Pain persists in treated Lyme patients
by Michael Lasalandra

Wednesday, December 22, 1999

Many patients who have been treated for Lyme disease in the past are likely to report continuing symptoms of pain and memory difficulties, a new study says.

"They say they still have joint pain and memory problems and difficulty doing their daily activities due to pain,'' said Dr. Nancy Shadick of Brigham and Women's Hospital, lead author of the study that appears in yesterday's Annals of Internal Medicine.

Although many leading Lyme disease specialists insist that the disease can be cured completely with a few weeks of antibiotic treatment, many patients and activists dispute that, saying they need continuing therapy.

While Shadick said her epidemiological study does not address the controversy, she said the patients' problems were "very real.''

"These patients are telling us what's wrong with them and I believe them,'' she said.

Still, tests measuring physical, neurological and cognitive functions showed no differences between those study subjects who had been previously treated for Lyme disease and control subjects who had never had the disease.

The problems they report "don't show up on the tests, but our tests may not be sensitive enough,'' Shadick said.

Subjects for the study came from Nantucket, where Lyme disease, caused by bacteria spread by ticks, is endemic. The study looked at 167 people who had previously been treated for Lyme and 167 who had never had it.

The study evaluated the subjects' health in a number of ways, including a questionnaire asking about psychological and physical symptoms, physical function and past and present illnesses.

They also performed a detailed examination of their joints, muscle strength and sensation and ran formal tests of memory, manual dexterity, ability to learn and ability to concentrate.

While the researchers found no differences between the two groups on the physical exams and on performance on the tests, they did find those treated for Lyme disease in the past were more likely to complain about pain.

"Even though our research did not show significant differences in performance between the two groups, there seems to be residual difficulties performing daily tasks in some individuals with prior Lyme disease,'' Shadick said.

"Rehabilitation may be one option to help such patients,'' she said.