Understanding Pain in Lyme Disease

Types, Treatments, and Strategies for Relief

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Jemsek Specialty Clinic

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Lyme disease, caused by the bacterium Borrelia burgdorferi transmitted through tick bites, is notorious for its variety of symptoms.  Among these symptoms is pain, which can be quite complex for people with this disease. The complex interaction of the spirochete and co-infections, i.e., Bartonella and Babesia, significantly contributes to the pain experienced by patients. Fatigue, cognitive impairment, and pain are the most persistent signs and symptoms in the LBC populace. In this article, we delve into the kinds of pain related to Lyme Borreliosis Complex, discover treatment measures, and share strategies to lessen systemic irritation.

When addressing pain, it is crucial to determine the type of pain reported by patients and then explore various treatment measures to limit discomfort and avoid the risk of addiction associated with opioids. Let’s review the forms of pain generally experienced by patients with Lyme disease.

Types of Pain and Exploring Comprehensive and Non-Opioid Pain Management Strategies:

1. Nociceptive Pain:  

Nociceptive pain arises from tissue damage, such as musculoskeletal or inflammatory arthritis. Topical anti-inflammatory medications like Voltaren gel, CBD creams, and oral non-steroidal anti-inflammatory drugs (NSAIDs) can be beneficial in managing this sort of pain.

2. Sensory Pain:

Sensory pain results from damage to nerve endings transmitting sensations to the brain, often referred to as neuropathic pain or neuralgia. Treatment options include anticonvulsants, antidepressants, and compounded topical neuro cream.

3. Central Pain/CRPS: 

This pain is characterized by severe damage to the sensory pathways of the central nervous system (CNS). Management may involve CBDs for pediatric patients, antidepressant agents like Mirtazapine, and synthetics THC/Medical THC, including Marinol. Ketamine, available in various forms like nasal spray, lozenge, or IV infusion, is an effective alternative to opioids.

Discussing those options with a healthcare expert can facilitate the development of a treatment plan that best meets the affected patient’s needs while minimizing the potential for adverse effects.

Unveiling Strategies to Alleviate Systemic Inflammation and Alleviate Pain

 

Pain can arise from diverse sources, including systemic and chronic infection, characterized by excess oxidative stress and genetic mutations, which play a significant role in pain variation. Additionally, dietary choices, especially the consumption of inflammatory foods such as sugar, gluten, and dairy, can exacerbate some discomfort as well.

To cope with pain beyond prescribed medications, there are proactive measures individuals can take. Natural relief can be found in anti-inflammatory dietary supplements such as Vitamin C, Fish Oil/Omega-3s, and Curcumin. Detoxifying practices like Epsom Salt baths, Infrared sauna sessions, along with acupuncture, cupping, as well as engaging in physical activities such as yoga, and range of motion exercises (which determine how far a person can move their joints or muscles in various directions), contribute to reducing systemic irritation. For those grappling with infections or comorbidities like LBC, treatment alternatives extend to oral or IV antibiotics and herbal agents, addressing the primary cause of pain. Adopting a holistic approach by integrating these measures into daily existence can pave the way not only for pain reduction but also for improved well-being.

Keynote Speakers: Candace Willett, PPCNP-BC, MSN, MPH and Joseph Jemsek, MD, FACP

Navigating the Spectrum of Headaches: Understanding and Alleviating Discomfort:

Chronic and debilitating symptoms can notably impact one’s quality of life, necessitating a thorough exploration of potential causes and targeted interventions. Global inflammatory complications may additionally signal underlying concerns, prompting holistic measures.

Migraines, characterized by diverse triggers, respond to abortive medications such as triptans (e.g., as Sumatriptan), CGRP receptor antagonists (e.g., Nurtec), and CGRP monoclonal antibodies (e.g., Emgality SQ or Ajovy). Histamine-associated complications require a faceted, demanding, tailored approach.

Craniocervical Instability (CCI), recognized through DMX imaging, requires stabilization measures alongside potential interventions like PRP injections, Prolotherapy, or Cold Laser therapy, retaining surgical options as a fallback. Premenstrual headaches can be relieved through triptans and birth control pills.

Lastly, cranial or intracranial abnormalities like Chiari Malformation or Arteriovenous malformation (AVM) require thorough assessment, imaging, and when/if applicable, surgical intervention.

An individualized protocol, guided by a comprehensive understanding of headache types, offers the potential for powerful pain management.

Navigating pain induced by Lyme disease can be challenging. Thus, adopting a strategic approach to pain management becomes crucial. Beyond relying solely on prescribed medications, individuals dealing with Lyme-associated pain can notably enhance their well-being by addressing systemic inflammation and integrating alternative therapies into their daily routine. Seeking counseling and guidance from a healthcare provider is paramount in establishing a custom-designed and efficient management plan, as they can provide personalized advice tailored to individual symptoms and clinical history.

References

Jaenson, T. G. T., Gray, J. S., Lindgren, P.-E., & Wilhelmsson, P. (2024). Coinfection of Babesia and Borrelia in the Tick Ixodes ricinus—A Neglected Public Health Issue in Europe? Pathogens13(1), 81. https://doi.org/10.3390/pathogens13010081

Batheja, S., Nields, J. A., Landa, A., & Fallon, B. A. (2013). Post-Treatment Lyme Syndrome and Central Sensitization. The Journal of Neuropsychiatry and Clinical Neurosciences25(3), 176–186. https://doi.org/10.1176/appi.neuropsych.12090223

Zuo, L., Prather, E. R., Stetskiv, M., Garrison, D. E., Meade, J. R., Peace, T. I., & Zhou, T. (2019). Inflammaging and Oxidative Stress in Human Diseases: From Molecular Mechanisms to Novel Treatments. International Journal of Molecular Sciences20(18). https://doi.org/10.3390/ijms20184472

How to Take Nurtec® ODT (rimegepant). (n.d.). Www.nurtec.com. https://www.nurtec.com/how-to-take-nurtec

Cohen, F., Yuan, H., & Silberstein, S. D. (2022). Calcitonin Gene-Related Peptide (CGRP)-Targeted Monoclonal Antibodies and Antagonists in Migraine: Current Evidence and Rationale. BioDrugs36(3), 341–358. https://doi.org/10.1007/s40259-022-00530-0

Centeno, C. (2020, April 2). DMX Technology: The Future Of Accurate CCI Diagnosis. Centeno-Schultz Clinic. https://centenoschultz.com/digital-motion-x-ray/

Platelet-Rich Plasma (PRP) Injections. (n.d.). Centeno-Schultz Clinic. Retrieved February 2, 2024, from https://centenoschultz.com/treatment/platelet-rich-plasma-prp-injections/

Prolotherapy Injections. (n.d.). Centeno-Schultz Clinic. Retrieved February 2, 2024, from https://centenoschultz.com/treatment/prolotherapy-injections/

Edlow, A. G., & Bartz, D. (2010). Hormonal contraceptive options for women with headache: a review of the evidence. Reviews in Obstetrics & Gynecology3(2), 55–65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938905/

Hidalgo, J. A., Tork, C. A., & Varacallo, M. (2021). Arnold Chiari Malformation. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK431076/

One Response

  1. We miss you Dr. Jemsek. Thank you for the wonderful care you and the whole team provided us! You saved our son’s life and there are no words that can express our gratitude for that.
    I hope you see this!

    Take care,
    The Levert Family

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