Pain Medicine DOI: 10.1111/pme.12454
Roland von Känel MD1,2,*, Veronika Müller-Hartmannsgruber MD1, Georgios Kokinogenis MD1 andNiklaus Egloff MD1,2
1Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
2Department of Clinical Research, University of Bern, Bern, Switzerland
*Reprint requests to: Roland von Känel, MD, Department of General Internal Medicine, Inselspital, Bern University Hospital, CH-3010, Bern, Switzerland. Tel: +41 31 632 20 19; Fax: +41 (0)31 382 11 84; E-mail: roland.vonkaenel at insel.ch.
Low vitamin D is implicated in various chronic pain conditions with, however, inconclusive findings. Vitamin D might play an important role in mechanisms being involved in central processing of evoked pain stimuli but less so for spontaneous clinical pain.
This study aims to examine the relation between low serum levels of 25-hydroxyvitamin D3 (25-OH D) and mechanical pain sensitivity.
We studied 174 patients (mean age 48 years, 53% women) with chronic pain. A standardized pain provocation test was applied, and pain intensity was rated on a numerical analogue scale (0–10). The widespread pain index and symptom severity score (including fatigue, waking unrefreshed, and cognitive symptoms) following the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia were also assessed. Serum 25-OH D levels were measured with a chemiluminescent immunoassay.
Vitamin deficiency (25-OH D < 50 nmol/L) was present in 71% of chronic pain patients; another 21% had insufficient vitamin D (25-OH D < 75 nmol/L). After adjustment for demographic and clinical variables, there was a mean ± standard error of the mean increase in pain intensity of 0.61 ± 0.25 for each 25 nmol/L decrease in 25-OH D (P = 0.011). Lower 25-OH D levels were also related to greater symptom severity (r = −0.21, P = 0.008) but not to the widespread pain index (P = 0.83) and fibromyalgia (P = 0.51).
The findings suggest a role of low vitamin D levels for heightened central sensitivity, particularly augmented pain processing upon mechanical stimulation in chronic pain patients. Vitamin D seems comparably less important for self-reports of spontaneous chronic pain.
an example of a visual pain scale chart
IF increasing vitamin D can reduce pain sensitivity, then an increase of about 30 ng would be needed to make a significant difference (2 units)
- Overview Pain and Vitamin D
- Blacks had lower vitamin D and more quantifiable pain than whites with knee osteoarthritis – Nov 2012 this study also found more sensitivity to pain with lower D
The TOP articles in Pain and Vitamin D are listed here:
- Low Level Laser Therapy greatly increased Vitamin D and Magnesium (for diabetics with nephropathy) – March 2019
- Fibromyalgia pain substantially reduced by weekly Vitamin D (50,000 IU) – June 2018
- Trigger points (myofascial pain) may be associated with low Vitamin D and low Magnesium – Jan 2018
- Fibromyalgia treated with Vitamin D (50,000 IU weekly for 3 months) – 2016, 2017, 2018, 2019
- Fibromyalgia pain reduced with vitamin D intervention that achieved 30-48 ng – RCT Feb 2014
- Vitamin D at CureTogether: Fibromyalgia, MS, Psorasis, etc - Dec 2013
- 7 improvements in lives of veterans with chronic pain with 50,000 IU vitamin D weekly – June 2012
April 2013 Unpublished results from www.grassrootshealth.net/index.php/documentation