by Dr. Bill Rawls
Posted 5/28/20

Lyme disease can affect several systems of the body — the brain, nervous system, joints, heart, and more — and so the list of symptoms infected individuals can experience is expansive and varies from person to person. It’s one of the reasons a Lyme disease diagnosis may be controversial, and yet one thing everyone seems to agree on about the tick-borne disease is that it can significantly impact the nervous system, especially without prompt treatment in the early stages of the infection.

Unfortunately, Lyme often goes missed early on. The telltale sign of a Lyme infection — an erythema migrans (EM) rash, or the classic “bull’s-eye” rash — doesn’t occur in every case (the actual frequency is unknown because the disease is so underreported). And the initial symptoms of infection may be nothing more than fever, chills, headache, fatigue, or muscle aches, making them easy to miss or brush off as a case of the flu.

Lyme disease bacteria, Borrelia burgdorferi, 3D illustration

But as the disease advances, the bacteria associated with Lyme, Borrelia burgdorferi, spreads via the bloodstream to other parts of the body, a process known as dissemination. Disseminated Lyme disease occurs in the days and weeks following infection, referred to as early disseminated Lyme disease.

If an infection goes untreated for months to years, however, there’s a good chance the infection will proceed to late stage or late disseminated Lyme disease, the form of the illness also known as chronic Lyme disease. That’s when the nervous system can become involved, and symptoms ratchet up to a whole new level.

Lyme, The Nervous System, and Neuropathy

Unfortunately, once the infection begins to spread throughout the body, many people will develop Lyme neuroborreliosis (LNB) — that is, neurological Lyme disease, which affects and inflames the central and peripheral nervous systems. Research suggests the neurologic manifestations of Lyme disease may be present in approximately 15% of the patient population. However, the exact incidence of LNB isn’t well known — a brief stint in an online Lyme patient forum will quickly reveal that most individuals report experiencing at least some amount of neurological involvement on a routine basis.

One debilitating symptom that may be present among those with LNB is peripheral neuropathy (also referred to as neuropathy), a disease process that impacts the nerves located outside of the brain and spinal cord. Neuropathy occurs when there is damage or dysfunction of neurons (nerve cells) in one or more nerves.

Image concept of neurons from the human brain.

The damage results in interference among the neurons, and they begin to have difficulty communicating with each other and the brain. To make matters worse, coinfections like Babesia and Bartonella can contribute to neuropathy as well, according to a study in the International Journal of General Medicine.

So how do you know if the symptoms you’re facing are neuropathy, and what can you do to find some relief? Read on to learn about the symptoms, diagnosis, and ideas on how to manage the pain and discomfort associated with neuropathy more effectively.

Symptoms of Neuropathy

Typically, neuropathy develops in various nerves leading to the hands and feet, causing discomfort that ranges from mild irritation to significant impairment. The symptoms of neuropathy in Lyme disease are likely to be similar to those from other diseases like diabetes, autoimmune disease, nutritional deficiencies (B12, B6, B1, copper, and vitamin E), different types of infections, and more.

Neuropathy begins gradually and worsens with time. The symptoms may include:

  • Pain that could be described as “sharp,” “burning,” or “throbbing”
  • Pins-and needles tingling sensations, most often felt in the hands and feet
  • Numbness or a reduced ability to feel sensation
  • Severe sensitivity to touch
  • Worsening pain during nighttime
  • Muscle weakness
  • Loss of coordination in hands and feet

While this may feel like an overwhelming list, rest assured that you have several options to improve your symptoms, heal your body, and mitigate the pain and discomfort caused by neuropathy. But first, let’s review some of the testing measures used to diagnose this condition.

How to Diagnose Neuropathy

For most people, a diagnosis of neuropathy may be based upon a person’s medical history, physical exam, lab work, and neurologic evaluation. The following tests can be useful to identify the condition, as well as rule out potential causes and contributing factors.

