Pain is common in people living with HIV or what is called as HIV+ people. Pain can occur at all stages of HIV disease and can affect many parts of the body including the facial area  As the disease progresses, pain usually becomes more severe, but each individual person is different. While some people may experience a lot of pain, others have little or none.

Why Pain? 
The pain related with HIV maybe a symptom of HIV itself or an infection. It may also be a side effect of drugs being used. Whatever the cause, the pain should be evaluated and treated to enable the patient to have a good quality of life. 

Types of Pain seen 
The management of HIV related pain begins with the identification of pain and if possible by understanding the cause of pain.  Some of the conditions that affect the facial region are:

 ▪ Neuropathies or pain due to nerve damage. Nerve damage can be caused by HIV itself, HIV drugs, or other medical conditions such as diabetes. Facial nerve paralysis is more common in immuno-compromised people than in immuno-competent individuals. Idiopathic facial nerve palsy is the most common diagnosis given for HIV-infected patients. The cause is an infection by Herpes Simplex Virus (HSV). Herpes Zoster infection also may occur (Ramsay Hunt Syndrome) causing damage to the sensory component of Facial Nerve.

 • Various types of skin lesions (Herpetic infections, dermatitis etc.) are seen also presenting symptoms of HIV infection. The herpes simplex or zoster may cause big rashes on facial skin. 

 • Headache– Head pain can be mild to severe, and may be described as pressure, throbbing, or a dull ache. The most common causes of mild headaches include muscle tension, flu-like illness, and HIV drug side effects. Moderate or severe headaches can be caused by sinus pressure, tooth infections, brain infections, brain tumors, bleeding in the brain, migraines, or strokes.

 • TMJ Joint Pain – This pain can also be mild to severe. It may be related to conditions such as arthritis, bone disease, injury, or just aging. It can also be a side effect of some HIV drugs and medications for other conditions like hepatitis or high cholesterol.

 • Herpes Pain– Herpes is a family of viruses common in people living with HIV. Herpes viruses stay in the body for life, going into hiding and flaring up later. The varicella-zoster herpes virus first causes chickenpox and later can cause shingles, a painful rash along nerve pathways. Herpes simplex virus types 1 and 2 cause painful blisters around the mouth ("cold sores") or genital area. Even after a herpes sore heals, a person may still have persistent pain.

 • Other Types
 ◦ Painful skin rashes due to infections or side effects of HIV drugs or other drugs
 ◦ Frequent fungal infections  
 ◦ Mouth pain caused by ulcers ("canker sores") 
 ◦ Fibromyalgia or related chronic pain conditions
 ◦ Pain due to different types of cancer

Seeking help:

You may be having pain and do not want to complain about it. Or perhaps you do not want to talk about your pain because you are afraid to know what is causing it. However, pain is your body's way of telling you that something is wrong.

Talking to your doctor about how you feel & find out what is wrong and get the right treatment. Your doctor will assess the pain by your description of its severity and quality etc. So, its important to share all the details with your doctor in the history. 
Pain Management

Once the type and characteristics of pain are identified, you can understand from your doctor on the options about how to manage or treat it. There are medicinal and alternative therapies for it.
Pain relief options without medications include:
 • Massage
 • Relaxation techniques, such as meditation
 • Physical therapy
 • Acupuncture or acupressure
 • Heat and cold therapy
 Regular physical activity

What to Do if You Have Pain

When you experience pain, it is important to know how to get fast, safe relief.

 • Do not ignore your pain – Pain is the body's way of telling us something is wrong. Ignoring pain often makes matters worse and can cause more damage in the long run.

 • Assess your pain – When pain occurs ask yourself the following questions:
 ◦ How long have I had the pain?
 ◦ Did it happen suddenly or over time?
 ◦ Is the pain sharp or dull?
 ◦ What makes the pain worse?
 ◦ Does anything ease the pain?
 ◦ Is the pain limited to one place or does it spread out to other areas?
 ◦ Are there other symptoms (for example numbness, cough, or fever)?
 • Report  it all to your doctor pain He needs it to decide how best to treat you.

 •  Pain medications work best if started early on. Trying to be tough is not of much use. 

Pain is common among people living with HIV. However, it can be managed using a variety of methods. Communication is the key so if you are having pain, talk to your doctor. He or she can work with you to find the cause, manage the pain, and improve your quality of life.