Various forms of pain are more common among people living with HIV. The types of pain related to HIV depend on the specific causes and can include headaches, joint pain, and abdominal cramping.

Pain can have a profound effect on people’s overall quality of life and daily functioning. It is important that healthcare providers identify causes of pain in people with HIV and try to find effective treatments for them.

Research has found that even though effective antiretroviral therapy is now available, people living with HIV are more likely to report pain than those without HIV.

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.

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There are different causes of HIV-related pain, and the type, location, and severity of the pain can vary among individuals.

HIV is a virus that targets the immune system, which protects the body from infection and disease. Without treatment, the immune system gradually becomes less able to fight infections.

Short-term pain can result from various secondary infections, injuries, or surgery. This pain usually goes away once the body recovers, and effective treatments and care can speed up recovery.

Many people who are living with HIV experience chronic or long-term pain. In one study that followed 238 people living with HIV, 53% of the participants reported having had chronic pain within the last 6 months. The most common primary pain sites included the joints and back.

Chronic pain in people living with HIV can be the result of:

  • the direct effects of HIV on the body
  • nerve damage, also known as peripheral neuropathy
  • opportunistic infections
  • a side effect of HIV treatments

Read about opportunistic infections and possible complications of HIV here.

HIV-related pain manifests in a variety of ways. People living with HIV can experience pain as a result of the virus itself or as a side effect of HIV treatment and other medications.

People with untreated HIV are at risk of developing secondary infections that can cause inflammation and painful symptoms.

Types of pain that commonly affect people with HIV include:

  • Headache: Pain can range from mild to severe and may present as intense pressure, tightness, or a throbbing sensation. Low CD4 cell counts, infections, or other HIV-related illnesses can cause headaches.
  • Joint, muscle, and bone pain: HIV can be associated with arthritis and osteoporosis, both of which can cause pain in the joints, muscles, and bones. This type of pain can also occur with aging.
  • Stomach pain: Without treatment, HIV can weaken the immune system, leaving the body vulnerable to opportunistic infections. These infections sometimes occur in the gastrointestinal tract, causing painful symptoms, such as inflammation and stomach pain. Some HIV treatments can also cause painful abdominal cramps.

HIV can 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 common neurological complication in adults with HIV. According to one study, older age and smoking increase a person’s risk of developing peripheral neuropathy.

Some symptoms of peripheral neuropathy include:

  • numbness or pain in the hands and feet
  • muscle weakness in the hands and feet
  • numbness or tingling in the extremities
  • increased sensitivity to pain

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There are many ways to manage HIV-related pain. Doctors can prescribe medications to reduce painful symptoms.

People living with HIV can also purchase over-the-counter (OTC) pain relievers, but they should speak with their doctor before starting any new medications or supplements. Nonmedicinal therapies and home remedies may also provide relief for some people.

Specific treatments can target the symptoms and causes of opportunistic infections. Depending on the type of infection, these can include antiviral drugs, antibiotics, or antifungal drugs.

We discuss the different types of treatments below:

Antiretroviral therapy

When a person takes antiretroviral therapy consistently and according to their prescription, it can reduce the amount of the virus in the body to very low levels.

When the viral load becomes undetectable, the virus no longer damages the immune system, and it cannot spread to other people.

Taking antiretroviral therapy consistently can help keep the body healthy and reduce the risk of any opportunistic infections, which can prevent various causes of pain.

Pain medications

Some drugs that treat HIV can increase a person’s pain sensitivity or cause uncomfortable side effects. If the side effects are intolerable, a healthcare provider may change the person’s medication. They may also recommend prescription or OTC pain relievers.

Pain medication options include:

Non-opioid medications

A wide variety of non-opioid pain relievers are available both OTC and by prescription. Common examples include acetaminophen, aspirin, and ibuprofen. Topical pain relievers, such as gels, creams, or patches, are also available.

Opioids

As these are the strongest type of pain medication, they are only available by prescription. Opioids can cause side effects, such as drowsiness, nausea, and constipation. It is essential to follow the doctor’s instructions when taking opioids to prevent complications and overdose.

Nonmedicinal therapies

Other possible ways to relieve pain include:

Some people may also 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.

Home remedies

Some ways to manage HIV-related pain at home include:

  • practicing relaxation techniques, such as meditation and mindful breathing exercises
  • applying hot and cold compresses to the affected area
  • taking warm baths when necessary
  • engaging in regular physical activity
  • identifying and reducing the causes of stress
  • limiting alcohol consumption
  • quitting smoking, if applicable

Some herbal remedies may interact with antiretroviral drugs. Due to this, it is best to talk to a healthcare provider before taking any herbal or natural remedies.

Read about alternative treatments for HIV here.

Pain is a common symptom of HIV, and it is different for everyone. Pain can result from the effects of the virus itself, as well as from complications of HIV and side effects of HIV treatment.

Pain is treatable, but it requires an individualized approach. Healthcare providers can determine the cause of the pain and recommend a treatment plan. This plan may involve adjusting current HIV treatments or taking prescription pain relievers.

Home remedies and alternative therapies, such as acupuncture and massage, may also help people manage pain.

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