Low vitamin D and the risk of developing chronic widespread pain: results from the European male ageing study
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This study measured vitamin D levels in more than 2300 older European men in good health and then checked up on them a few years later. If they had low vitamin D at the beginning, they were more likely to have chronic widespread pain later. However, that connection got much weaker when they eliminated obese and depressed patients from consideration. Obesity and depression are known, confirmed risk factors for chronic pain. The study concluded: “Low vitamin D is linked with the new occurrence of chronic widespread pain, although this may be explained by underlying adverse health factors, particularly obesity and depression.”
This study is one about a dozen others investigating a link between chronic pain and vitamin D deficiency, reviewed by Hsiao et al. Notably, in most studies the link is clear even after adjusting for other factors.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: The association between low levels of vitamin D and the occurrence of chronic widespread pain (CWP) remains unclear. The aim of our analysis was to determine the relationship between low vitamin D levels and the risk of developing CWP in a population sample of middle age and elderly men.
METHODS: Three thousand three hundred sixty nine men aged 40-79 were recruited from 8 European centres for a longitudinal study of male ageing, the European Male Ageing Study. At baseline participants underwent assessment of lifestyle, health factors, physical characteristics and gave a fasting blood sample. The occurrence of pain was assessed at baseline and follow up (a mean of 4.3 years later) by shading painful sites on a body manikin. The presence of CWP was determined using the ACR criteria for fibromyalgia. Serum 25-hydroxyvitamin D (25-(OH) D) was assessed by radioimmunoassay. Logistic regression was used to determine the relationship between baseline vitamin D levels and the new occurrence of CWP.
RESULTS: Two thousand three hundred thirteen men, mean age 58.8 years (SD = 10.6), had complete pain and vitamin data available and contributed to this analysis. 151 (6.5%) developed new CWP at follow up and 577 (24.9%) were pain free at both time points, the comparator group. After adjustment for age and centre, physical performance and number of comorbidities, compared to those in upper quintile of 25-(OH) D ( ≥36.3 ng/mL), those in the lowest quintile (<15.6 ng/mL) were more likely to develop CWP (Odds Ratio [OR] = 1.93; 95% CI = 1.0-3.6). Further adjustment for BMI (OR = 1.67; 95% CI = 0.93-3.02) or depression (OR = 1.77; 95% CI = 0.98-3.21), however rendered the association non-significant.
CONCLUSIONS: Low vitamin D is linked with the new occurrence of chronic widespread pain, although this may be explained by underlying adverse health factors, particularly obesity and depression.
related content
- “Is Serum Hypovitaminosis D Associated with Chronic Widespread Pain Including Fibromyalgia? A Meta-analysis of Observational Studies,” Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Der-Sheng Han, and Tyng-Guey Wang, Pain Physician, 2015.
- “Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis,” Zhenqiang Wu, Zarintaj Malihi, Alistair W Stewart, Carlene Mm Lawes, and Robert Scragg, Pain Physician, 2016.
These two articles on PainScience.com cite McCabe 2016 as a source:
- PS Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- PS Vitamin D for Pain — Is it safe and reasonable for chronic pain patients to take higher doses of Vitamin D? And just how high is safe?
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.