In the late spring of 2008 I noticed a redness on my upper left shoulder. It looked more like an enlarged and slightly irritated mosquito bite more than anything else. But in three days it grew from the size of a nickel to a circular patch with a diameter of more than eight inches. On the fifth day I woke up to discover it covered close to one-quarter of the left side of my upper body, and large red splotches were appearing on my left leg as well. A trip to the doctor confirmed it was Lyme disease and three weeks of antibiotics ensued.

Despite my diligence, earlier this summer, I discovered that familiar bull’s-eye circle on my left leg, behind my knee. I had removed a tick attached there about two weeks earlier, monitored it for about ten days and everything seemed fine. It was the Fourth of July weekend, and I waited until Monday to go to the ER – when once again I was diagnosed with Lyme disease.

I like to think that as a massage therapist with knowledge of pathology, a desire to maintain good health, as well as being a nature lover living in the woods, would mean I was up on the facts about preventing and recognizing Lyme disease. But it took this most recent bout to get me to read up on it and share the information with other massage therapists.

What Causes Lyme Disease?

Lyme disease is caused by a spiral shaped bacteria belonging to the genus Borrelia, which is carried by ticks belonging to the species of the genus Ixodes. The deer tick is responsible for Lyme in the Eastern United States, while the western black-legged tick is responsible for Lyme on the West Coast of the U.S. (Europe and China have other species of ticks that transmit diseases similar to Lyme.)

A tick itself is no larger than a poppy seed, which makes them very hard to detect. The bacteria transfers to humans via an infected tick, which is in either the nymph or female adult stage of development. The tick needs to be attached to the body for more than 24 hours to transmit Lyme.


Diagnosing Lyme disease is tricky. Perhaps the most definitive diagnosis comes when you know you’ve been bit by a tick and then get the classic bull’s-eye rash (erythema migrans). Most doctors won’t even bother with a blood test if those two factors are evident. However, not everyone with Lyme knows he or she has been bit. And of those diagnosed with Lyme, only about 60% – 80% present the rash.

Even the typical blood tests given often show false positives, as well as false negatives. This means that Lyme could be either vastly over- or under-diagnosed. A person infected with Lyme may not show any symptoms for 30 days or more, or symptoms can manifest just a few days after the tick bite.

Some of the symptoms of Lyme disease, especially if there is no rash, can be confused with other pathologies including fibromyalgia and chronic fatigue syndrome, which are treated much differently than Lyme.

Who Is At Risk?

If you live in or near a wooded area, especially in the Northeastern United States, you are at risk for getting Lyme disease if bitten by a tick. Though living elsewhere is not a guarantee of safety. According to the Center For Disease Control (CDC), about 93% of all cases of Lyme disease come from the Northeast states and Minnesota though every state, as well as the District of Columbia, has reported cases. Depending on where you live, ticks can be active anywhere from mid-May to November and tend to thrive in moist, grassy areas.


Lyme disease is typically treated with antibiotics with different ones used to treat children and adults. Doxycycline is generally prescribed for adults, amoxicillin for children and erythromycin for pregnant women.

In the past it was thought that only long-term use of antibiotics could totally rid the body of the Lyme causing bacteria. There is still some controversy over the use of long-term antibiotic treatment, though most doctors advise against it and the typical treatment now lasts three weeks. Long-term antibiotic use comes with a high price – including a depressed immune system and the development of drug resistant infections.


There are three stages of Lyme disease.

First Stage: The initial phase (7 – 10 days after the bite) may include the hot, itchy circular rash and typical flu-like symptoms such as high fever, swollen lymph nodes, headache, night sweats and fatigue. There may be overall achiness and stiffness as well. If there is no bull’s-eye rash, this phase may be misdiagnosed as the flu, mononucleosis or even meningitis and so may be treated incorrectly.

Second Stage: If left untreated, the disease may progress to a second stage and result in cardiovascular problems including irregular heartbeat and dizziness, neurological problems such as Bell’s Palsy, numbness, tingling, poor coordination and even forgetfulness. There can be a general malaise and debilitating fatigue as well.

Third Stage: The third stage is associated with inflammation of one or more large joints, most notably the knees. If left untreated it can cause permanent damage.
The second and third phase can occur weeks, months or even years after infection with Lyme causing bacteria. In later stages, if left untreated, the bacteria disseminate throughout the body and can cross the blood-brain barrier making the Lyme much more difficult to treat.

Can Massage Help?

Massage can’t cure or treat Lyme, but it can help with the symptoms such as the aches and pains, and also help to boost the immune system. In the initial stages of Lyme, a person may be too uncomfortable to even want a massage – (I know I was) – and it often is not advisable to administer massage to a person on antibiotics. Massage can reduce the discomfort of later symptoms that may continue long after the completion of antibiotic use.

Deep tissue massage is not recommended in acute stages of the disease, but gentler modalities, such as lymphatic drainage, polarity therapy, reflexology can be helpful. Light Swedish massage and Shiatsu can also be effective as long as the massage therapist recognizes the client’s tolerance level.

Complementary Treatments

In addition to massage there are some other natural remedies that can complement allopathic treatment.

  • Probiotic supplements, such as Lactobacillus acidophilus, can help maintain gastrointestinal health by replacing good bacteria and offsetting some of the effects of the antibiotics, such as diarrhea and yeast infections. Look for live, active probiotics in foods like yogurt and kefir, or get them in supplement form at your local health food store.
  • Herb teas, or dried extracts in the form of capsules, powders or tinctures can help because of their antioxidant, anti-inflammatory and immune support qualities. Try decaffeinated green tea, ginkgo biloba, cat’s claw, reishi mushroom, olive leaf or garlic. Inform your doctor if you take any of these to avoid any possible interactions with prescribed drugs.
  • Homeopathic remedies, prescribed by a professional homeopath, can reduce the effects of Lyme. They may include ledum, thuja or lac canimum among others, depending on the homeopath’s evaluation.
  • Acupuncture can help to relieve pain, increase mobility and reduce fatigue. As they are also schooled in Chinese herbal medicine they can also offer remedies that may help with other symptoms and side effects of Lyme.
  • Essential oils can help to alleviate some of the symptoms. For example cinnamon, clove or ginger can reduce fatigue and keep you alert; chamomile, lavender or myrrh can help reduce inflammation; and bay laurel, clove bud or garlic are powerful antibacterial agents.

If You Think You Have Lyme

If you have found a tick attached to your body, or if you find a bull’s-eye rash (particularly prone areas are back of the knee, inside of elbows, armpits, groin, under the breasts and on the back), go to a doctor for evaluation and treatment as soon as possible.

To get up-to-date information on Lyme disease, tick removal and tick identification contact your local department of health. 1-800-866-LYME (5963) is a 24-hour hotline provided by the Lyme Disease Foundation.

Recommended Study:

Advanced Anatomy & Pathology

More Information:

Lyme Disease: Description and Massage Precautions