People living with HIV often experience chronic, or long-term, pain. However, the direct causes of this pain vary. Determining the possible cause of HIV-related pain may help narrow down treatment options, so it’s important to talk about this symptom with a healthcare provider. Some factors that can cause pain include: inflammation and nerve damage caused by the infection; lowered immunity from the effects of HIV on the immune system and side effects of HIV medication, among others.
Pain caused by HIV is often treatable. However, HIV-related pain is often underreported and goes untreated. Being open about this symptom enables healthcare providers to find the direct cause and coordinate a treatment plan for pain that works along with HIV treatment.
Treating chronic pain related to HIV requires a delicate balance between relieving pain and preventing complications. Many HIV medications can interfere with pain medications and vice versa. Also, HIV-related pain can be more difficult to treat than other types of chronic pain.
Healthcare providers consider the following factors when recommending a treatment for HIV-related pain: medications being taken, including over-the-counter drugs, vitamins, supplements, and herbal products. Some medications may heighten pain sensitivity in people with HIV. Because of this, a healthcare provider might first recommend stopping certain medications or reducing the dosage to see if that helps resolve pain. However, a person with HIV should never stop taking any prescription medication without first consulting their healthcare provider.
If stopping or reducing certain medications does not work or is not possible, one of the following pain medications may be recommended: non-opioid pain relievers e.g. tylenol or aspirin. People who want to try these options should talk with a healthcare provider first. Overuse of these medications can cause damage to the stomach, liver, or kidneys. Topical anesthetics, such as patches and creams, can provide some relief in people with mild to moderate pain symptoms. But topical anesthetics can interact negatively with some medications, so a healthcare provider should be consulted before using them.
Opioids can temporarily help relieve symptoms of moderate to severe HIV-related pain. For most people, only a short course of opioids should be used to treat acute worsening of pain. Opioids aren’t recommended for chronic pain.
Many healthcare providers are moving away from opioids due to their high potential for addiction and misuse. However, there are some patients who do receive adequate relief from opioids and do not develop an addiction.
It’s important for a person living with HIV who is experiencing pain to speak to their healthcare provider about it. There are many causes of HIV-related pain. It can be difficult to treat, but relieving it is often possible. A healthcare provider can help identify the factors that are causing pain, which is the first step in finding the right treatment