HIV-Related Pain

Table of Contents

• Introduction
• What Causes Pain?
• Common Types of Pain
• Assessing Pain
• Pain Management
• What to Do if You Have Pain

Introduction

Pain is common in people living with HIV (HIV+ people). One study found that more than half of HIV+ women had pain in the last six months. Pain can occur at all stages of HIV disease and can affect many parts of the body. Usually pain occurs more often and becomes more severe as HIV disease progresses. But each individual is different. While some people may experience a lot of pain, others have little or none.

What Causes Pain?

HIV related pain may be:

• A symptom of HIV itself
• A symptom of other illnesses or infections
• A side effect of HIV drugs

Regardless of its cause, pain should be evaluated and treated to help HIV+ people have a good quality of life.

Common Types of Pain

The first step in managing HIV related pain is identifying the type, and if possible, the cause of pain. Some common types of pain include the following:

• Peripheral Neuropathy -- Pain due to nerve damage, mostly in the feet and hands. It may be described as numbness, tingling, or burning. Nerve damage can be caused by HIV drugs or other medical conditions such as diabetes. The older HIV drugs that caused the most peripheral neuropathy are not commonly used today.

• Abdominal Pain -- There are many possible causes of abdominal pain (pain in the stomach area):
  • A side effect of some HIV drugs (for example, cramps)
  • Infections caused by bacteria or parasites
  • Problems of the intestinal tract such as irritable bowels
  • Inflammation of the pancreas (pancreatitis) can caused by some HIV drugs, high levels of fat in the blood, or drinking alcohol
  • Bladder or urinary tract infections (especially in women)
  • Menstrual cramps or conditions of the uterus, cervix, or ovaries
• Headache -- Head pain can be mild to severe, and may be described as pressure, throbbing, or a dull ache. The most common causes of mild headaches include muscle tension, flu-like illness, and HIV drug side effects. Moderate or severe headaches can be caused by sinus pressure, tooth infections, brain infections, brain tumors, bleeding in the brain, migraines, or strokes.
• Joint, Muscle, and Bone Pain -- This pain can also be mild to severe. It may be related to conditions such as arthritis, bone disease, injury, or just aging. It can also be a side effect of some HIV drugs and medications for other conditions like hepatitis or high cholesterol.
• Herpes Pain -- Herpes is a family of viruses common in HIV+ people. Herpes viruses stay in the body for life, going into hiding and flaring up later. The varicella-zoster herpes virus first causes chickenpox and later can cause shingles, a painful rash along nerve pathways. Herpes simplex virus types 1 and 2 cause painful blisters around the mouth ("cold sores") or genital area. Even after a herpes sore heals, a person may still have persistent pain.
• Other Types
  • Painful skin rashes due to infections or HIV drug side effects
  • Chest pain caused by lung infections such as TB, bacterial pneumonia, or PCP pneumonia (Pneumocystis pneumonia)
  • Mouth pain caused by ulcers ("canker sores") or fungal infections like thrush
  • Fibromyalgia or related chronic pain conditions
  • Pain due to cancer anywhere in the body