Lyme Disease: Symptoms, Causes, and Treatments

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Lyme Disease: Symptoms, Causes, and Treatments

written by Sofie Wise Written by Sofie Wise
Sofie Wise

Sofie Wise

Sofie hopes to create a more sustainable healthcare system by empowering people to make conscious health decisions. Her interests include cooking, reading, being outdoors and painting.

Read more posts by this author.
reviewBy Reviewed by: Linda Anegawa MD, FACP

Linda Anegawa MD, FACP

Dr. Anegawa graduated from the Univ. of Pennsylvania School of Medicine and completed residency at Stanford. She has over 20 years of practice experience and specializes in Internal Medicine and Obesity Medicine.

August 2, 2021 Read Time - 11 minutes

Learn About Lyme Disease Symptoms and When to Seek Treatment

Did you know that cases of tick and mosquito-borne diseases have tripled since 2004? Reported cases of Lyme disease specifically increased 80% from 2004 to 2016, and scientists estimate that as many as 300,000 people per year are infected by Lyme disease without even knowing it.

How much do you know about Lyme disease? Are you and your family at risk? Could you have Lyme disease and not even know it? Is it curable? What are the symptoms?

With cases of Lyme disease increasing everywhere and diagnoses happening in more states around the country, you should know about Lyme disease. Read on to get the facts.

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What is Lyme Disease?

Lyme disease is the most-common tick-borne disease in the United States.

Lyme disease is an illness caused by several different strains of bacteria (Borrelia burgdorferi or Borrelia mayonii in the United States and Borrelia afzelii or Borrelia garinii in Europe) that are transmitted by the bite of a tick (usually black-legged or deer ticks). The bacterium are called “spirochetes” and look like spiral pasta under a microscope.

Symptoms usually start within 3 to 30 days after being bitten by an infected tick, although sometimes it can take years or even decades for symptoms to spring up. Lyme disease occurs in three stages and can affect the skin, joints, heart, and nervous system.

Typically, the tick must remain attached to your skin for at least 36-48 hours to pass on the bacteria that cause Lyme disease, so you should immediately check for ticks every time you come inside after spending time in places where ticks live and Lyme disease is endemic.

Lyme disease isn’t the only disease caused by the black-legged tick. They can also cause babesiosis, anaplasmosis, and Powassan virus, although these are much more rare. It is possible to get more than one disease from the same tick, and scientists believe that having multiple tick-borne infections can make each one more difficult to diagnose and treat.

Where is Lyme Disease Found?

Lyme disease cases have been documented all across the United States (and the world). In the United States, Lyme disease is more prevalent in the Northeast from Maryland to Maine, the upper Midwest in Minnesota and Wisconsin, and the West in Oregon and northern California.

Thanks to climate change and habitat destruction, ticks and their favorite hosts – white-tailed deer and the white-footed mouse – are moving outside their normal range and spreading Lyme disease as far north as Canada and as far south as Florida and Mexico.

As humans encroach further on wildlife habitat, we become more susceptible to diseases perpetuated in wildlife. White-footed mice, for example, thrive in small habitats (like a backyard) where other animals need more space.

Is Lyme Disease Contagious?

Lyme disease can only be transmitted to humans via tick bites, so it is not contagious. There is no evidence of it being passed through the placenta from a mother to her unborn child.

Who is the Most at Risk for Lyme Disease?

Children ages 5-15 and adults aged 40-60 are at highest risk, as these are age ranges of people who tend to spend more time outside. These groups seem to be at the most risk of developing Lyme disease since they are more likely to be bitten by ticks, vs. those who spend most of their time indoors.

People who enjoy outdoor activities like gardening, camping, hunting, and hiking are especially at risk and should take as many precautions as possible to avoid being bitten by ticks. Any ticks should be removed as soon as possible to prevent the transmission of Lyme disease.

What are Lyme Disease Symptoms?

Lyme disease symptoms will vary from person to person and can also depend on the stage of the disease.

