Neck pain and Lyme Disease: Will treating neck pain make Lyme Disease symptoms go away?

Ross Hauser, MD, Caring Medical Florida, Fort Myers, FL

When a patient comes into our office, and they have a diagnosis of Lyme Disease and have cervical spine instability, we often see that when the issues of cervical instability are addressed, the problems of Lyme Disease are greatly alleviated and sometimes eliminated.

In the many patients we see with cervical spine instability, chronic neck pain, and neurological challenges, there is sometimes a concurrent diagnosis of Lyme Disease. It is often thought that neck pain is a symptom of Lyme Disease, and that is why the neck pain is there, for many people it is. Neck pain is also a symptom of cervical spine instability which in some Lyme Disease patients, the neck problems were already there and now these neck problems are compounding their Lyme disease symptoms.

Other symptoms that may have existed before the Lyme Disease diagnosis including a tingling or numbness sensation, symptoms we see in cervical spine instability patients, especially in the arms, is also attributed to being a symptom of Lyme Disease. Nerve issues such as facial palsy and slurred speech are thought to be problems of Lyme Disease. Problems of cognition, memory loss, confusion, mood swings, and other problems considered mental health issues are also thought to be symptoms of Lyme Disease. While these problems can be attributed to the progression of Lyme Disease, these are also symptoms and manifestations we see in our cervical spine instability patients. So here we are, which came first? Symptoms of cervical spine instability or symptoms of Lyme Disease? To the patients, it may not matter because they are stuck in a myriad of symptoms. Some of their stories sound like this:

I am in perfect health except:

I have Lyme Disease and I have digestive and gut issues. I suffer from lightheadedness and dizziness. I have brain fog and memory recall issues. As far as my doctors are concerned, I only have anxiety. I have been sent to numerous cardiovascular tests and assessments. These tests always come back “normal.”  I am, according to my doctors, “in perfect health.”

I am confused because there is nothing wrong with me except a herniated disc in my neck that the surgeon wants to operate on.

I have a diagnosis of Ehlers-Danlos Syndrome (hypermobile type), Postural Orthostatic Tachycardia Syndrome (POTS), TMJ, Lyme disease, IBS, dizziness, and more. One doctor said I don’t have anything wrong with me except a bulging disc at C4/5. He recommended surgery. One doctor says I have Chiari malformation but another doctor says I don’t. 

When a patient comes into our office, and they have a diagnosis of Lyme Disease and have cervical spine instability, we often see that when the issues of cervical instability are addressed, the problems of Lyme Disease are greatly alleviated and sometimes eliminated.

Is it Lyme Disease or cervical spine instability causing your symptoms? Uncertain clinical consequences because people are not getting better.

Lyme disease is caused by the spirochete Borrelia burgdorferi, which is carried by infected ticks. This disorder has a variable clinical course and involves multiple systems, affecting the skin, nervous system, heart, and eyes. Early in the illness, many patients experience migratory musculoskeletal pain in joints, bursae, tendons, muscle, or bone, in one or a few locations at a time, frequently lasting only hours or days in a given location. Weeks to months later, untreated patients often have intermittent or chronic arthritis, primarily involving the large joints, especially the knees, over a period of several years.

Since the clinical course of the disorder is so varied, from mild aches and pains to debilitating memory, neurologic and heart conditions, there is no one symptom that is diagnostic for Lyme disease. For this reason, it is important for those with chronic pain and/or fatigue to get the various blood and urine tests for the condition.

Let’s look at a July 2020 paper published in the journal Clinical Infectious Diseases (1). The paper was offered to give clinical guidelines and education to doctors. You will probably see a lot of yourself in the explanation of what doctors should look for in suspected Lyme Disease patients. The doctors reading this paper are also reminded at the very opening: “Lyme disease is the most commonly reported vector-borne disease, but its clinical consequences remain uncertain.” If you are reading this article, you may be a patient who is suffering from uncertain clinical consequences because you are not getting better.

In this paper, the researchers examined studies published between 1994 and 2019. Cumulatively the symptoms in patients were:

Listen to this part: “Patients with Lyme Disease are more likely to report nonspecific long-term sequelae (symptoms that started with the Lyme Disease), especially those experiencing persistent symptoms post-treatment.”

