Have lower back pain?

[Nebu]

I wasn't sure where to post this, but ran across the study today while catching up on my journal reading.  Since I've seen quite a few people state that they have lower back problems, I found this particularly topical.

Chronic Pain Linked to Low Vitamin D

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," Michael Turner, 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. Turner 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. Turner 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.

Inadequate Vitamin D May Create or Sustain Pain

The preliminary results suggest that inadequate vitamin D may play a role in creating or sustaining chronic pain. During an interview, Dr. Turner suggested that patients with inadequate vitamin D may benefit from cholecalciferol 50,000 international units dosed according to the level of deficiency.

But he urged caution for patients with calcium- or phosphate-processing disorders. "Increasing vitamin-D levels could be problematic in patients with kidney failure or stones or primary hyperparathyroidism or sarcoidosis. This doesn't preclude increasing levels, but it might warrant discussion with an endocrinologist," he said.

For patients with adequate vitamin D looking to maintain levels, he recommends10 to 15 minutes of sun exposure with no sunscreen on the trunk and arms and legs 3 times a week.

Sun Exposure or Diet and Supplements?

It is a recommendation often made by proponents of vitamin D but hotly contested by the American Academy of Dermatology. The academy recommends that vitamin D be obtained from a healthy diet and supplements and not from unprotected exposure to ultraviolet (UV) radiation.

"Unprotected UV exposure to the sun or indoor tanning devices is a known risk factor for the development of skin cancer," dermatologists write in the academy's position statement.

Dr. Turner and his team conclude: "Prospective trials utilizing a repeated-measures design are warranted to assess the effects of vitamin-D repletion on pain outcomes and physiological measures of neuromuscular functioning among patients with chronic pain and comorbid vitamin-D inadequacy."

[rattran]

10-15 minutes of full body sun exposure 3 times a week? That may be as much as I get in a couple months. Guess I'll just keep taking vitamin pills.

[Yegolev]

This is incredibly relevant to my wife's laundry-list of ailments.  Many thanks for posting.

[NowhereMan]

I'm not sure that Vitamin D works supplements wise, it's become a more prevalent health concern recently since you need a certain amount of UV exposure and in most of Northern Europe that can only really happen for about 6 months of the year (the rest of they year you have to last out on the stuff you generate then). It's an issue because of the number of darker skinned immigrants who need to spend more time exposed to sunlight in order to generate and more especially muslim women in those communities who really don't do a lot of tanning.

Basically though if you're getting out of the house for a couple of hours a couple of times a week during the summer you should be ok (especially if you're freakishly pale basement dwellers ))

Of course I'm not really familiar with all the ins and outs but I read about it in the paper

[Nebu]

There are versions of vitamin D available by prescription that are in the active form (renal or hepato-renal metabollites).  This makes access to the sun a lot less important.  Of course, they aren't available over-the-counter either. 

[Hawkbit]

So this week the sun is OK? 

Pistachios are out, I hear.

[Yegolev]

This makes access to the sun a lot less important.

Applying this information retroactively to various scenarios in which my wife mysteriously felt much, much better leads me to believe that the amount of sunlight required is not huge in her case.  I doubt a prescription would be necessary for her if she would just go outside frequently.

[Nebu]

Well, I hope that she finds something that at least alleviates some of her discomfort.  Lower back (or any back) pain is a miserable thing.

[Yegolev]

It's mostly a pain that very closely resembles bursitis.  Comes on about twenty minutes after she goes to bed.  Recent scans reveal her bursars aren't really that bad.  She did not have this leg pain during the week we were in WDW a few weeks ago, nor when we went to Biltmore last fall and spent time outdoors, and she didn't have it over the weekend we spent in AZ back in 2007.  Aggregating a few more examples creates a suggestion that sunlight could be the commonality.  Previously I was blaming the stress of work/family but that did not hold in every case.  Stress does affect her various pains, but it's probably not the primary agent.

[WayAbvPar]

I take a vitamin every morning, drink lattes several times a week, and eat enough cheese to choke a horse. Pretty sure my lower back pain is due to my being a giant fat ass.

[Yegolev]

Or not pooping.

[schild]

Or not pooping.

Both are a brutal combination.

[FatuousTwat]

The only time I've ever had (chronic) back pain in my life is when I was using a shitty chair at my PC. Getting a new one = best money I ever spent.

[shiznitz]

Unless Vitamin D cures minor scoliosis, I am still fucked.