Lyme disease is spread through the bite of infected blacklegged ticks, also known as deer ticks. Ticks can attach to any part of the human body, but tend to reach areas that are difficult to see such as the groin, armpits, or scalp. Ticks must be attached for 36 hours or more before the Lyme disease bacterium, Borrelia burgdorferi, can be transmitted.
There are four stages in the progression of Lyme disease. The first stage, known as the early localized stage, takes place between 3-30 days after the tick bite. The infected person can experience fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes. One of the most prominent signs of this stage is the Erythema migrans rash, also known as the bull’s-eye rash for its unique shape. This rash occurs in 60% of infected individuals. (CDC)
The second stage is known as the early disseminated stage and it occurs days to a week after the tick bite if the bite is not treated within the early localized stage. During this stage, a person starts to experience more noticeable and serious symptoms. These symptoms include Facial or Bell’s palsy, additional erythema migrans rashes, and stiffness due to meningitis. At this point, patients begin to feel shooting pains that can interfere with sleep as well as pain and swelling in the large joints.
If the disease is not treated, 60% of patients enter into the late disseminated stage which happens months to years post-tick bite. These individuals typically develop arthritis with severe pain and swelling in the joints. It is typically found in the larger joints, for example the knees. Arthritis caused by Lyme disease exhibits itself differently than other causes of arthritis. Lyme arthritis is similar to osteoarthritis because of stiffness due to painful swollen joints. This happens because Lyme bacteria invade the joints and cause inflammation to the tissue that lines the joints, and eventually, if untreated, can cause the cartilage within the joints to become damaged.
The final stage is the lingering symptoms after treatment. About 10-20% of patients experience symptoms after the patient has taken antibiotics. This is called Post-treatment Lyme disease syndrome (PTLDS). Some evidence shows this is due to an autoimmune response, in which the immune system is continuing to respond after the infection has been cleared, causing damage to be done to a body’s tissues. Symptoms of PTLDS can include muscle and joint pain, cognitive defects, sleep disturbance, and fatigue. (CDC)
The quicker a doctor is able to diagnose Lyme disease, the quicker they can treat it. Patients can be prescribed antibiotics in order to rid their system of the bacteria. Most patients who are prescribed the antibiotic during the early stages usually recover quickly and completely.
With the antibiotics working to take care of the bacteria, what is taking care of the pain associated with Lyme disease? A patient can still be experiencing pain while taking these antibiotics, which progressively becomes worse throughout all the stages Lyme disease. Patients who experience pain in association with Lyme disease are less likely to be active, sleep well, or eat properly due to pain.
Commonly prescribed pain medications are opioids and NSAIDs. Both, although common, can be very dangerous. According to a report released by the National Institute on Drug Abuse, there can be consequences when choosing to use an opioid. Opioids are easy to abuse because of their addictive qualities. Regular or long term use of opioids can lead to physical dependence and addiction. Once a patient stops using opioids, they can experience withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements. An overdose can cause severe respiratory depression and death. 
NSAIDs, although effective in treating pain and inflammation, are linked to adverse side effects which make them inappropriate for use in many patient populations. There are several serious side effects and toxicity related to use of traditional NSAIDs which can lead to costly hospitalizations or death. A study on the effects of NSAID induced side effects in the elderly reflected the average direct costs of GI side effects per patient-day on NSAIDs were 3.5 times higher than those of a patient-day not on NSAIDs. Seventy percent of the cost was attributed to GI events resulting from NSAID treatment. Treatment of GI problems alone caused by the use of NSAIDs is estimated to add over 40% to the cost of arthritis care.
Stephen Harrod Buhner’s book “Healing Lyme Disease Coinfections” discusses an alternative to these common pain medications called Theramine®. Theramine is a medical food specifically designed for the dietary management of pain syndromes. This specialized natural product, provides the specific amino acids and nutrients required by the brain and nervous system to effectively reduce pain and inflammation. Theramine is non-addictive and is not associated with adverse GI or cardiovascular side effects. It is used in clinical practice to reduce inflammation and improve pain perception by addressing the increased nutritional requirements of pain syndromes. In two double blind, multi-center clinical studies comparing Theramine and an NSAID, Theramine was shown to be more effective at treating pain and inflammation than either naproxen or ibuprofen. Lyme disease can alter the metabolic requirements of the body, leading to specific amino acid and nutrient deficiencies. Effectively managing the increased demand for these essential physiologic components should be an integral part of any pain management protocol.
 American Academy of Orthopaedic Surgeons. “Effective treatment of Lyme-disease-related arthritis depends on proper diagnosis.” ScienceDaily. ScienceDaily, 2 February 2011.
 “Prescription Drugs: Abuse and Addiction” NIDA. October 2011. National Institute on Drug Abuse.
 Br J Clin Pharmacol. 2001 August; 52(2): 185–192. Cost of prescribed NSAID-related gastrointestinal adverse events in elderly patients
 Bloom, BS. Direct medical costs of disease and gastrointestinal side effects during treatment for arthritis. Am J Med. 1988; 84(2A): 20-24