First Comprehensive Guidelines for Chronic Pain in HIV

[Jim Allen]

I live with pain, so I know pain management is very personal and differs per person and there is no one size fits all solution however there are solutions, key is finding what works for you / your pain.



Full story:
http://www.medscape.com/viewarticle/885670

First Comprehensive Guidelines for Chronic Pain in HIV
Veronica Hackethal, MD September 14, 2017

The HIV Medicine Association (HIVMA) of the Infectious Disease Society of America (IDSA) has issued the first comprehensive guidelines for managing chronic pain in people living with HIV.

The guidelines, published online September 14 in Clinical Infectious Diseases, recommend that everyone living with HIV be screened for chronic pain. People who screen positive should be offered multidisciplinary treatment focused on nondrug therapies.

"It has been long known that patients with HIV/AIDS are at high risk for pain, and for having their pain inadequately diagnosed and treated," Peter Selwyn, MD, MPH, said in a news release. Dr Selwyn was cochair of the guidelines committee and is affiliated with Albert Einstein College of Medicine, Bronx, New York.
Between 39% and 85% of people living with HIV experience chronic pain, the authors note. And pain represents the second most common symptom for which patients with HIV seek care in outpatient settings. Because chronic pain has been linked to poor adherence to antiretroviral therapy (ART), treating chronic pain may be important for disease management, as well as quality of life.

However, pain often goes undertreated among people living with HIV. In particular, women, people with low socioeconomic status, and injection drug users often do not receive adequate pain management. Moreover, many patients do not have access to pain specialists.
To counter these issues, the IDSA stresses that all providers who care for patients with HIV should be familiar with chronic pain management.

[kentfrat1783]

Hi Jim,

Sorry to ask an odd questions but how are you tested for pain?  Is it a blood test or a survey type thing that is done?  Or is it a side effects of the Rx's that give the pain?  Just with such a high percentage I'm sure I'll be one of the lucky ones.   

Yes I am new to all of this and just didn't expect this would be coming down the road.  Just want to be aware prior to something potentially happening.   

Thanks,
Kenneth

[Jim Allen]

Its a fair question as such, however I will say I am not buying the high numbers quoted in this study and the pain i live with is not HIV related.

Anyhow to answer the question, in my case nerve conduction testing, this next to clinical observation, see my pain is nerve damage related.

http://www.webmd.com/brain/electromyogram-emg-and-nerve-conduction-studies#1 
http://www.nhs.uk/Conditions/Peripheral-neuropathy/Pages/Diagnosis.aspx

I had surgery resulting in nerve damage, the damage and the pain is not HIV related, the reason that I however had surgery is because my HIV was untreated for so long and this is in part my own fault ... No, I must correct myself "It is my own fault"

Anyhow pain can be diagnosed differently depending what type of pain you are experiencing and the area that is affected. It also differs on diagnosis standard set by the nation or state you are in, for me as example in Ireland to gain treatment a lower standard of proof or testing is needed however if i was to claim disability over the same condition i am treated for, I would need to jump through additional hoops.

Jim

[Jim Allen]

Poz is covering this topic as well:

https://www.poz.com/article/first-guidelines-issued-treating-chronic-pain-people-hiv