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Michael Carter, Greta Hughson
Published: 06 June 2012

Every day most of us will experience physical pain of some sort. For the most part it will cause only minor discomfort and won’t interfere with day-to-day life, and will go away either of its own accord, after rest, with the use of mild painkillers or with a gentle physical treatment like massage.

However pain in both the short term (acute), and long term (chronic), can be significant enough to lower quality of life, and in severe cases profoundly disrupt your ability to engage in day-to-day activities.

Pain can also cause both short-term and long-term emotional and mental health problems.


The causes of pain in people with HIV are varied. Short-term pain can be caused by infections, surgery or may even have no apparent cause. Nevertheless the pain will go as the body recovers after surgery or the infection heals.

Chronic pain in people with HIV can be caused by infections, cancers, gut problems, and nerve damage, such as peripheral neuropathy.

HIV treatment can also cause side-effects which can be painful. For example, nucleoside reverse transcriptase inhibitors (NRTI) drugs, particularly the older 'd' drugs, ddI (Videx) and d4T (Zerit) can cause a condition called peripheral neuropathy, damaging the nerves in the feet and lower legs, and occasionally the hands. Some protease inhibitors can also cause painful side-effects, including stomach cramps, and kidney stones. The fat wasting caused by some now rarely used anti-HIV drugs (AZT and d4T), particularly in the buttocks, can cause discomfort when sitting. Often people taking anti-HIV drugs report feeling generally unwell, involving, for example muscle pain and headache.

If an anti-HIV drug or other medicine is causing painful side-effects, it may be possible to change to medicines which don’t have such side-effects.

The drugs most commonly used in routine HIV treatment these days are much less likely to cause side-effects like these. If you have concerns about side-effects, it is important to talk to your doctor about them, so you can choose the best treatment for you.

What to do

Pain which 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 of an underlying 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 causes and treat them.

Treating underlying medical problems can help address pain in the long term. If an anti-HIV drug or other medicine is causing painful side-effects, it may be possible to change to medicines which 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. Aspirin, paracetamol and ibuprofen are painkillers available over the counter without a prescription. 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 difficult. 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, and you should 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 a short- and long-term solution to skeleto-muscular pain, and your doctor can provide you with a referral.

Complementary approaches

Acupuncture, massage and osteopathy can relieve pain. Gentle exercise can also be effective for some kinds of pain, as can heat and cold.

Cannabis, an illegal drug, is also sometimes used by people to relieve pain.

Contact NAM to find out more about the scientific research and information used to produce this factsheet.

Talking points

Talking points is designed to help you talk to your doctor about HIV treatment.

Go to Talking points >
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap