A new study has revealed alarming trends in chronic pain across America — prevalence jumped from 21% in 2019 to 24% in 2023, now affecting 60 million adults. While researchers attributed about 13% of this increase to long-COVID, a significant portion remains unexplained.
As a physician specializing in tick-borne diseases, I believe we’re missing a crucial piece of this puzzle: the hidden epidemic of chronic pain due to Lyme disease.
The Numbers Don’t Add Up
The study found increases across nearly all pain categories — back and neck pain, arm and shoulder pain, hip and knee pain, headaches, and abdominal pain. What’s particularly striking is that conventional demographic, health, and socioeconomic factors, even combined with long-COVID, couldn’t fully explain these dramatic increases.
This unexplained surge points to what many of us in the Lyme community have been witnessing for years: a growing population of patients with complex, multi-system pain that often goes undiagnosed or misdiagnosed for years.
Chronic Lyme Disease Pain: The Great Imitator
Chronic Lyme disease pain often mirrors the widespread, multi-site pain patterns documented in this national study. In my practice, I regularly see patients whose pain presentations align with the research:
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Musculoskeletal Pain: Migrating joint pain that shifts from knees to shoulders, often without consistent inflammation markers.
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Neurological Pain: Headaches unresponsive to migraine therapies, nerve pain described as burning or electric shocks, and diffuse muscle aching without a clear trigger.
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Abdominal and Pelvic Pain: Digestive distress, pelvic discomfort, and abdominal cramping that defy conventional gastroenterology explanations.
The Diagnostic Gap
One of the most challenging aspects of chronic Lyme disease pain is how easily it’s missed by standard medical evaluations. Patients often describe their pain as:
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“It moves around my body.”
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“Some days I feel fine, others I can barely function.”
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“Stress or fatigue makes it worse.”
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“Nothing helps consistently.”
These vague or shifting patterns don’t align with conventional medical conditions. Too often, patients are given labels like fibromyalgia, chronic fatigue syndrome, or “pain of unknown origin,” while an untreated infection is actually the root cause.
Geographic and Demographic Clues
While the chronic pain study didn’t break down results by region, looking at Lyme disease data provides useful insights. Areas with the most reported Lyme cases — the Northeast, upper Midwest, and Pacific Coast — are also places where people often report unexplained chronic pain.
Working-age adults, particularly those active outdoors, appear in both datasets: the groups most likely to develop chronic Lyme disease pain and the groups showing the steepest rise in chronic pain overall.
The Pandemic Connection
The COVID pandemic likely increased our exposure to ticks and the risk of developing Lyme disease — possibly contributed to the rise in chronic pain cases:
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More outdoor activity during lockdowns increased tick exposure.
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Delayed medical care in 2020–2021 left acute Lyme cases undiagnosed.
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Immune system stress from COVID-19 triggered symptoms in patients with dormant Lyme infections.
This overlap suggests that chronic Lyme disease pain may be an underrecognized factor in the broader post-pandemic pain epidemic.
Treatment Response That Tells the Story
The strongest evidence linking chronic Lyme disease pain to the national pain crisis is treatment response. Patients who spent years in severe pain, visiting multiple specialists without relief, often improve dramatically once Lyme and co-infections are addressed with antibiotics or integrative protocols.
This repeated clinical experience points to chronic Lyme disease pain as a hidden contributor to the rising prevalence.
Implications for Healthcare
If chronic Lyme disease pain is driving part of the chronic pain epidemic, the healthcare implications are profound:
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Screening Protocols: Pain evaluations should include tick exposure history and symptom patterns.
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Testing Guidelines: Current Lyme tests need revision to detect chronic or relapsing cases.
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Treatment Access: Insurance barriers and limited physician awareness delay care for patients.
A Call for Recognition
Chronic pain is now a national crisis. Long-COVID has rightfully received attention, but chronic Lyme disease pain must also be recognized. The overlap in symptoms, geography, and treatment response is too strong to ignore.
As the study authors concluded, we need “a broader set of explanatory factors” to account for post-pandemic pain trends. Chronic Lyme disease pain belongs at the top of that list.
Until the role of chronic infections is acknowledged, millions will continue to live with unexplained, untreated pain. It’s time to connect the dots and provide the care these patients urgently need.
👉 Have you experienced chronic Lyme disease pain or seen its impact on your patients? Share your story below.
