Treatment for Black Widow Spider Bites

Initial Assessment and First Aid

• Black widow spider bites cause severe crampy pain, muscle rigidity, diaphoresis, and hypertension, and typically do not cause local tissue injury, though a rash is sometimes observed around the bite site 1
• Seek medical care if pain extends beyond the bite site, becomes severe, is not controlled by over-the-counter pain medications, or if systemic symptoms develop, such as difficulty breathing, muscle rigidity, dizziness, or confusion 2

First-Line Treatment Options

• First aid treatment involves localized wound care and over-the-counter analgesics for pain 1
• Over-the-counter acetaminophen and nonsteroidal anti-inflammatory agents can be used to alleviate local pain 3
• If the skin is intact, topical lidocaine can be useful for pain relief 3
• Ice application can be useful for local pain relief 3

Special Considerations

• The very young, very old, and those with underlying health conditions may be at higher risk for severe reactions 1

Common Pitfalls to Avoid

• Delaying medical care when systemic symptoms are present, such as difficulty breathing, muscle rigidity, dizziness, or confusion 1, 2
• Underestimating the severity of envenomation based solely on local findings at the bite site 1