What Are the Long-Term Effects of Lyme Disease? - GoodRx (2024)

Lyme disease is caused by the bacteria Borrelia burgdorferi. The bacteria is transmitted through a bite from a deer tick. That means the best way to avoid Lyme disease is through prevention. So if you know you’ll be around ticks, protect yourself by using insect repellant, covering your skin with proper clothing, and checking for ticks (and their bites).

Ticks are very small and can be hard to spot. But with early treatment, Lyme disease is curable and very unlikely to cause long-term health problems. But not everyone gets early treatment. That’s because not everyone with early Lyme disease gets symptoms. So — like the ticks themselves — it can be easy to miss.

Most people who get Lyme disease are cured after a few weeks of antibiotics. Lyme disease can make some people feel fatigue, pain, or have difficulty thinking months after they stop taking the antibiotics. While early treatment is quicker and more effective, you can still treat late-stage Lyme disease. We’ll review treatment options, stages, and possible long-term effects of untreated Lyme disease.

The 3 stages of Lyme disease

If you get the Borrelia burgdorferi bacteria and don’t get antibiotic treatment, the infection will not go away. Untreated Lyme disease will progress through three stages.

1. Stage 1 Lyme disease

The first stage is called “localized” or “early” Lyme disease. This means the bacteria haven’t spread around the body yet. Symptoms usually start between 3 and 30 days after the tick bite. The typical symptom is a “bullseye” or “target lesion” rash. The rash looks like a red spot at the site of the tick bite. Over a few days, the rash expands. Sometimes, as the rash grows, it can look like a large, red ring around a smaller red rash (the bullseye, or target). Erythema migrans is another name for this rash. About 80% of people get this rash after Lyme disease infection.

Other symptoms during the first stage include:

• Fever

• Chills

• Headache

• Stiff neck

• Joint pain

• Muscle aches

• Swollen lymph nodes

Some people may have these symptoms and no rash. Other people may have no obvious symptoms or rash at all — and they may never know they’ve been infected with Lyme disease.

2. Stage 2 Lyme disease

In the second stage, or “early disseminated” Lyme disease, the bacteria have spread around the body. It can happen anywhere from a few weeks to a few months after an untreated Lyme disease infection.

Skin symptoms in the second stage are multiple bullseye or target rashes. This stage can also affect the nerves, brain, eyes, and heart. Nerve and brain symptoms can include:

• Meningitis (headaches and fever)

• Facial weakness (Bell’s palsy)

• Pain, numbness, and weakness in certain nerves (radiculoneuritis)

The most common eye condition is pink eye (conjunctivitis). When stage 2 Lyme disease affects the heart, symptoms can include skipped or irregular heartbeats and chest pain.

3. Stage 3 Lyme disease

In the third stage, or “late-phase” Lyme disease, the bacteria live in the joints, nerves, brain fluid, or heart. It can happen months to years after the initial untreated infection.

Arthritis is the most common symptom of late-stage Lyme. It can affect one or more joints. Typically, large joints (like the knees) are the most affected.

When it affects the brain or nerves, symptoms can include:

• Memory and concentration problems

• Irritability

• Nerve pain, weakness, or numbness in the arms and legs

What are the long-term effects of untreated Lyme disease?

As we reviewed in the different stages, undiagnosed or untreated Lyme disease can cause serious medical problems that affect different parts of the body. We’ll provide a more in-depth explanation of these long-term conditions here.

Joint pain and swelling

About half of people with untreated Lyme disease get chronic (long-term) arthritis. Joint pain and damage most commonly occur in the knee. But Lyme disease can also affect other joints, such as the:

• Shoulders

• Ankles

• Elbows

• Wrists

• Jaw

These joints may feel swollen and warm to the touch. Lyme disease arthritis is more common in older people with Lyme disease.

Nerve problems

Nerve problems — like pain, tingling, numbness, and weakness — are another symptom of late Lyme disease. The bacteria can attack nerves and cause inflammation and damage. In early disseminated Lyme disease, the most common nerve symptom is Bell’s palsy, a one-sided facial weakness. This usually improves gradually. In later Lyme disease, tingling, weakness, numbness, and nerve pain can affect the limbs, which can be harder to treat.

Thinking and memory problems

Untreated Lyme disease can cause inflammation in the brain tissue. This can lead to problems with memory and concentration.

Heart problems

Lyme carditis (heart inflammation) can happen when the Lyme disease bacteria enter the heart and cause inflammation. There are a range of symptoms, depending on the parts of the heart Lyme affects. Lyme carditis can include problems like:

• Myocarditis: heart muscle inflammation

• Pericarditis: inflammation of the lining around the heart

• Heart block: interruption of the electrical circuits that control the heartbeat

• Palpitations: sensation of fast and irregular heartbeat

• Heart failure: buildup of fluid related to heart failure, which happens when the heart can’t pump effectively and properly

Can Lyme cause permanent damage?

Without treatment, Lyme disease can cause permanent damage. But most people with late-stage Lyme disease can recover if they get treatment with antibiotics. The longer you wait before treating Lyme disease, the longer it can take for symptoms to go away.

A small subset of people may have symptoms that persist after treatment. Some long-term complications people experience include:

• Synovitis: This is inflammation of the linings of the joints. Up to 10% of people with late-stage Lyme have visible joint inflammation, even after antibiotic treatment. Immunosuppressive medications or surgery can sometimes help to reduce pain.

• Post-treatment Lyme disease: This is also called “chronic Lyme disease” or “post-lyme syndrome.” It happens in around 10% to 20% of people who have had Lyme disease. It’s similar to fibromyalgia and chronic fatigue syndrome. Symptoms include fatigue, widespread musculoskeletal pain, and problems with thinking and concentration.

• Encephalitis, encephalomyelitis, or encephalopathy: These types of brain and spinal cord inflammation can cause long-standing problems with movement and thinking. These symptoms rarely persist after treatment.

• Neuritis or neuropathy: This is inflammation of the nerves outside of the brain, throughout the body. It can cause long-lasting problems with feeling (sensation) and muscle strength (power) — even after treatment. These symptoms rarely persist after treatment.

Is there a cure for Lyme disease?

The right antibiotics can cure Lyme disease. For early Lyme disease, common antibiotics do the trick, like doxycycline or amoxicillin. Typically, you take the antibiotics as oral pills for 10 to 14 days. The earlier you start antibiotics, the easier it is to cure Lyme disease.

The treatment for late-stage Lyme disease is a 28-day course of antibiotics with doxycycline, amoxicillin, or cefuroxime. People with Lyme arthritis or heart problems from Lyme infection may need intravenous antibiotics. And, some people with late-stage Lyme may need other medications like immunosuppressants. If symptoms improve significantly but are still present, healthcare providers will recommend a second month of a different oral antibiotic.

If you have pain, your healthcare provider may recommend pain-relieving medications, such as ibuprofen (Advil, Motrin) or gabapentin.

Chronic Lyme disease

For most people, antibiotics cures Lyme disease. Rarely, however, some people continue to feel tired and in pain several months after treatment. This is known as post-treatment Lyme disease syndrome or chronic Lyme disease. Scientists are still researching the underlying reasons why some people get chronic Lyme and others don’t —as well as the best treatment. Most people usually get better over time. And physical therapy, yoga, and acupuncture may help relieve some of the symptoms.