A) Yes, Lyme causes inflammation in various places in the body. The immune system wants to get rid of the bacteria, thus an inflammatory response is launched. Also, the damage Lyme inflicts on the body causes an inflammatory response as part of the healing process. And some believe also that Lyme triggers an autoimmune response to specific tissues (such as joints/connective tissue) in the body.
B) Some foods seem to promote inflammation, such as dairy protein, gluten (wheat/rye/barley/oats) and nightshades (potatoes, tomatoes, sweet & hot peppers, eggplant, etc. - see http://www.whfoods.com/genpage.php?tname=george&dbid=62 for a more complete list). A low glycemic index diet (i.e., low intake of simple sugars/carbohydrates) may help reduce inflammation in many autoimmune disorders (Diabetes, Lupus, Inflammatory Bowel Disease, etc.).
C) I use heat primarily for any muscle stiffness, joint pain, etc. because it helps in my case. Cold / ice always seems to make me feel worse. Magnesium supplements also seem to help.
D) I have chronic inflammation, proven by a chronically elevated Sed Rate (Erythrocyte Sedimentation Rate - a generic marker for inflammation in the body) I've had since 2005 (and intermittantly prior to that). I get inflammation in my joints, gut, and sometimes elsewhere...and I suspect I also have inflammation in my blood vessels and/or nervous system. Yes, sometimes the inflammation is painful. Antibiotics do help some, but this has been around for such a long time for me that I think it will take more than a few weeks of abx to get past this. I also know my food allergies play a role because I have such a limited diet that it is hard to eat the anti-inflammatory foods (fresh fruits & vegetables, foods high in Omega 3 fatty acids, etc.) and I also don't absorb nutrients well from my diet but there aren't enough IV forms of these nutrients to help me at this point...still working out how to get what I need in the right amounts.
To answer the "how long one needs to be on abx" question, there is no one pat answer that can be applied to everyone with Lyme. Every person's case of Lyme is unique - there are too many variables that affect how severely the person is impacted by the Lyme, and thus each treatment must be customized to the individual. So if you have been on abx for 3 months and are still experiencing pain, then obviously you need further treatment. And there may be some additional things you need to do to help, such as diet modification, anti-inflammatory medications and/or herbs, exercise, etc. This is something you and your doctor must work out, though - it needs to be customized to your individual uniqueness.
I hope this helps - take care,
Chronic Lyme Disease, Chronic Bartonella (clinical dx only), Gluten & Sulfite Sensitivity, Many Food/Inhalant/Medication/Chemical Allergies & Intolerances, Asthma, Gut issues (dysmotility, non-specific inflammation), UCTD ("Secondary Lupus-Like Syndrome"), Osteoporosis, chronic Lymphopenia, etc.; G-Tube; Currently weaning off TPN.
Meds: Pulmicort, IV Doxycycline, Heparin (to flush PICC line), Claritin, Singulair, Domperidone, Colloidal Silver (topically & nasally), probiotics, Liver support herbs, Ailanthus, digestive enzymes, homeopathy.