The Role Of Vitamin D In Pain

According to a 2006 National Center for Health Statistics Report: 76.5 million Americans have some form of musculo-skeletal pain (statistics here). That is fully 1/4 of the population. The National Institute of Arthritis and Musculo-Skeletal and Skin Diseases advocates taking time off and over the counter pain relievers. (report here)

While this strategy is easy to follow it is not clinically effective. Treating musculo-skeletal pain in the clinic can be very frustrating. Common modalities used are electric stimulation to ease muscle spasm, acupuncture, spinal manipulation, topical creams and herbs such as turmeric and ginger to reduce inflammation. But the darling of any protocol involving musculo-skeletal pain is the ever underestimated Vitamin D.

We all think of Vitamin D as the nutrient added to milk to enhance bone growth in children and to prevent rickets. Often overlooked is the role Vitamin D plays in Cancer, diabetes, obesity, schizophrenia, autoimmune diseases and Most definitely musculo-skeletal pain.

Research shows the epidemic of Vitamin D deficiency is widespread with 40% of the population showing deficiency upon random blood testing. 76% of all pregnant mothers are severely vitamin D deficient. This may account for the increase in type 1 diabetes, multiple sclerosis and arthritis we see in the general population.(reported here)

in the December 2003 Mayo Clinic Proceedings, there was an interesting Study on the incidence of musculo-skeletal pain and low vitamin D. They found that 92% of patients complaining of musculo-skeletal pain had lowered vitamin D levels. And 100% of the patients with darker skin pigmentation had low Vitamin D. (here)

How is this possible? How does vitamin D deficiency cause pain? Published in the same edition of the journal of Mayo Clinic Proceedings, the means by which vitamin D causes pain is detailed (here):

1. Low Vitamin D causes us to absorb less calcium from our diet
2. The Parathyroid gland draws calcium from bone to maintain correct levels of blood calcium
3. The Parathyroid gland increases the urinary loss of phosphorus.
4. Without phosphorus the body makes an un-mineralized type of collagen to surround bone.
5. Un-mineralized collagen swells when hydrated. This swelling presses against pain receptors in the joint causing the symptoms of musculo-skeletal pain.

The impact of vitamin D in my treatment of low back pain has been nothing short of amazing. Patients who tried everything from injection therapy to back surgery have had complete resolution of symptoms with vitamin D supplementation.

Is It Right For You?
Vitamin D is a Fat Soluble vitamin meaning it must be taken with caution. Overdosing vitamin D via sunlight exposure is impossible, but through oral supplements it is very possible and dangerous. In order to establish a correct diagnosis of low vitamin D I order a simple blood test. The test is covered by insurance and is very accurate. The test lets us plan on how long and how much Vitamin D would be effective.

If you feel you may have a vitamin D deficiency I strongly recommend you see your physician (preferably a Naturopath) and get tested. Vitamin D is inexpensive, and very available. One of the brands I prefer is Metabolic Maintenance. It is prescription grade and one of the best prices on the market-Metabolic Maintenance Vitamin D-3, 2000 IU - 120 Capsules