The problem of being successfully treated for Lyme Disease and the continuation of symptoms.

This is a frustration we often see in our cervical spine instability patients. They have been declared “recovered,”  yet symptoms persist.

In December 2017 research paper, lead by Alison W Rebman at Johns Hopkins University School of Medicine published in the journal Frontiers in Medicine (2) these observations:

“Although a physical exam and clinical laboratory tests showed few objective abnormalities, standardized symptom questionnaires revealed that patients with post-treatment Lyme Disease symptoms are highly and clinically significantly symptomatic, with poor health-related quality of life.

Post-treatment Lyme Disease symptoms patients exhibited levels of fatigue, musculoskeletal pain, sleep disturbance, and depression which were both clinically relevant and statistically significantly higher than controls.

As the prevalence of post-treatment Lyme Disease symptoms continues to rise, there will be an increased need for physician education to more effectively identify and manage post-treatment Lyme Disease symptoms as part of integrated patient care.”

A second paper published in 2021 (3), and again lead by Alison W. Rebman at Johns Hopkins University School of Medicine made many observations into the symptoms of Lyme Disease. Some of these findings included neck pain of unknown origin. Here are some brief learning points from this paper.

Case study: Treating cervical spine instability treats and alleviates symptoms attributed to Lyme Disease

In the video below, Ross Hauser, MD discusses a case history of a patient with cervical spine instability who also had a diagnosis of Lyme Disease. This particular patient had significant positive treatment results. This may not be typical for everyone. This is one case study. If you would like to discuss your symptoms, send us an email.

Summary transcript and learning points of this video:

At 2:30 of the video, Dr. Hauser demonstrates one case of cervical spine instability and neck pain treatments that alleviated symptoms related to the patient’s diagnosis of Lyme Disease.

If you have Lyme Disease or have been on a chronic Lyme Disease treatment program or maintenance program and these treatments have not helped you as much as you would have hoped, one possible solution may be found in the treatment of cervical spine instability. The patient in this video is having a Digital Motion X-ray (DMX) examination. This allows the doctor and patient to visually see in real time and real movement, problems of cervical spine and neck instability that may be leading to symptoms attributed to Lyme Disease.

If you have Lyme Disease or have been on a chronic Lyme Disease treatment program or maintenance program and these treatments have not helped you as much as you would have hoped, one possible solution may be found in the treatment of cervical spine instability.

The patient in this video is having a Digital Motion X-ray (DMX) examination. This allows the doctor and patient to visually see in real-time and real movement, problems of cervical spine and neck instability that may be leading to symptoms attributed to Lyme Disease.

What are we seeing in this image?

The cervical spine is intertwined with nerves and blood vessels. Cervical spine instability can compress or pinch the nerves and arteries causing a myriad of symptoms depending on how the patients moves his/her head. Cervical spine instability can cause restriction and compression of vital arteries and nerves that supply blood and sensation to the brain, face, and neck. Brain fog is a manifestation of cervical spine instability and is a symptom of both cervical spine instability and Lyme Disease.

 

The cervical spine is intertwined with nerves and blood vessels. Cervical spine instability can compress or pinch the nerves and arteries causing a myriad of symptoms depending on how the patients moves his/her head. Cervical spine instability can cause restriction and compression of vital arteries and nerves that supply blood and sensation to the brain, face and neck. Brain fog is a manifestation of cervical spine instability and is a symptom of both cervical spine instability and Lyme Disease.

At 2:57 of the video Dr. Hauser illustrates that in this one case, one Prolotherapy treatment into the cervical spine was sufficient enough to provide noticeable pain relief and reduction of brain fog symptoms. It should be pointed out this is not typical, patients usually will require 3 to 8 treatments to achieve long-lasting and demonstrable symptom reduction.

In this video, a demonstration of treatment is given

Prolotherapy is referred to as a regenerative injection technique (RIT) because it is based on the premise that the regenerative healing process can rebuild and repair damaged soft tissue structures. It is a simple injection treatment that addresses very complex issues.

This video jumps to 1:05 where the actual treatment begins. This video is a demonstration of treatment, this patient did not have Lyme Disease.

This patient is having C1-C2 areas treated. Ross Hauser, MD is giving the injections.

