References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Pain is one of the most common symptoms reported by people living with HIV. It can come from the virus itself, from treatment side effects, from related conditions, or from the same sources that affect everyone — muscle strain, headaches, dental problems. Understanding the cause is the first step to getting relief.
Here’s an overview of pain and HIV, and what help is available.
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Types of Pain in HIV
| Type | Examples | Common Cause |
|---|---|---|
| Neuropathic | Burning, tingling, numbness in hands/feet | HIV neuropathy, older drugs, B12 deficiency |
| Musculoskeletal | Joint pain, muscle aches, back pain | Inflammation, ageing, some ART |
| Headache | Tension headache, migraine | Stress, ART side effects, infections |
| Abdominal | Stomach pain, cramps | ART side effects, infections, liver disease |
| Oral | Mouth sores, dental pain | Thrush, ulcers, dental disease |
When Pain Needs Urgent Attention
- Severe headache with fever, neck stiffness or confusion — could be meningitis
- Chest pain or difficulty breathing
- Severe abdominal pain
- New neurological symptoms (weakness, vision changes)
- Pain preventing you from taking your HIV medication
Pain Management Options
Simple analgesics
- Paracetamol — safe with HIV treatment at standard doses
- Ibuprofen — use occasionally; avoid regular use if on tenofovir (kidney risk)
Neuropathic pain treatments
- Amitriptyline, gabapentin, pregabalin, duloxetine
- Capsaicin cream for localised symptoms
Non-drug approaches
- Exercise — proven to reduce chronic pain
- Physiotherapy
- Mindfulness and relaxation techniques
- Acupuncture (some people find benefit)
- CBT (cognitive behavioural therapy) for chronic pain
What to avoid
- Long-term opioids for chronic non-cancer pain — limited benefit, significant risks
- Unregulated supplements or remedies — may interact with ART
- Ignoring pain — it’s real, it deserves attention
Talking to Your HIV Team
Pain is sometimes under-reported because people assume it’s “just part of having HIV.” It shouldn’t be. Your HIV team can:
- Investigate the cause
- Prescribe appropriate treatment
- Check for drug interactions with pain medication
- Refer to pain specialists if needed
Read more: Neuropathy and HIV | Side effects of treatment | What is HIV?
Frequently Asked Questions
Is pain a normal part of having HIV?
Pain is common but should not be accepted as inevitable. Most pain in HIV has a treatable cause.
Can I take over-the-counter painkillers with my HIV medication?
Paracetamol is generally safe. NSAIDs like ibuprofen should be used cautiously, especially with tenofovir. Check with your HIV pharmacist.
Should I see a pain specialist?
If pain is chronic and not responding to standard treatment, a referral to a pain clinic can be helpful. Ask your HIV team.
Related reading
- Abnormal Genital Discharge and Chlamydia
- Asymptomatic STIs: Silent Infections Explained
- Causes of Painful Sex and How to Treat It
- Cold Sores vs Syphilis Sores: How to Tell the Difference
- Common STI Symptoms in Women
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
