By Greg Arnold, DC, CSCS, March 30, 2009, abstracted from “Prevalence and Clinical Correlates of Vitamin D Inadequacy among Patients with Chronic Pain” in the March 2009 issue of Pain Medicine

Chronic pain permeates all areas of our healthcare system. According to Healthy People 2010, we spend $1.9 trillion on healthcare each year and “much of this spending is for care that controls or reduces the impact of chronic diseases and conditions affecting an aging population.” In 2004, 32% of those 75 years of age and over reported fair or poor health (due to chronic pain), compared with 22% of people age 65–74 and 6% of young adults age 25–44 years (1).

Research has found ways, such as Tai Chi (2), to help improve the quality of life in people with chronic pain. Now a new study (3) has found that helping ease chronic pain may lie in making sure you have enough vitamin D.

A 2007 study showed that “vitamin D [deficiency] may represent an under recognized source of [pain] and impaired neuromuscular functioning among patients with chronic pain” (4). Building on these findings, researchers gathered information on 267 patients with an average age of 48 who were admitted to the Mayo Clinic Rehab center in February 2006, and were patients through December 2006. The patients provided blood samples and also completed a Short Form-36 (5) concerning their chronic pain.

The researchers found that 69 of the 267 patients (26%) had “vitamin D inadequacy” blood levels that were 20 ng/mL or less. Among those 69 patients, 38 of them (55%) used pain medication (morphine) regularly compared to 52% of patients with adequate vitamin D levels (102 of 198 patients). But what differed significantly was the amount of morphine used per day. Patients with inadequate vitamin D blood levels took 48% more morphine per day than those with adequate vitamin D blood levels (133.5 mg per day vs. 70 mg per day).

For the researchers, “The prevalence and clinical correlates identified in this pilot study provide the basis for the assertion that vitamin D inadequacy may represent an under-recognized source of nociception and impaired neuromuscular functioning among patients with chronic pain.”

When it comes to vitamin D intake, research has shown this antioxidant to be beneficial at doses ranging from 400 IU (6) to 700 IU (7) per day. New research has started to recommend 2000 IU per day “for all individuals 12 years and older” and 1000 IU per day for children age 6 months to 11 years (8). No adverse effects of vitamin D have been observed with dosages up to 10,000 IU per day (9, 10).

Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at mailto:PitchingDoc@msn.com or visiting his web site at www.CompleteChiropracticHealthcare.com

Reference:

1. Healthy People 2010 www.healthypeople.gov/
2. Wang, C., J.P. Collet, and J. Lau, The effect of Tai Chi on health outcomes in patients with chronic conditions: a systematic review. Arch Intern Med, 2004. 164(5): p. 493-501
3. Turner MK. Prevalence and Clinical Correlates of Vitamin D Inadequacy among Patients with Chronic Pain. Pain Med 2009; 9(8): 979-984 DOI: 10.1111/j.1526-4637.2008.00415.x
4. Hooten WM. Prevalence and Clinical Correlates of Vitamin D Inadequancy among Patients with Chronic Pain. Abstracft A1380. Presented October 15, 2007 www.asaabstracts.com/strands/asaabstracts/abstract.htm;jsessionid=322B71A1205E5A48DE86C59DD815D36A?year=2007&index=3&absnum=1501
5. Ware JE, Jr., Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30(6):473–83.
6. Pratt T. Bone mass and density response to a 12-month trial of calcium and vitamin D supplement in preadolescent girls. J Musculoskelet Neuronal Interact. 2003 Mar;3(1):63-70
7. Harris SS. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997 Sep 4;337(10):670-6
8. Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007;85: 6–18
9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academies Press; 1997. Available at: www.nap.edu/books/0309063507/html
10. Vieth R. Why the optimal requirement for Vitamin D3 is probably much higher than what is officially recommended for adults. J Steroid Biochem Mol Biol. 2004;89-90:575–579