Can Lyme Disease Cause Back Pain, Nerve Pain, or Joint Pain? 90 Ways It Can Present
IS THIS LYME PAIN?
BACK PAIN. NERVE PAIN.
PAIN THAT MOVES?
Yes—Lyme disease can cause pain in many parts of the body, including the back, neck, shoulders, joints, muscles, and nerves.
In fact, pain is one of the most common symptoms of Lyme disease—and it can move, change, flare, or appear without a clear injury.
Lyme disease pain often appears as inflammatory, neurologic, musculoskeletal, or visceral pain. It may shift location, cluster with other symptoms, or persist despite normal imaging or standard testing.
This shifting pattern of pain is one reason Lyme disease is often misdiagnosed.
These pain patterns are part of the broader multisystem presentation described in the Lyme disease symptoms guide.
They may also overlap with autonomic dysfunction in Lyme disease, where dizziness, nerve-related pain, and other symptoms may occur together.
Can Lyme Disease Cause Pain in Different Parts of the Body?
Yes. Lyme disease can affect multiple systems and cause pain in the muscles, joints, nerves, head, spine, chest, abdomen, and limbs. The pattern of pain is often more important than the location.
Pain may reflect overlapping neurologic, inflammatory, immune, and autonomic mechanisms. For a broader framework, see neurologic Lyme disease.
Where Does Lyme Disease Cause Pain?
- Back and neck pain
- Joint pain, including shoulders, knees, hips, elbows, and wrists
- Nerve pain, including burning, tingling, electric shocks, or stabbing pain
- Headaches, facial pain, scalp sensitivity, or occipital neuralgia
- Muscle pain, cramping, spasms, or twitching
- Chest wall, rib, abdominal, pelvic, or bladder pain
The following are common patterns of pain seen in Lyme disease and tick-borne infections.
Neurological & Nerve-Related Pain
- Burning or tingling in hands and feet: Often worse at night; reflects small fiber nerve involvement.
- Electric shock sensations: Sudden jolts of pain down the spine or limbs.
- Allodynia (pain from light touch): Normal touch feels painful.
- Facial nerve pain: Stabbing or electric pain in the face.
- Occipital neuralgia: Pain radiating from neck to scalp or eyes.
- Scalp sensitivity: Pain when brushing or touching the scalp.
- Paresthesias (pins and needles): Tingling or crawling sensations.
- Burning tongue or mouth: Oral pain without dental cause.
- Radiculopathy: Pain radiating along nerve paths.
- Stabbing eye pain: Sudden sharp eye discomfort.
- Limb pain without cause: Pain without injury.
- Pain worse at night: Disrupts sleep.
- Crawling or buzzing sensations: Sensory disturbance under skin.
- Muscle burning without exertion: Occurs at rest.
- “Fire” pain down limbs: Traveling burning sensation.
- Hypersensitive skin: Increased pain response to touch.
Many of these symptoms reflect nerve involvement. See Lyme disease neuropathy for a structured breakdown of nerve-related pain patterns.
Some patients experience not just pain, but an amplification of normal sensation. Learn more about this pattern in sensory overload in Lyme disease.