Stage one is referred to as an early localized disease. Symptoms include:

  • Bullseye Rash – Up to 80% of people with Lyme disease will develop the traditional bullseye rash (also known as erythema migrans), which is a circular red rash that can grow from at least 2 inches up to 12 inches in diameter and may or may not have clear areas in the center, causing the classic bullseye shape.
    The rash usually will not itch or be painful, but it may be warm to the touch. It usually isn’t raised. The rash is often the first symptom of Lyme disease, and it is the most tell-tale sign, but as many as one in four people who contract Lyme disease won’t get the trademark bullseye rash.
  • Flu-like symptoms – Symptoms of the flu are also common in stage one Lyme disease. These symptoms include fatigue, muscle and joint pain and stiffness, swollen lymph nodes, sore throat, headache, and sometimes fever.
    People with flu-like symptoms and no rash are unlikely to be properly tested and treated for Lyme disease and may be treated as if they have a viral infection instead. If you have signs of the flu in the summer and you know you’ve been bitten by a tick recently, be sure to let your doctor know so they can be on the lookout for signs of Lyme disease.

Without treatment, the bacteria can spread throughout the body and causes a second bout of symptoms weeks to months later.

Stage two occurs when no treatment is implemented, allowing the disease to spread through the body. Stage two is called early disseminated disease with heart and nervous system involvement. Symptoms can include:

  • A second round of flu-like symptoms, this time with pain, weakness or numbness in the arms and legs
  • Vision changes
  • Rashes elsewhere, and not just where the tick bite was
  • Heart palpitations and chest pain
  • Bell’s palsy, which involves paralysis or drooping of facial muscles
  • Meningitis, which is swelling of the brain or spinal cord.

Stage three is a result of a continued lack of treatment (or lack of response to treatment). It is referred to as late disease, which includes motor and sensory nerve damage and brain inflammation, as well as arthritis. Symptoms may start weeks, months, or even years after the initial tick bite and can include:

  • Vertigo
  • Fatigue and headaches
  • Heart rhythm abnormalities
  • Heart failure
  • Peripheral neuropathy, which involves shooting pain, numbness, or tingling in the hands or feet
  • Meningitis
  • Bell’s palsy
  • Confusion
  • Chronic arthritis with joint pain and swelling, especially in the knees
  • Anxiety
  • Depression

Approximately 10% of people never get rid of Lyme disease even after treatment, and continue to suffer from symptoms such as joint or muscle pain, fatigue, and short-term memory loss or mental confusion. This is referred to as post-treatment Lyme disease syndrome, and there’s no blood test for it. These symptoms can also occur with  many other diseases and conditions, so doctors argue over whether or not and to what extent post-treatment Lyme disease syndrome needs to be treated..

How to Test for Lyme Disease

Unfortunately, there aren’t any reliable methods to test for Lyme disease, especially at the beginning of onset. Doctors will often diagnose it based on the bullseye rash or other symptoms, a patient’s medical history, and if they’ve been bitten by a tick in an area of the country where Lyme disease is prevalent.

After the patient has been affected for a while, doctors can test for antibodies to the bacteria that cause Lyme disease. Unfortunately, this isn’t a foolproof method, since false positives can occur and people can also carry the antibodies around for years after fighting off the disease. The two tests currently used to check for antibodies are the enzyme-linked immunosorbent assay (ELISA) and the Western Blot assay antibody test.

Scientists are currently working on developing more accurate tests.

How to Treat Lyme Disease

Lyme disease treatment starts with a round of antibiotics. Oral antibiotics are prescribed for the early stages of Lyme disease, but intravenous antibiotics may be necessary in later stages of the disease. If the Lyme disease isn’t cured by the first round of antibiotics, there is no evidence that additional antibiotics are effective.

Beyond antibiotics, Lyme disease treatment deals with managing the symptoms. Pain-relievers like non-steroidal anti-inflammatory drugs (NSAIDS), which include drugs like Aleve (naproxen) and Motrin (ibuprofen), as well as gentle activity, may be recommended to manage pain.

A doctor can remove fluid from swollen joints with a procedure called arthrocentesis, where the fluid is removed by a sterile needle and syringe.

Swollen joints and arthritis may persist and are typically managed with pain relievers.

Antibiotics are required to treat Lyme disease. There are no home remedies that are effective Lyme disease treatments.