In our 2014 research lead by Danielle R. Steilen-Matias, MMS, PA-C and published in The Open Orthopaedics Journal (4) our research team was able to demonstrate that when the neck ligaments are injured and cause cervical spine instability (excessive movement of the cervical vertebrae), can cause a number of symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated brain fog, vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches.

This is what we wrote: “To date, there is no consensus on the diagnosis of cervical spine instability or on traditional treatments that relieve chronic neck instability issues like those mentioned above. In such cases, patients often seek out alternative treatments for pain and symptom relief. Prolotherapy is one such treatment that is intended for acute and chronic musculoskeletal injuries, including those causing chronic neck pain related to underlying joint instability and ligament laxity. While these symptom classifications should be obvious signs of a patient in distress, the cause of the problems is not so obvious. Further and unfortunately, there is often no correlation between the hypermobility or subluxation of the vertebrae, clinical signs or symptoms, or neurological signs or symptoms. Sometimes there are no symptoms at all which further broadens the already very wide spectrum of possible diagnoses for cervical instability.”

What we demonstrated in this study is that the cervical neck ligaments are the main stabilizing structures of the cervical facet joints in the cervical spine and have been implicated as a major source of chronic neck pain and possibly in the case of Lyme Disease type symptoms, cervical instability symptoms.

Prolotherapy, the curve of the neck and blood flow

In this image, the progression and degeneration of the cervical spine is demonstrated, from Lordotic curve to the Military curve to the Kyphotic curve to the "S" curve of severe osteoarthritis.

In this image, the progression and degeneration of the cervical spine are demonstrated, from the Lordotic curve to the Military curve to the Kyphotic curve to the “S” curve of severe osteoarthritis.

In February 2016 a paper appeared in the Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. (5) Here medical university researchers in Turkey made these observations:

This is research with which we have seen empirical evidence in our over 27 years of regenerative medicine practice. To fix the problems related to the cervical spine, you need to restore the natural curvature of the neck.

In the medical journal Brain Circulation (Jan-March 2019) (6), doctors wrote up their analysis of case study patients who had cervical lordosis. They wrote that if you restored the natural curve to the neck, you could immediately increase cerebral blood flow as pressure is removed from the cerebral artery.

Here are the learning points of this research. They present a good summary of what we discussed in this article:

The challenges of vertebrobasilar insufficiency are many. Fixing cervical neck instability is not something that can be treated simply or easily, it takes a comprehensive non-surgical program to get the patient’s instability stabilized and the symptoms abated. We believe that if you have been going from clinician to clinician, practitioner to practitioner, doctor to doctor, there is a good likelihood that you have problems of cervical neck instability coming from weakness and damage to the cervical ligaments.

If this article has helped you understand the problems you are facing and you would like to explore Prolotherapy as a possible remedy, ask for help and information from our specialists


1 Mac S, Bahia S, Simbulan F, et al. Long-Term Sequelae and Health-Related Quality of Life Associated With Lyme Disease: A Systematic Review. Clin Infect Dis. 2020;71(2):440-452. doi:10.1093/cid/ciz1158 [Google Scholar]
2 Rebman AW, Bechtold KT, Yang T, et al. The Clinical, Symptom, and Quality-of-Life Characterization of a Well-Defined Group of Patients with Posttreatment Lyme Disease Syndrome. Front Med (Lausanne). 2017;4:224. Published 2017 Dec 14. doi:10.3389/fmed.2017.00224 [Google Scholar]
3 Rebman AW, Yang T, Aucott JN. Symptom heterogeneity and patient subgroup classification among US patients with post-treatment Lyme disease: an observational study. BMJ open. 2021 Jan;11(1):e040399. [Google Scholar]
4 Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. The open orthopaedics journal. 2014;8:326. [Google Scholar]
5 Piersiala K, Akst LM, Hillel AT, Best SR. Chronic Pain Syndromes and Their Laryngeal Manifestations [published online ahead of print, 2020 Apr 30]. JAMA Otolaryngol Head Neck Surg. 2020;e200530. doi:10.1001/jamaoto.2020.0530
6 Katz EA, Katz SB, Fedorchuk CA, Lightstone DF, Banach CJ, Podoll JD. Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis. Brain Circulation. 2019 Jan 1;5(1):19. [Google Scholar]

This article was updated October 8, 2021

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