The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 4: PainTable 4-1: Classification of PainNociceptive Pain26 picas• Results from stimulation of intact ‘nociceptors’ (pain receptors)• Includes: somatic pain (involving skin, soft tissue, muscle, bone); visceral pain (involvinginternal organs, hollow viscera)• Responds to opioid and non-opioid analgesicsNeuropathic Pain• Results from stimulation of damaged or compromised nerve tissue• Responds to opioid and non-opioid analgesics AND adjuvant medicationsSummary of Pain Syndromes in HIV/AIDSPain syndromes encountered in AIDS are diverse in nature and etiology (see Table 4-2). The mostcommon pain syndromes reported in studies to date include painful sensory peripheral neuropathy,pain due to extensive Kaposi’s sarcoma, headache, oral and pharyngeal pain, abdominal pain, chest4, 6, 8, 10, 12, 15, 16, 17, 18pain, arthralgias and myalgias, and painful dermatologic conditions.Table 4-2: Pain Syndromes and Most Common Pain DiagnosesPain Type N % Patients (n=151)Somatic pain 107 71Neuropathic pain 69 46Visceral pain 44 29Headache 69 46Pain DiagnosisJoint pains 47 31Polyneuropathy 42 28Muscle 40 27Skin 23 15Bone 31 20Abdominal 25 17Chest 19 13Radiculopathy 18 12Source: Reprinted with permission from Hewitt D, McDonald M, Portenoy R, et al. Pain syndromes and etiologies in ambulatoryAIDS patients. Pain 70:117-23, 1997.86U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau