Chronic Lyme disease: Everything you need to know

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What is chronic Lyme disease?

People with chronic Lyme disease continue to have symptoms of Lyme disease despite receiving treatment for the initial infection.

Chronic Lyme disease is also known as posttreatment Lyme disease syndrome.

According to 2016 research, about 10–20% of people who receive treatment for Lyme disease develop chronic symptoms.


People get Lyme disease if an infected tick bites them. Researchers are not sure why some people develop chronic Lyme disease, but they have several theories:

  • Some of the bacteria may survive the treatment and continue to cause symptoms.
  • Lyme disease may cause an autoimmune response in a similar way to other diseases. Examples include strep throat, which can lead to rheumatic fever, and chlamydia, which has an association with Reiter’s syndrome. When this happens, the immune system continues to be active even after treatment destroys the bacteria, causing persistent symptoms.
  • Symptoms may be a result of other causes that do not relate to the original Lyme disease.

The symptoms of chronic Lyme disease are similar to those of the original infection. They include:


There is no set test to check for chronic Lyme disease. Initially, a doctor is likely to use an antibody test to look for the antibodies that the body produces to fight the bacteria responsible for Lyme disease.

Two standard tests are the Western blot test and the enzyme-linked immunosorbent assay (ELISA) test.

However, a doctor may be able to test for damage using other tests, depending on a person’s symptoms. Some tests that a doctor may try include:

  • a spinal tap to measure cerebrospinal fluid (CSF)
  • a brain MRI scan to look for neurological changes
  • an electrocardiogram (EKG) or echocardiogram to evaluate heart functioning

There is currently no cure for chronic Lyme disease. People with the condition typically get better with time, although it may take several months. In most cases, a doctor will focus the treatment plan on managing pain and other symptoms.

The doctor may recommend over-the-counter pain relievers, or they might prescribe medications to treat muscle soreness.

Although some doctors may recommend continuing to use antibiotics, experts have not reached a consensus on the effectiveness and safety of this practice.

For example, the National Institute of Allergy and Infectious Diseases note that several clinical trials found no benefit in continuing antibiotic therapy in people with chronic Lyme disease.


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