People with human immunodeficiency virus (HIV) often experience chronic pain. Treatment is possible, but initial treatments aren’t always fully successful.
Don’t suffer from HIV-related chronic pain in silence. Seek treatment. Work with your doctor to find a treatment that helps you.
People who are HIV-positive may experience chronic pain because of the infection. HIV causes disability and can interfere with a person’s quality of life as it advances.
Several HIV-related issues can impact a person’s pain, including:
- inflammatory response caused by the infection
- complications of poorly managed HIV
- side effects of medication
- damage caused by HIV medication
- lowered immunity
Pain caused by HIV is often treatable. However, HIV-related pain is often underreported, untreated, or ineffectually treated. Even in patients being treated for pain, treatments may not be as effective as they should be.
This may be due to biases of providers, social stigmas about potent painkillers, or pre-existing addiction issues. It can also be due to a generally poor appreciation for the many painful HIV-associated conditions that don’t have obvious physical correlates.
Work with your doctor to find a treatment plan that addresses your pain without worsening any disease-related complications.
Treating chronic pain is a delicate balance between finding a treatment that helps and one that doesn’t cause additional problems. This fine line can be exceptionally thin for people with HIV. Many HIV medications can interfere with pain medications. Also, HIV-related pain can be more difficult to treat than other cases of chronic pain.
Reasons that HIV pain may be difficult to treat include:
- complicated medication interactions
- high risks of complications and side effects from medications
- increased rates of psychiatric illnesses
- increased rates of substance abuse
- complex drug regimens that rule out some possible pain treatments
Avoiding Problematic Medication Combinations
Certain medications may actually heighten pain sensitivity in people who are HIV-positive. Stopping these medications may stop the progression of HIV-related pain and reverse the pain level. If you can’t stop using the medication, work with your doctor to reduce the dosage. This may lower your pain level.
Treating HIV-related pain must take into account:
- your current medicine treatment plan
- your risk for side effects or complications
- your history of complications
These factors may influence the type of pain medicine treatment you can use. Below are the most common treatments for HIV-related pain.
Antiretroviral therapy. HIV-positive people who aren’t using any type of highly active antiretroviral therapy (HAART) may find that they have less pain once they begin treatment.
Nonopioid pain relievers. Mild analgesics, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), can be used to treat mild symptoms of pain. But be careful. Overuse of these medications can cause damage to the liver and kidneys.
Opioids. Long-acting narcotic opiate medications can help relieve symptoms of moderate to severe HIV-related pain. These medicines include oxycodone, methadone, and morphine.
Opioids lead to physical dependence with regular use and they can be addictive. Treatment with opioids may be problematic for some people. Doctors who prescribe opioids to HIV-positive people should take great care to monitor the person’s use. People who take opioids to treat their chronic pain should also be aware of the likelihood to form addictions to the medicine.
Topical anesthetics. Patches and creams can provide some pain relief in people with mild to moderate pain symptoms. Topical anesthetics can interact negatively with some medications, so talk with your doctor before you begin using them.
HIV can damage your peripheral nerves over time. In fact, peripheral neuropathy is one of the most frequent neurological complications of an HIV infection, according to The Peripheral Nerve Center at Johns Hopkins. HIV can impact your sensory nerves, motor nerves, autonomic nerves, and cranial nerves, preventing them from responding as quickly as they once did. Neuropathy can also cause you pain and discomfort.
Symptoms of HIV neuropathy include:
- numbness in your extremities
- unusual or unexplainable sensations in your hands and feet
- painful sensation after non-painful stimuli
- muscle weakness
- tingling in your extremities
HIV neuropathy can be diagnosed by your doctor. To reach a diagnosis, your doctor will conduct a thorough medical history. They will want to know the symptoms you’re experiencing, when they started, and what — if anything — makes them better or worse. Your doctor may order one or more laboratory or imaging tests to rule out other possible causes of your symptoms.