There is no treatment for post-treatment Lyme disease syndrome.

When traditional medicine fails to treat the symptoms of Lyme disease or post-treatment Lyme disease syndrome, some people turn to alternative methods such as taking turmeric and ginger, giving up gluten, grains, refined foods, and sugar; and using a Rife machine, which is an electromagnetic device that is reported to emit radio signals that may destroy harmful bacteria.

While thousands of people claim that alternative therapies have helped them manage their symptoms, there isn’t any research to back up the claims.

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Lyme Disease Antibiotics

Oral antibiotics are typically prescribed for the early stages of Lyme disease. Doxycycline (Vibramycin), amoxicillin (Amoxil), or cefuroxime axetil (Ceftin) are the most popular choices to treat Lyme disease.

Later-stage Lyme disease requires intravenous antibiotics such as ceftriaxone (Rocephin) and penicillin G.

Is Lyme Disease Curable?

For most people, Lyme disease can be cured with one round of oral antibiotics. About 10% of people will suffer long-term complications from Lyme disease. Doctors are not sure why this is, but one theory is that the body continues to fight the infection even after it’s cleared up, similar to an autoimmune disorder.

Lyme Disease Complications

Lyme disease does carry some risk of long-term complications such as permanent damage to the joints, heart, brain, and nervous system as well as autoimmune forms of arthritis like psoriatic arthritis, rheumatoid arthritis, and peripheral spondyloarthropathy. Fortunately, these are rare.

The History of Lyme Disease

Lyme disease was first discovered when a group of mothers in Lyme, Connecticut realized that an unusual number of their children had developed joint pain from rheumatoid arthritis. When researchers looked into it, they discovered the bacteria that causes Lyme disease and named it in 1982.

How Can You Prevent Lyme Disease?

Unfortunately, there is no vaccine available to prevent Lyme disease in humans. The best ways to reduce your risk of catching Lyme disease is to prevent tick bites and remove ticks as quickly as possible.

When you’re outside in areas where ticks live, particularly forests with tall grass, you should wear long pants tucked into your shoes, long sleeves, insect repellant with at least 20% DEET, and clothing treated with permethrin.

As soon as you come inside, you should wash your clothes in hot water (if possible), dry them on high heat, and shower so that you can wash off ticks that haven’t latched on yet and find ticks that have.

How Small are Ticks?

Ticks have three different life stages. At their smallest life stage, they’re only the size of the period in this sentence. At the larger life stages, they can be the size of a poppy seed or the size of an apple seed.

Where Should You Look for Ticks?

Ticks especially like to attach themselves to your hairline, armpits, waistline, groin, legs, the back of your neck, inside your belly button, behind your knees, between your toes, and inside or behind your ears. Ticks may also attach themselves to your pets.  Be sure to check these areas extra thoroughly, as well as any furry hiking companions.

How Do You Remove a Tick?

Use pointy tweezers to carefully grasp the tick as close to the skin as possible and pull straight up. Be careful not to squish the tick’s body, as doing so can cause it to regurgitate bacteria. You need to make sure the entire head and mouth pieces are removed and don’t just pull off the body. Wash the area with soap and water or an antiseptic. You can dispose of the tick in alcohol, a sealed plastic bag, a piece of tape, or by flushing it down the toilet.

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Is My Dog at Risk for Lyme Disease?

Ticks love dogs, and dogs are as susceptible to Lyme disease as humans. If you live in an area where Lyme disease is common, you should use a recommended tick control method and check your dog daily for ticks. There is a vaccine available for dogs that prevents Lyme disease. Talk to your veterinarian about whether or not your dog should get it.

Think you may be experiencing symptoms of Lyme disease? Book an appointment with a PlushCare doctor today to get treatment as quickly as possible.

Read More About Lyme Disease


PlushCare is dedicated to providing you with accurate and trustworthy health information.

Centers for Disease Control and Prevention. Lyme Disease. Accessed August 2, 2021 at  

Centers for Disease Control and Prevention. Tickborne Disease Surveillance Data Summary. Accessed August 2, 2021 at   

Mayo Clinic. Lyme disease – Symptoms and causes. Accessed August 2, 2021 at 

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