Musculoskeletal & Joint Pain
- Sciatica-like pain without disc findings
- Large joint swelling, including knees or shoulders
- Migratory joint pain
- Small joint stiffness
- Deep bone pain
- Muscle cramping or tightness
- Back or neck pain
- Jaw pain / TMJ dysfunction
- Rib pain / costochondritis
- Bruxism-related pain
- Tendon pain
- Sacroiliac joint pain
- Thumb joint pain
- Hip or groin tightness
- Muscle strain without injury
- Shoulder impingement-type pain
- Knee locking or catching
- Elbow or wrist soreness
- Morning stiffness improving with movement
- Myofascial trigger point pain
- Frozen shoulder sensation
- Heel or arch pain
Visceral & Internal Pain
- Chest pain (non-cardiac)
- Chest wall tenderness
- Abdominal pain or cramping
- Esophageal spasm pain
- Pelvic or groin pain
- Bladder pain or urgency
- Rectal or perineal pain
- Pain during urination without infection
- Vulvodynia (women)
- Testicular pain (men)
- Pain during intimacy
- Breast pain
- Nausea-linked stomach pain
- Diaphragm or upper abdominal pain
- Pain after eating
- Pain with gas or bloating
- Pelvic floor dysfunction pain
- Groin pain when walking
Sensory, Head & Facial Pain
- Headaches, migraine, or pressure
- Eye pain or pressure
- Throat or jawline pain
- Ear pain or fullness
- Pain triggered by light or sound
- Postural head or neck pain
- Sinus-like pressure
- Tooth pain without cause
- Facial numbness with pain
- Base-of-skull pain
- Burning eyes
- Nose bridge pressure
- Forehead pressure
Systemic & Flare-Linked Pain
- Menstrual-related pain flares
- Cold-triggered pain
- Fibromyalgia-like pain
- Hormonal-linked pain
- Herxheimer reaction pain
- Inflammatory flare pain
- Morning whole-body soreness
Regional, Rare, or Activity-Linked Pain
- Muscle twitches with pain
- Pain at old injury sites
- Pain after massage
- Pain with swallowing
- Lightning bolt pain
- Heel pain (plantar fasciitis-like)
- Ribcage pain with pressure
- Sore throat without cause
- Upper back burning patch
- One-sided body pain
- Pain that disappears and returns
- Pain with eye pressure
- Pain that moves hour-to-hour
- Pain with minor movement
In Lyme disease, the pattern of pain is often more important than the location.
FAQ: Lyme Disease Pain
Can Lyme disease cause back pain?
Yes. Lyme disease can cause back pain, neck pain, and radiating nerve pain, especially when inflammation or nerve involvement is present.
Can Lyme disease cause shoulder pain?
Yes. Lyme disease can cause shoulder pain, joint pain, tendon pain, or frozen-shoulder-like symptoms.
Can Lyme disease cause sciatica-like pain?
Yes. Lyme disease can cause nerve-related pain that mimics sciatica, even without disc problems on imaging.
How painful is Lyme disease?
Lyme disease pain can range from mild aches to severe nerve, joint, muscle, or whole-body pain. It may fluctuate, move, or worsen during flares.
Clinical Takeaway
Lyme disease pain is not a single symptom—it is a spectrum. These presentations reflect how pain can vary across systems, shift over time, and resist conventional explanations.
If your pain doesn’t fit in one box—or has been dismissed—you are not alone. Recognizing patterns is often the first step toward understanding, validation, and recovery.
Related Symptom Systems in Lyme Disease
- Neurologic Lyme Disease
- Lyme Disease Neuropathy
- Dizziness in Lyme Disease
- Lyme Disease Pain
- Autonomic Dysfunction in Lyme Disease
References
Erdogan O, Hu XQ, Chiu IM. Sensory Neurons on Guard: Roles in Pathogen Defense and Host Immunity. Curr Opin Immunol. 2025. Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884989/
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
going on 12 – 14 years of unrelenting pain and discomfort. I have a wonderful Dr. but he doesn’t believe in long term lymes. However, he lets me have doxycycline to use periodically. Not much or (no) help from neurologist or rheumatologist. Most recent approach or treatment, I’ve had the beginning dose and two weeks later the second dose (shots) of Dupexant. Seems to help some symptoms. Is this something that has been tried by many? One of my most recent symptoms starting 2-3 years ago and getting much worse to the point of being debilitating is extreme temperature intolerantance. Symptoms express when above 70-75 ° or below 62-58°. Express Raynaud’s type symptoms when cold, especially in the hands and feet, strangest wrinkling of skin on fingers, mostly when cool,cold. Complaining of feeling of something (liquid) pooling under the skin and feeling of separation of the dermis and epidermis, mostly the finger tips but also the palms and bottom of my feet.