While HIV treatment has come a long way, people living with the condition report chronic pain more often than those without HIV. This is true even in people taking antiretroviral therapy (ART).
By Jammie Eske
ART can reduce levels of HIV in the blood to undetectable levels, lengthening a person’s life to that of an average adult. But the virus can still have an impact on the body.
A 2018 study suggests that people living with HIV may be more likely to experience pain than those without, which can have a significant impact on quality of life and daily functioning.
The types of pain depend on the specific cause and may include headaches, joint pain, and abdominal cramping or stomach problems.
Understanding the source of the pain and receiving effective treatment can greatly improve a person’s physical and mental health.
In this article, we discuss the causes and types of HIV-related pain. We also look at the treatment options and suggest home remedies that may help.
Pain in people living with HIV can happen for several reasons.
For those not undergoing treatment for HIV, pain can be a direct result of the virus. HIV targets the immune system, making it harder for the body to fight germs. Without ART, people may get opportunistic infectionsTrusted Source that cause pain and other symptoms.
However, even when treatment successfully suppresses the virus to undetectable levels, people can still develop pain. A 2020 study states that the reasons for this are not well understood, but may be the result of:
- nerve damage, also known as peripheral neuropathy
- chronic inflammation
- drug side effects, although this is more common with older HIV drugs
Previous research has also found that those with HIV who have a history of illicit drug use are more likely to report pain, and are more likely to need higher doses of pain medications to manage it.
Read about the possible complications of HIV here.
HIV-related pain can manifest in a variety of ways. Those with a weakened immune system may experience infections that cause:
- headaches
- body aches
- stomach pain and cramping
Untreated HIV can also damage the peripheral nerves, which can lead to a neurological disorder known as peripheral neuropathy. In people living with HIV, doctors sometimes also refer to this condition as HIV neuropathy.
Peripheral neuropathy is the most commonTrusted Source neurological complication in adults with HIV. According to a 2017 studyTrusted Source, older age and smoking increase a person’s risk of developing peripheral neuropathy.
Some symptoms of peripheral neuropathy include:
- pain in the hands and feet
- muscle weakness in the hands and feet
- numbness or tingling in the extremities
- increased sensitivity to pain
With treatment, HIV still has links to various types of chronic pain, such as muscle and joint pain. This may be more common with age, or in those who previously took older HIV drugs. Some common areas this may affect include the:
- head
- neck
- back
- legs
There are many ways to manage HIV-related pain. Doctors can prescribe medications to reduce painful symptoms, and there are some nondrug options some people find helpful.
The exact treatment plan may vary depending on the cause and type of the pain, but may include a combination of:
ART
When a person takes ART consistently and according to their prescription, it can reduce the amount of the virus in the body to very low or undetectable levels. This reduces the risk of opportunistic infections.
When the viral load becomes undetectable, the virus also cannot spread to other people via sex.
However, some drugs that treat HIV may increase a person’s pain sensitivity or cause uncomfortable side effects. If the side effects are significant, speak with a doctor about ways to address this.
ALSO READ HIV: 7 ways to manage medication side effects
Antimicrobials
Antimicrobials can target opportunistic infections if they occur. Depending on the type of infection, this may include antiviral drugs, antibiotics, or antifungal drugs.
Pain medications
For chronic pain, a person may benefit from pain medications to reduce inflammation or improve quality of life. This could involve trying:
Over-the-counter pain medications
A wide variety of pain medications are available over-the-counter (OTC). Some examples include acetaminophen, aspirin, and ibuprofen. Topical pain medicines, such as gels, creams, or patches, are also available for pain that is in a specific area.
Speak with a doctor before trying OTC medications to check they are suitable and will not interact with HIV treatments.
Prescription nonopioids
If OTC drugs are not helping to reduce pain, a doctor may suggest a prescription drug. First, they may suggest a nonopioid option. These drugs do not contain opioids, meaning they can have less potential for addiction or dependence.
Opioids
Opioids are some of the strongest pain medications available. They are controlled substances available only by prescription. Doctors should only prescribe them when other options have not worked, for the shortest period of time and at the lowest effective dose possible.
Opioids can cause side effects, such as drowsiness, nausea, and constipation. They also have a risk for dependence, addiction, overdose, and progression to the use of illegal opioids, such as heroin.
It is essential to follow the doctor’s instructions when taking opioids to reduce these risks.
Complementary therapies
Other possible ways to relieve or cope with pain include:
- massage
- acupuncture
- physical therapy or yoga
- breathing exercises
- meditation or mindfulness
- pain management courses
- an anti-inflammatory diet
- talk therapies
Some people may benefit from joining a chronic pain support group, as the other members will be able to offer support and understanding. They may also have useful pain relief tips to share.
Always check that any practitioners of complementary therapies are fully qualified, licensed, and operate in a safe way. For example, acupuncture needles should be sterile and single-use.
People with HIV may want to let practitioners know their status before a session. It should not affect the therapy they offer, though.
Some ways to manage HIV-related pain at home include:
- heat therapy, which could involve taking warm baths or using a heat pad
- cold therapy, such as using cold compresses
- getting some gentle exercise
- relaxation techniques, such as meditation
- quitting smoking, if applicable
- limiting alcohol consumption
Some herbal remedies may interact with ART. Due to this, it is best to talk to a healthcare provider before taking any herbal products or supplements.
Read about alternative treatments for HIV here.
Pain is common in those with HIV. It can result from the effects of the virus itself, secondary infections, or other complications.
Some people with undetectable levels of HIV can also experience chronic pain. Scientists are not yet sure why this happens, but it may be due to previous nerve damage, inflammation, or the side effects of some HIV treatments.
Pain is treatable, but it requires an individual approach. Doctors may help to determine the cause of the pain and recommend a treatment plan. This may involve a combination of medications. Some people also benefit from complementary therapies.
