Back pain associated with less than 40 ng vitamin D – March 2013

Vitamin D levels appear to be normal in Danish patients attending secondary care for low back pain and a weak positive correlation between serum level Vitamin D and Modic changes was demonstrated: a cross-sectional cohort study of consecutive patients with non-specific low back pain

BMC Musculoskeletal Disorders, Volume 14, March 2013
Jannick Vaaben Johansen, Claus Manniche and Per Kjaer

Background:Hypovitaminosis D has previously been reported in both the general population, in people with chronic musculoskeletal pain, and in people with low back pain (LBP). Myopathy-related symptoms such as diffuse bone and muscle pain, weakness and paresthesia in the legs, have also been observed in people with non-specific LBP and associations with low levels of Vitamin D have been suggested. The objectives of this study were to investigate (1) Vitamin D levels in patients seeking care for LBP in a Danish out-patient secondary care setting, and (2) their possible relationship with myopathy-related symptoms, Body Mass Index (BMI), and Modic changes.

Methods: A total of 152 consecutive patients with non-specific LBP participated in a cross-sectional study. Participants were recruited at The Spine Centre of Southern Denmark during springtime 2011. Individual serum levels of 25-Hydroxyvitamin-D were determined using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Information about symptoms, height, and weight were collected from electronic questionnaires completed by the participants. All patients had an MRI from which Modic changes were identified. Correlations between Vitamin D level and pain, paresthesia, weakness in the legs, BMI or Modic changes were described using correlation coefficients and odds ratios obtained from logistic regression.

Results:Two-thirds of the included patients with LBP had normal Vitamin D levels of >50 nmol/L.
No correlations were seen between Vitamin D deficiency and gender, age, back pain intensity, leg pain intensity, and duration of pain.
Statistically significant, but low, correlation coefficients were found between Vitamin D levels and BMI as well as Modic changes.
Low Vitamin D levels and Modic changes were statistically significantly associated with an odds ratio of 0.30 (95% CI 0.12;0.75) while weakness, paresthesia and widespread pain were not.

Conclusions: In patients seeking care for low back pain in a Danish outpatient clinic, Vitamin D deficiency was not common.
Whether patients who are overweight or who have Modic changes might represent subgroups of people for whom their LBP may be associated with Vitamin D levels, needs further investigation.

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Provisional PDF is attached at the bottom of this page

See also VitaminDWiki

• Overview Pain and Vitamin D
• Back pain reduced for 95 percent of those who took vitamin D - 2003 PDF file
  5,000 - 10,000 IU vitamin D3 intervention
• Back pain gone and grew 3 inches with vitamin D - Dec 2010
• Vitamin D reduced skeletal pain in 85 percent of the patients – Nov 2012
• All items in category Back pain and Vitamin D 44 items

See also web

• Modic Changes Wikipedia
  Modic changes can only be seen on a magnetic resonance imaging, an MRI.
  Modic changes were first described and separated into 3 different types of changes by Dr. Michael Modic in 1988.
  Studies have shown that patients with Modic changes are rather different from other patients with normal back pain. For example 75 –80 % of patients suffering from Modic changes have constant pain, which means they do not ever have a pain-free moment day or night. There might be fluctuations in the intensity, but no break from the pain. 75% of the patients also suffers from pain during the night, and many wake up during the night because it is painful to turn in bed.
• Overweight/obesity and vitamin D deficiency contribute to the global burden of low back pain
  April 2014 no abstract, PDF costs $35