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Suggest Medication For Pain In A Person With Lyme Disease

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Posted on Fri, 22 Jan 2016
Question: I have Lyme Disease and in constant pain have been to multiple clinics surgeries and am now having trouble getting my pain medication or any for that matter what is going on I am becoming more end more bedridden with so much pain
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Answered by Dr. Dr. Matt Wachsman (27 minutes later)
Brief Answer:
might not be lyme.

Detailed Answer:
Lyme acts by causing areas of infection with inflammation. These produce multiple areas of scar like small wounds here and there. It is no more reasonable to have pain all over from this process than from having pain all over after getting shot in the foot. Lyme treatment eradicates the germ. Doesn't eradicate damage. Several features of the underlying damage. There can be nerve irritation, especially since lyme attacks and damages nerves. Any nerve pill/medicine is likely to be helpful: lidocaine patches, neurontin, pregabalin, amitryptiline, dilantin all can be helpful. Local instillation of medication by a physical therapist can be helpful. Mobilizing the area, accupuncture, massage, physical therapy.

But that is unlikely to be the reason. The pain isn't any more progressive in this than from a gunshot wound.

Cannot diagnose, prescribe or treat someone who I am not seeing, but I can give general information that will apply to pretty much everyone. Narcotics change pain perception. Someone who has been on more than 50 mg a day of morphine equivalents (a high dose), WILL have both decreased effectiveness of the drug over time (tolerance) and an increased perception of all pain everywhere. The treatment, of course, has to include not being on the narcotics for an extended time. Personally, I would consider adding a blocker of narcotics after a week of being off of them to further speed the recovery of the body's balance of response to narcotics (similar to having the room look brighter by blocking all light to your eyes for a few minutes... it's a bit slower for other nerves, but not a lot slower, days or a week). Or another painful process altogether. Measures of inflammation like sed rate and level of reactive proteins and immunoglobulins can screen for an overall inflammatory process like lupus, rheumatoid, hepatitis, or even theoretically chronic lyme infection (which has never been convincingly demonstrated to actually exist any more than chronic gun shot... although.... I live near XXXXXXX so getting shot on a daily or weekly basis certainly occurs so I cannot say that immunity from prior exposure is 100% protective against reinfection with either lyme or bullets.)

Certainly many people have germ phobias. Being on antibiotics forever might not be good for them but they certainly feel better getting them.

But, in chronic gunshots, fibromyalgia, and every psychological cause of pain, increasing physical therapy and antidepressants have always been shown to be effective. So, for whatever the cause of the pain, physical therapy, encouragement, and cymbalta are likely to be helpful and narcotics likely to produce some issues.

Note: there are sometimes secondary mental processes that occur in those taking narcotics with progressive inability to perceive normal reality. Defensiveness, argumentation, seeing physicians solely as ATM's for getting drugs, focusing only on getting narcotics, use of them for non-medical purposes, use to prevent withdrawal are some of the many signs of progressive addiction. This usually interacts with pain perception and with decreased functionality. There is no indication from your question that this applies, but I am required to mention it.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Medication For Pain In A Person With Lyme Disease

Brief Answer: might not be lyme. Detailed Answer: Lyme acts by causing areas of infection with inflammation. These produce multiple areas of scar like small wounds here and there. It is no more reasonable to have pain all over from this process than from having pain all over after getting shot in the foot. Lyme treatment eradicates the germ. Doesn't eradicate damage. Several features of the underlying damage. There can be nerve irritation, especially since lyme attacks and damages nerves. Any nerve pill/medicine is likely to be helpful: lidocaine patches, neurontin, pregabalin, amitryptiline, dilantin all can be helpful. Local instillation of medication by a physical therapist can be helpful. Mobilizing the area, accupuncture, massage, physical therapy. But that is unlikely to be the reason. The pain isn't any more progressive in this than from a gunshot wound. Cannot diagnose, prescribe or treat someone who I am not seeing, but I can give general information that will apply to pretty much everyone. Narcotics change pain perception. Someone who has been on more than 50 mg a day of morphine equivalents (a high dose), WILL have both decreased effectiveness of the drug over time (tolerance) and an increased perception of all pain everywhere. The treatment, of course, has to include not being on the narcotics for an extended time. Personally, I would consider adding a blocker of narcotics after a week of being off of them to further speed the recovery of the body's balance of response to narcotics (similar to having the room look brighter by blocking all light to your eyes for a few minutes... it's a bit slower for other nerves, but not a lot slower, days or a week). Or another painful process altogether. Measures of inflammation like sed rate and level of reactive proteins and immunoglobulins can screen for an overall inflammatory process like lupus, rheumatoid, hepatitis, or even theoretically chronic lyme infection (which has never been convincingly demonstrated to actually exist any more than chronic gun shot... although.... I live near XXXXXXX so getting shot on a daily or weekly basis certainly occurs so I cannot say that immunity from prior exposure is 100% protective against reinfection with either lyme or bullets.) Certainly many people have germ phobias. Being on antibiotics forever might not be good for them but they certainly feel better getting them. But, in chronic gunshots, fibromyalgia, and every psychological cause of pain, increasing physical therapy and antidepressants have always been shown to be effective. So, for whatever the cause of the pain, physical therapy, encouragement, and cymbalta are likely to be helpful and narcotics likely to produce some issues. Note: there are sometimes secondary mental processes that occur in those taking narcotics with progressive inability to perceive normal reality. Defensiveness, argumentation, seeing physicians solely as ATM's for getting drugs, focusing only on getting narcotics, use of them for non-medical purposes, use to prevent withdrawal are some of the many signs of progressive addiction. This usually interacts with pain perception and with decreased functionality. There is no indication from your question that this applies, but I am required to mention it.