You stand up to walk to the bathroom at night—and wince. The soles of your feet ache like you’re stepping on broken glass.

By morning, the pain fades, only to return the next night. This pattern may seem harmless, but painful feet and Lyme disease are often connected—an early warning sign that shouldn’t be ignored, making it an important Lyme disease symptom.

When to Consider Lyme Disease

Your doctor might diagnose plantar fasciitis and prescribe rest, stretching, and supportive footwear. But if the pain doesn’t improve, it’s time to consider other causes including Lyme disease.

Watch for symptoms beyond foot pain. If you’re experiencing fatigue, brain fog, joint pain, or have a history of tick exposure, painful feet may signal nerve inflammation from Lyme disease rather than a mechanical foot problem.

What It Feels Like

Research shows that peripheral nerve dysfunction occurs in patients with late Lyme disease, with many experiencing distal paresthesia and sensory loss. Patients describe:

• Walking on bruises
• Needle pricks with each step
• Numbness alternating with sharp pains
• Temperature sensitivity (cold floors feel painfully cold)

The pain typically worsens at night, making bathroom trips excruciating. Both feet hurting similarly is common with Lyme neuropathy.

Co-Infections Worsen Symptoms

Ticks often carry multiple infections beyond Lyme disease. Co-infections like Babesia, Bartonella, or Anaplasma can intensify symptoms, making painful feet from Lyme disease more severe and treatment-resistant.

Recent research identified small fiber neuropathy associated with post-treatment Lyme disease syndrome, which may explain persistent sensory symptoms.

What You Should Do

Research indicates that peripheral neuropathy can improve following appropriate antibiotic treatment. Early intervention can halt nerve inflammation and prevent permanent damage.

If you’re experiencing persistent foot pain that doesn’t respond to standard treatments—especially alongside fatigue, brain fog, joint pain, or tick exposure—ask your doctor about testing for Lyme disease and co-infections.

Document when pain occurs and accompanying symptoms. Don’t wait until the pain becomes constant. Early treatment makes all the difference.

Clinical Takeaway

Painful feet when walking at night may signal peripheral nerve inflammation from Lyme disease rather than mechanical foot problems like plantar fasciitis. Research shows peripheral nerve dysfunction occurs in late Lyme disease, with patients experiencing distal paresthesia and sensory loss—pain typically worsens at night and affects both feet similarly. Co-infections like Babesia, Bartonella, or Anaplasma can intensify symptoms, and peripheral neuropathy can improve following appropriate antibiotic treatment when intervention is early.

Frequently Asked Questions

Can Lyme disease cause painful feet?
Yes. Lyme disease can cause peripheral nerve inflammation (neuropathy) that produces foot pain, typically worsening at night and affecting both feet similarly.

Why does foot pain from Lyme disease worsen at night?
Nerve inflammation from Lyme disease often causes pain that intensifies at night, making activities like walking to the bathroom painful.

Can co-infections make painful feet from Lyme disease worse?
Yes. Co-infections like Babesia, Bartonella, or Anaplasma can intensify foot pain and make symptoms more severe and treatment-resistant.

Related Reading

Lyme Disease Symptoms: What Patients Need to Know
Chronic Pain in Lyme Disease: Why It Moves and What Helps
Lyme Disease Neuropathy: Symptoms and What Causes It
Is It Lyme Disease? Unexpected Symptoms of Lyme Disease
Tick-Borne Co-Infections: What Patients Need to Know
Post-Treatment Lyme Disease Syndrome (PTLDS)

References

1. Flanagan EP, et al. Lyme Disease Manifestations in the Foot and Ankle: A Retrospective Case Series. J Foot Ankle Surg. 2016;55(2):266-271.