Just like everybody else, people with HIV
will experience some sort of physical pain most days, for all sorts of reasons.
This will usually be mild, go away by itself and not cause any real problems.
However, pain in both the short term
(acute), and long term (chronic), can be severe enough to lower quality of life and
can cause emotional distress.
The causes of pain in people with HIV (just
like in the general population) are varied. Short-term pain can be caused by
infections, injuries, the after-effects of medical procedures, or may
even have no apparent cause. Nevertheless, the pain will usually go as the body
Long-term pain can similarly have a
range of causes. It can be caused by other long-term health problems, including
some relating to age, such as arthritis, or to the chronic effects of an
injury. For people with HIV, there can be long-term pain as a result of the
side-effects of treatment (usually related to older treatments that are no
longer commonly used) or because of damage done before treatment was started.
Some anti-HIV drugs can cause you to feel generally
unwell, involving, for example, muscle pain and headache, but these side-effects
should reduce and go away over time, and can be treated while they are still
A painful longer-term side-effect that can
be caused by older anti-HIV drugs ddI (Videx) and d4T (Zerit)
is called peripheral neuropathy. This involves damage to the
nerves in the feet and lower legs, and occasionally the hands. Neither of these
drugs is used very much now, mainly because drugs that don't cause such
side-effects are now available.
Some protease inhibitors can cause painful
side-effects, for example, stomach cramps. Kidney stones can be a
side-effect of the now rarely used indinavir (Crixivan).
The fat wasting caused by some older anti-HIV
drugs, including AZT (zidovudine, Retrovir)
and d4T (stavudine, Zerit) ,
particularly in the buttocks, can cause discomfort sitting. These drugs are no
longer recommended for routine HIV treatment if other treatment options are
Pain that has minor causes will often go
away quite quickly without you taking any action. However, both acute and
chronic pain can be distressing and disabling, and can also be a warning sign
that you have a serious medical problem. Therefore, it is important to tell
your doctor if you are experiencing distressing or constant pain so he or she
can find out the underlying causes and treat them.
Treating underlying medical problems can
help address pain in the long term. If one of your anti-HIV drugs or other
medicine is causing painful side-effects, it may be possible to change to
medicines that don’t have such side-effects.
Pain-killing medication of varying strengths
can also be used in both the short and long term to control pain. For
short-term pain, aspirin and paracetamol are painkillers available over the
counter without a prescription. Make sure you check for any possible interactions
with your anti-HIV drugs orany other
medication you are on.
If the pain lasts for more than a few days,
or is very severe, see a doctor. Never take more than the recommended daily
dose of any pain medication. Over–the-counter pain medication should be used
very cautiously if you have liver problems.
Managing chronic pain can be more complex.
You might need to receive treatment from a specialist pain clinic, which your
doctor can refer you to.
There’s nearly always a way to control pain.
Talk over your options with your doctor, when you will have an opportunity to
discuss the side-effects of pain medication and possible interactions with
other drugs you are taking.
Physiotherapy can be a good way of providing both short- and long-term solutions to
skeleto-muscular pain – your doctor can provide you with a referral.
Some people find complementary therapies such as acupuncture, massage and osteopathy are helpful. You will probably
have to pay for these, and bear in mind that there may always not be the same
levels of regulation of complementary therapies as there for conventional
Your mood can affect how you experience and cope with pain. Sometimes,
people find that getting help for their emotional wellbeing also helps them
manage physical pain.