disease Pain Control
Most people with Lyme have pain. In this article I review the causes of Lyme pain and the steps a person can take to control and eliminate pain. I provide a strategy for controlling Lyme disease pain which uses:
- Sleep,
- Diet,
- Anti-cytokine herbs and supplements to lower inflammation,
- Supplements that support repair of mitochondria cell energy factories,
- Low dose naltrexone (LDN),
- Medical marijuana and/or CBD oil,
- Magnesium to relax muscles,
- Acupuncture, and
- Prescriptions medications.
Types of Pain in Lyme Disease
There are three types of pain occuring in chronic Lyme disease. They are
- inflammation,
- neurologic, and
- muscle spasm.
Cytokine Inflammation in Lyme Disease Pain
It is well known that Lyme disease triggers white blood cells to make excess inflammation chemicals called cytokines. These cytokines cause pain. For a detailed description of this and a review of options see Control Cytokines to Improve Symptoms & Immune Health.
Lyme disease Pain Strategy
So one strategy to lower pain in Lyme disease is to take herbs and supplements that may support lowering cytokines. These include curcumin and liposomal glutathione. Low dose naltrexone (LDN), a prescription medicine, can also lower cytokines.
Neurologic Pain in Lyme Disease
Lyme disease can also cause neurologic pain. Nerve pain has qualities of sharp, stabbing, shooting, piercing, or electrical type pain. These qualities of pain occur when Lyme germs directly injure nerves. Or it occurs as a result of inflammation of those nerves from cytokines.
There is a second type of nerve pain known to occur in people with fibromyalgia and MS, that likely occurs in people with Lyme disease. This is due to infection in the brain activating a brain immune cell called “microglia”. When infections activate Toll-like receptors on microglia, this leads to neurologic pain felt throughout the body. Some think this is the cause of the muscle pain (myalgia) seen in people with fibromyalgia. It is also likely a major cause of the myalgia seen in Lyme disease.
Lyme Disease Pain Strategy
For nerve pain due to microglia activation in the brain, one strategy is to block the Toll-like receptors to stop the microglia from turning on. LDN helps with this.
Another strategy is to decrease the inflammation of nerves. LDN, anti-cytokine herbs, and medical marijuana/cbd oil may help with this.
The last nerve strategy is to decrease the nerve signals that transmit nerve pain. Sleep helps with this, medical marijuana/cbd, prescriptions anti-seizure prescriptions and anti-depression prescriptions can help this too.
Muscle Spasm Pain in Lyme Disease
Due to inflammation or nerve injury, many with Lyme have pain due to muscle spasm. In addition to strategies to lower cytokines and to control nerve pain signals, muscle relaxers can help with this situation.
Lyme Disease Pain Strategy
Magnesium is a useful supplement that supports muscle relaxation. The salt forms of magnesium that are most helpful for this are Magnesium Malate and Magnesium Citrate. Prescription muscle relaxers are also helpful.
Additional Pain Factors in Lyme Disease
Sleep in Lyme Disease Pain Management
The center of a pain control strategy in Lyme disease is sleep. Sleep helps in two ways.
- Getting adequate sleep decreases pain sensitivity, which increases pain tolerance.
- Sleep also lowers inflammation cytokines that lead to Lyme pain.
Lyme Disease Pain Strategy
Get 7-9 hours of sleep a night. To do this use good sleep hygiene, sleep herbs and supplements, and/or sleep prescriptions. See Sleep in Lyme Disease: The Basic Steps, Sleep: The Natural Medicines, and Sleep: The Prescription Medicines.
Mitochondria Dysfunction and Chronic Pain
Mitochondria are the energy factories found in every cell. By some estimates there are 300 to 400 mitochondria in a cell. Chronic infection can damage the mitochondria. There is a growing body of science showing damaged mitochondria leads to chronic pain.
Lyme Disease Pain Strategy
It is possible to repair mitochondria. See Power Up Your Mighty Mitochondria & Get Energy for steps to repair the injured mitochondria.
One other strategy is to eat low inflammatory foods which support mitochondria. See The Best Brain, Inflammation, Pain, Energy, and Detox Diet Ever for more information about an effective paleo diet.
Traditional Pharmaceuticals for Lyme Disease Pain
Pharmaceutical medicines can control pain. However, they carry increased risks of side effects. In general, unlike the functional medicine approaches I described above, these medicines mask the symptoms, but do not fix the underlying problems that give pain.