  • Neurologic Exam: During a neurologic exam, your doctor, usually a neurologist, assesses reflexes; ability to feel sensations like hot, cold, and pain; coordination; balance; muscle strength; and muscle tone.
  • Blood Tests: Blood tests are run to assess nutritional deficiencies, organ function, toxins, and the presence of an atypical immune response.
  • Electrodiagnostic Tests (EDX): EDX testing checks how well the muscles and nerves are functioning by measuring their electrical activity, which assists in determining the extent of nerve damage. Two commonly used procedures are electromyography (EMG) and nerve conduction velocity (NVC).
    During an EMG, small needle electrodes are inserted through the skin into the muscle to measure the electrical activity while the muscle is at rest, during a mild contraction, and during a powerful contraction. Frequently, the NVC will be completed at the same time as the EMG, which helps further assess the amount and speed with which an electrical impulse moves through a nerve.
  • Other Tests: The need for other testing will depend on the severity of your symptoms and could include specialized sensory testing, genetic testing, or a biopsy with tissue samples from a nerve, muscle, or skin.

If you’re dealing with neuropathy, a multi-faceted treatment approach centered around providing symptom relief, curbing chronic inflammation, and strengthening your body will aid you on your road to recovery.

Strategies for Managing Nerve Pain

1. Reduce Your Microbial Burden.

When you’re dealing with Lyme disease and coinfections, it’s not always easy to pinpoint which stealth pathogen is affecting your nervous system. In fact, it’s most reasonable to recognize that all sneaky microbes are capable of disrupting immune function and causing it to go awry.

When your body’s microbial burden becomes too great, your microbiome becomes imbalanced, driving inflammation and aggravating neuropathy. Thus, at the top of the priority list is decreasing the infectious load to normalize and calm the immune system.

Alternative medicine herbal capsules on a wooden spoon, green leaf.

When you’re looking for natural solutions to lessen the impact of stealth pathogens, herbal therapy can play a critical role. Not only do herbs have antimicrobial properties, but they are anti-inflammatory and contain antioxidants as well.

Moreover, herbs don’t disrupt the delicate balance of the microbiome like synthetics medications do. Some of my favorite herbs with antimicrobial and immunomodulating properties to keep in mind include:

2. Use Medications Cautiously.

When it comes to neuropathy, the reality is that sometimes you need some extra support to get your pain levels to a tolerable level. Though there are a variety of over-the-counter and prescription medications that may be useful from time to time. The value of medications is limited to short term management of symptoms because of cumulative side effects. The list of medications commonly recommended by healthcare providers includes::

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin
  • Antidepressants like amitriptyline, duloxetine, and nortriptyline
  • Anticonvulsants (anti-seizure drugs), including gabapentin and pregabalin
  • Topical agents, such as lidocaine and capsaicin

However, many drugs have unwanted side effects such as gastrointestinal (GI) distress, impaired liver function, and dependence. If you’re on a quest to find something natural to improve your symptoms, CBD (cannabidiol) may fit the bill.

hemp cbd oil being dripped from a dropper into a bottle

CBD is derived from hemp, and it’s emerging as a real contender for those seeking relief from nerve pain. In fact, a 2019 study in Current Pharmaceutical Biotechnology evaluated the use of topical CBD on 29 people with peripheral neuropathy. At the end of the four-week study, the participants reported a marked improvement in severity and sharpness of pain and sensations of itchiness and cold in comparison to those who were administered a placebo.

The findings suggest that topical CBD is a promising development for those who suffer from neuropathy. But CBD can be taken orally, too. Oral use of full-spectrum CBD promotes a healthy immune response and combats inflammation in the brain and nervous system.

3. Be Mindful of What You Eat.

Processed foods, sugar, gluten, and dairy tend to be inflammatory for most people, and they neglect to deliver the vital nutrients your body needs to keep neuropathy at bay and manage pain. Not only are these types of foods an insufficient source of nourishment, but many are also filled with artificial ingredients like dyes, preservatives, and other additives that contribute to inflammation and increase pain. Additionally, foods and beverages that contain gluten, salt, and alcohol can exacerbate symptoms — try to steer clear of them as best you can. Right about now, you might be asking, “You just named all the good stuff. So, what can I eat?” Plenty, I promise!

