Key takeaways:
- Treatment with the right antibiotics can cure Lyme disease.
- Late-stage Lyme disease is what happens months to years after a Lyme infection doesn’t get treatment.
- Antibiotics can treat late-stage disease, but recovery can take much longer than it would with early treatment.
The cause of Lyme disease is an infection with the bacteria Borrelia burgdorferi. The transmission, or spread, is through a bite from a deer tick. That means the best way to avoid Lyme disease is through prevention. So if you know you’ll be around ticks, protect yourself by using insect repellant, covering your skin with proper clothing, and checking for ticks (and their bites).
Unfortunately, ticks are very small and can be hard to spot. The good news is that with early treatment, Lyme disease is very unlikely to cause long-term health complications. But not everyone gets early treatment. That’s because not everyone with early Lyme disease gets symptoms. So — like the ticks themselves — it can be easy to miss.
While early treatment is quicker and more effective, you can still treat late-stage Lyme disease. We’ll review treatment options, stages, and possible long-term effects of untreated Lyme disease.
The 3 stages of Lyme disease
If you contract the Borrelia burgdorferi bacteria and don’t get antibiotic treatment, the infection will not go away. Untreated Lyme disease will progress through three stages.
1. Stage 1 Lyme disease
The first stage is called “localized” or “early” Lyme disease, meaning the bacteria haven’t spread around the body yet. Symptoms usually start between 3 and 30 days after the tick bite.
The typical symptom is a “bullseye” or “target lesion” rash. The rash looks like a red spot at the site of the tick bite. Over a few days, the rash expands. Sometimes, as the rash grows, it can look like a large, red ring around a smaller red rash (the bullseye, or target). Erythema migrans is another name for this rash. About 80% of people get this rash after Lyme disease infection.
Other symptoms during the first stage include:
- Fever
- Chills
- Headache
- Stiff neck
- Joint pain
- Muscle aches
- Swollen lymph nodes
Some people may have these symptoms and no rash. Other people may have no obvious symptoms at all — and they may never know they’ve been infected with Lyme disease.
2. Stage 2 Lyme disease
In the second stage, or “early disseminated” Lyme disease, the bacteria have spread around the body. It can happen anywhere from a few weeks to a few months after an untreated Lyme infection.
Skin symptoms in the second stage are multiple bullseye or target rashes.
This stage can also affect the nerves, brain, eyes, and heart. Nerve and brain symptoms can include:
- Meningitis (headaches and fever)
- Facial weakness (Bell’s palsy)
- Pain, numbness, and weakness in certain nerves (radiculoneuritis)
The most common eye condition is pink eye (conjunctivitis). When stage two Lyme disease affects the heart, symptoms can include skipped or irregular heart beats and chest pain.
3. Stage 3 Lyme disease
In the third stage, or “late-phase” Lyme disease, the bacteria live in the joints, nerves, brain fluid, or heart. It can happen months to years after the initial untreated infection.
Arthritis is the most common symptom of late-stage Lyme. It can affect one or more joints. Typically, large joints (like the knees) are most affected.
When it affects the brain or nerves, symptoms can include:
- Memory and concentration problems
- Irritability
- Nerve pain, weakness, or numbness in the arms and legs
What are the long-term effects of untreated Lyme disease?
As we reviewed in the different stages, undiagnosed or untreated Lyme disease can cause serious medical problems that affect different parts of the body. We’ll provide a more in-depth explanation of these long-term conditions here.
Joint pain and swelling
About half of people with untreated Lyme get chronic (long-term) arthritis. Joint pain and damage most commonly occur in the knee. But Lyme can also affect other joints, like the:
- Shoulders
- Ankles
- Elbows
- Wrists
- Jaw
These joints may feel swollen and warm to the touch. Lyme arthritis is more common in older people with Lyme disease.
Nerve problems
Nerve problems — like pain, tingling, numbness, and weakness — are another symptom of late Lyme disease. The bacteria can attack nerves and cause inflammation and damage. In early disseminated Lyme disease, the most common nerve symptom is Bell’s palsy, a one-sided facial weakness. This usually improves gradually. In later Lyme disease, tingling, weakness, numbness, and nerve pain can affect the limbs, which can be harder to treat.
