Sore, Tender Spots on my Scalp

This post is a response by a doctor to a question one of our community members asked.

Diane Asks:

Over a year ago I fell down our old farm steps. The pain never went away but recently has gotten worse and it is all over my head now. I also have anxiety and depression so not sure if that is causing it. My neck is sore, up the back of my head, on the sides of my head and on top, at spots. I was diagnosed with lyme a little over a year ago. I have since had many ticks pulled off of me since then. Please help.

Dr Alejandro’s reply:

Hello Diane,

While most patients with Lyme disease are cured after a 3 to 4 weeks’ course of antibiotics, about 10% have prolonged symptoms, which is medically known as “Post-Lyme Disease Syndrome”. This medical term is used to describe nonspecific symptoms (including headache, fatigue, arthralgias [joint pain], musculoskeletal pain, neck pain, backache, difficulty with memory and concentration), that may persist for months after treatment for Lyme disease has finished. Generally, these symptoms improve gradually over a period between six months to one year.

The symptoms you have been experiencing lately are consistent with Post-Lyme Disease Syndrome. While not being reported often, anxiety and depression can also be part of this syndrome. Treatment options include antidepressants medications, some antineuritic drugs (such as pregabalin and gabapentin) analgesics, psychotherapy and alternative medicine. Antibiotics have not been shown as an effective treatment option for this medical condition.

Another possible explanation for your symptoms could be that the anxiety and depression you have been experiencing lately, may be expressed as other symptoms like headache and neck pain, especially in the event of stressful situations. This means that Mixed Anxiety and Depression Disorder could be the main diagnosis and that antidepressant therapy could be the treatment needed. However, it is not that common that for the pain to get worse and that it is the main complaint you have, so I don’t think that anxiety and depression are the cause of it all.

In conclusion, I strongly believe that Post-Lyme Disease Syndrome is more likely, and that you should strongly consider the possibility of seeking a proper medical evaluation so that an antidepressant and antineuritic medication (which have been shown to be the most promising treatments for Post-Lyme Disease Syndrome) can be started. I would also recommend to you to start an alternative treatment like yoga or meditation, that could also help you a lot, have no side effects and that will improve your overall health.

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