Healthy vegetarian dinner. Woman in grey jeans and sweater eating fresh salad, avocado half, grains, beans, roasted vegetables from Buddha bowl. Superfood, clean eating, dieting food concept

Start by replacing pre-packaged, refined foods with nutrient-dense vegetables, low-sugar fruits, lean meats, and healthy fats, especially those high in inflammation-fighting omega-3s. A good rule of thumb to follow is to fill your plate with at least 50% vegetables. With this strategy, you’ll be well on your way to minimizing your intake of problematic foods. If you’re unsure of whether a particular food is causing a flare-up, you might choose to begin an elimination diet and keep a food journal so you can more accurately identify triggers that could be contributing to the severity of the issue.

Although making dietary changes can sometimes be overwhelming, start slow, and make one change at a time. Before you know it, you’ll get the hang of it — soon, you’ll be fueling your body with antioxidant-rich and anti-inflammatory foods galore.

4. Get Adequate Sleep.

Poor sleep can wreak havoc on your immune system, cause inflammation to soar, and push your pain into overdrive. However, neuropathy can be the very thing that keeps you awake at night — adding to the vicious cycle of pain and inflammation.

To get the recommended eight hours of sleep per night, consider taking an Epsom salts bath at a comfortable temperature before bedtime. The magnesium in Epsom salts acts as a natural calming agent for the nervous system and relaxes muscles. Additionally, gentle yoga in the evening may release tension and minimize pain levels.

Finally, for some people, the key to a better night’s rest lies quite literally in their mattress. If the mornings are particularly challenging for you, that’s a clue that your bed might be the culprit, and you may need to look into investing in a more comfortable mattress as a way to lessen pain.

5. Consider Adjunct Therapies.

In addition to herbs, supplements, and lifestyle changes, you may find that you need some more help to improve function in your affected extremities and enhance your quality of life. Adjunct therapies like physical and occupational therapy, chiropractic care, acupuncture, exercise, yoga, meditation, and other mind-body therapies can be a boon to people with neuropathy.

Young woman doing pilates on mat in the park

However, whenever you decide to try a new therapy or exercise, ease into it. For some people, overexertion and manual manipulation of the musculoskeletal system can be a trigger and intensify neuropathic pain.

Ultimately, when it comes to healing neuropathy, there’s no quick fix — nerves require time and patience to heal. However, by reducing your body’s burden of stealth pathogens, minimizing sources of chronic inflammation, eating nutritious foods, and calming your nervous system, you’ll go a long way in supplying your body with the tools it needs to repair and regenerate your neurons.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.

 

REFERENCES
1. Mayne PJ. Clinical determinants of Lyme borreliosis, babesiosis, bartonellosis, anaplasmosis, and ehrlichiosis in an Australian cohort. Int J Gen Med. 2014;8:15–26. Published 2014 Dec 23. doi: 10.2147/IJGM.S75825
2. Neurological Evaluations. The Foundation for Peripheral Neuropathy website. https://www.foundationforpn.org/what-is-peripheral-neuropathy/evaluation-and-tests/
3. Neuropathy. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/14737-neuropathy
4. Peripheral Nerve Disorders. MedlinePlus website. https://medlineplus.gov/peripheralnervedisorders.html
5. Ramesh G, Didier PJ, England JD, et al. Inflammation in the pathogenesis of lyme neuroborreliosis. Am J Pathol. 2015;185(5):1344–1360. doi: 10.1016/j.ajpath.2015.01.024
6. Staff NP, Windebank AJ. Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1293–1306. doi: 10.1212/01.CON.0000455880.06675.5a
7. Yang XD, Fang PF, Xiang DX, Yang YY. Topical treatments for diabetic neuropathic pain. Exp Ther Med. 2019;17(3):1963–1976. doi: 10.3892/etm.2019.7173
8. Xu DH, Cullen BD, Tang M, Fang Y. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Curr Pharm Biotechnol. 2019;10.2174/1389201020666191202111534. doi: 10.2174/1389201020666191202111534