Why Lidocaine Is Gaining Attention in the Fight Against Long COVID

More than 400,000 people in the Netherlands still grapple with lingering post‑COVID symptoms such as brain fog, post‑exertional malaise (PEM) and chronic neuropathic pain. Recent observations from a private pain clinic suggest that a century‑old local anesthetic—lidocaine—might dramatically ease these complaints.

From Operating Rooms to Home Injections

For decades lidocaine has been used to numb tissue during surgery. Clinicians at Excellent Care Clinics in Velsen‑Noord repurposed the drug for long‑COVID sufferers by allowing patients to administer tiny sub‑cutaneous doses themselves. The approach bypasses frequent clinic visits and puts control in the hands of the patient.

What the First Real‑World Data Show

An observational cohort of 103 severely affected patients reported an 80 % improvement rate after four weeks of self‑injection. Symptoms ranged from slight relief to complete disappearance, according to lead researcher Wendy Scholten‑Peeters, professor at Vrije Universiteit Amsterdam.

Key outcomes included:

  • Reduction of 28 out of 30 tracked symptoms (e.g., neuropathic burning, cognitive fog, over‑stimulation).
  • Average illness duration before treatment: 2.5 years.
  • All‑cause quality‑of‑life scores rose by an average of 30 % (measured with the EQ‑5D‑5L).

Cost, Accessibility, and Insurance Gaps

Each lidocaine dose costs roughly €27 and must be taken multiple times daily, pushing the monthly bill past €3,000. Because the therapy is still classified as experimental, Dutch health insurers do not reimburse it. This financial barrier raises questions about equitable access once larger trials confirm efficacy.

Future Trends Shaping Post‑COVID Care

1. Large‑Scale Randomised Controlled Trials (RCTs)

Governments and private foundations are earmarking funds for RCTs that will compare lidocaine to placebo and to other emerging treatments like low‑dose naltrexone and antivirals. Expect results from multinational studies within the next 24‑36 months.

2. Personalized Medicine & Biomarker‑Guided Therapy

Researchers are hunting for blood‑based biomarkers (e.g., cytokine signatures, auto‑antibodies) that predict who will respond best to lidocaine. Tailoring dosage to individual neuroinflammatory profiles could cut costs and boost success rates.

3. Home‑Delivery Platforms and Tele‑Monitoring

Digital health startups are already developing apps that remind patients of injection times, record symptom scores, and transmit data to clinicians in real time. Integration with wearable devices (heart‑rate variability, sleep trackers) will enable “closed‑loop” adjustments of lidocaine dosing.

4. Insurance Reform and Reimbursement Pathways

As evidence mounts, health insurers in the EU and North America are likely to introduce conditional coverage—similar to the pathways used for chronic pain pumps—requiring documented symptom improvement before full reimbursement.

5. Cross‑Therapeutic Synergy

Combination protocols pairing lidocaine with graded exercise therapy, cognitive rehabilitation, or nutritional interventions (e.g., omega‑3 fatty acids) are being piloted. Early case series hint that multimodal regimens may prevent relapse after drug discontinuation.

Did You Know?

Unlike systemic painkillers, lidocaine works locally on sodium channels in nerve fibers, reducing painful signaling without the sedative side‑effects of opioids.

Pro Tip for Patients Considering Lidocaine

Start low, go slow. Begin with a 0.5 mg/kg sub‑cutaneous dose under medical supervision, track your symptoms daily, and only increase the dose if side‑effects (e.g., mild local irritation) are absent.

Frequently Asked Questions

Is lidocaine safe for long‑term use?
When administered in low, sub‑cutaneous doses the drug has a strong safety record. Monitoring liver function and local skin reactions is recommended every three months.
<dt>Can I purchase lidocaine over the counter?</dt>
<dd>No. In most countries lidocaine for injectable use is prescription‑only. Self‑administration should only follow a physician’s protocol.</dd>

<dt>How quickly can I expect relief?</dt>
<dd>Patients in the pilot study reported noticeable improvement within 5‑7 days, with maximal benefit after 3‑4 weeks.</dd>

<dt>Will lidocaine cure long COVID?</dt>
<dd>Current evidence suggests it can *significantly reduce* neuropathic and fatigue‑related symptoms, but it is not a universal cure. Ongoing research aims to identify which sub‑groups benefit most.</dd>

<dt>Is this treatment covered by health insurance?</dt>
<dd>Not yet in most markets. Coverage may become available once large‑scale RCTs demonstrate definitive efficacy.</dd>

Where to Learn More

Explore related articles on our site for deeper insight:

Take Action

If you or someone you know is struggling with post‑COVID symptoms, talk to a qualified pain specialist about the possibility of lidocaine therapy. Share your experience in the comments below, and subscribe to our newsletter for real‑time updates on the emerging science of long COVID.