NSAIDS
Non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naprosyn, may lower inflammation and help with pain. However, they have significant risk of hurting cartilage, stomach lining irritation and bleeding, or even nausea. So I do not recommend these for long-term use.
Lyrica and Cymbalta
Both of these medications are approved by the US Food and Drug Administration to manage nerve pain and fibromyalgia. Lyrica is very costly, so some insurance companies will not pay for it. And both medications have significant side effect risk of sleepiness and some nervous system side effects too. Cymbalta is useful for depression. So, these medications can help with muscle achiness pain and nerve pain seen in Lyme.
Anti-seizure medicines
Lyrica, Neurontin (gabapentin), Gabitril, Topamax, and other anti seizure medicines are useful for nerve pain. These medicines bind to the GABA-benzodiazepine receptors and nerve cells to change the transmission of pain by nerves.
Anti-depression medicines
These are medicines like amitriptyline, nortriptyline, desipramine, and imipramine. The medicines are from an older family of anti-depression medicines called the tricyclic antidepressant medicines. Cymbalta also is an anti-depression medicine.
Muscle relaxers
These include Flexeril (cyclobenzaprine), Robaxin (Methocarbamol), and Skelaxin (metaxalone).
Narcotics
As a last resort, narcotics are an option. These are medicines like oxycodone, Percocet, hydrocodone, Vicodin, methadone, fentanyl, and others. Because of the risk of addiction, these should only be used as a last resort. They usually are used in combination with anti-seizure medicines or anti-depression medicines
Putting It All Together
Basic Approach
- Get 7-9 hours of sleep. Use sleep hygiene, herbs, or prescriptions as necessary. See Sleep in Lyme Disease: The Basic Steps, Sleep: The Natural Medicines, and Sleep: The Prescription Medicines.
- Lower cytokines. Use liposomal curcumin 500 mg 1 pill 3 times a day or an anti-cytokine formula 1-2 pills 3 times a day. (Anticytokine combinations include curcumin, resveratrol, black tea extract, and N-Acetyl Cysteine (NAC). Consider adding liposomal glutathione 400 to 500 mg 1 time a day. For additional anti-cytokine options see Control Cytokines: A Guide to Improve Lyme Symptoms & Immune Health.
- Try A Paleo Diet, or at a minimum, avoid gluten. Paleo diets are not for everyone though. Paleo diets do not include gluten from wheat. At a minimum, if a person cannot eat paleo, at least avoid gluten which is inflammatory in many. See The Best Brain, Inflammation, Pain, Energy, and Detox Diet Ever for more information about an effective paleo diet.
Enhanced Basic Approach
If the basic approach is not effective, then add one or more of the following.
- LDN. This is useful for ongoing myalgia pain, nerve pain, and inflammation pain. But be aware it can take 3 or more months to work. This is a slower approach. LDN is made by a compounding pharmacist. Start at 1.5mg a day and work up to 4.5mg a day. See full prescribing information and side effect issues in Low Dose Naltrexone (LDN) & Lyme.
- CBD Oil or Medical Marijuana. This is very useful for nerve pain. It can sometimes help with myalgia pain too. This is a quick acting approach. The trick is to find the right dose. Generally, use CBD starting at 5mg 2 times a day. For night time use, use medical marijuana which is higher in THC. CBD is upping, which is useful in the day, and THC causes sleep. Also start this at 5mg. For CBD and THC marijuana, dosing is very individual. For full information about options for taking and using CBD and THC see Medical Marijuana, Cannabis, & CBD for Lyme.
- Repair Mitochondria. For chronic pain which is not responding to the basic approach, especially if you have low energy, consider taking steps to repair the mitochondria energy factories with a Phospholipid Mix + CoQ10 + PQQ 3 pills 1 time a day. Take this with liposomal glutathione 400 to 500 mg 1 time a day. For a more detailed plan see Power Up Your Mighty Mitochondria & Get Energy.
- Acupuncture. This is very useful for nerve and muscle pain.
Enhanced Basic Approach Plus Drugs
If the above approaches are not working then consider working with a physician to add anti-seizure medicines or anti-depression medicines including Lyrica or Cymbalta. As a last option, consider narcotics.
Muscle Spasms
Decrease muscle spasms with Magnesium Malate or Magnesium Citrate 400 to 600 mg at bed time. Decrease the dose if diarrhea develops. Take at night because it can make a person sleepy. If this does not work, then consider adding prescription muscle relaxers.
Disclaimer
The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the site wide Terms & Conditions.
