Vitamin D Supplementation for Chronic Low Back Pain

In a study performed by Ghana B., et al. the value of vitamin D supplementation was assessed in patients with chronic low back pain (CLBP). A high prevalence of hypovitaminosis D (50-90%) was observed in the study group, attributed to low dietary intake, skin color, and “changing lifestyle”, despite ample sunlight. The patients (18-75 year olds) had CLBP for <-3 months, and were not responding to medical or physical therapies. Their pain score was >- 50 on a 0 – 100 visual analog scale, and the mean baseline of vitamin D was 12.8 ng/mL.

This study involved two phases; an induction phase and a maintenance phase. In the induction patients received a dose of 60,000 IU of vitamin D3 orally each week for 8 weeks. In those patients with vitamin D levels <5mg/mL, 60,000IU/day of vitamin D3 was administered once daily for the initial 5 days, then they received supplementation as noted above for eight weeks. After the initial 8-week induction phase, if the vitamin D remained below 29 ng/mL, the regimen was repeated. In the maintenance phase patients were given 60,000IU/month for six months. Following six months of therapy two-thirds of the group achieved normalization of vitamin D. A significant reduction in pain scores were also observed, as well as improved disability, which increased over the six months. Serum vitamin D levels increased significantly, to 36.07 post supplementation (p<0.01). Of the group 45 (66%) attained normal vitamin D levels (>29ng/mL), while 18 (27%) remained insufficient and 5 (7%) remained deficient.

Although a single-arm, open-label study, without concomitant assessment of medication use, this study demonstrated an improvement in pain and disability with vitamin D supplementation in patients with CLBP.

Ghai B, Bansal D, Kanukula R, Gudala K, Sachdeva N, Dhatt SS, Kumar V. Vitamin D Supplementation in Patients with Chronic Low Back Pain: An Open Label, Single Arm Clinical Trial. Pain Physician. 2017; 20:E99-E105 • ISSN 2150-1149