RESEARCH - Chronic pain linked to low vitamin D

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Chronic Pain Linked to Low Vitamin D

March 25, 2009 — Inadequate vitamin D may represent an underrecognized

source of nociperception and impaired neuromuscular functioning, say

researchers.

" Physicians who care for patients with chronic, diffuse pain that

seems musculoskeletal — and involves many areas of tenderness to

palpation — should strongly consider checking vitamin-D level, "

, MD, from the Mayo Clinic in Rochester, Minnesota, said

in a news release issued Friday.

" For example, " he added, " many patients who have been labeled with

fibromyalgia are, in fact, suffering from symptomatic vitamin-D

inadequacy. Vigilance is especially required when risk factors are

present, such as obesity, darker pigmented skin, or limited exposure

to sunlight. "

Dr. was lead investigator of a study published in the journal

Pain Medicine in November 2008. The work suggests a correlation

between inadequate vitamin-D levels and the amount of narcotic

medication taken by chronic pain patients.

Required Nearly Twice As Much Pain Medication

The researchers found that patients who had inadequate vitamin-D

levels and required narcotic pain medication were taking much higher

doses — nearly twice as much — as those with adequate levels. These

patients also reported worse physical function and worse overall

health perception.

Dr. told Medscape Neurology & Neurosurgery his group was

surprised by the finding. " We didn't anticipate that the difference

would be so high. "

The investigators retrospectively studied 267 patients admitted to the

Mayo Comprehensive Pain Rehabilitation Center. They compared serum

25-hydroxyvitamin-D levels at the time of admission with other

parameters such as the amount and duration of narcotic pain medication

used, self-reported levels of pain, emotional distress, physical

functioning, health perception, and demographic information such as

sex, age, diagnosis, and body-mass index.

Patients with vitamin-D levels below 20 ng/mL were considered to have

inadequate amounts. The prevalence of low vitamin D was 26% (95% CI,

20.6% – 31.1%).

Among patients using opioids, the mean morphine-equivalent dose for

the inadequate vitamin-D group was 133.5 mg/day compared with 70.0

mg/day for the adequate group (P = .001). The mean duration of opioid

use for the inadequate and adequate groups was 71.1 months and 43.8

months, respectively (P = .023).

The researchers also observed a link between increasing body-mass

index and decreasing levels of vitamin D.

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