Vitamin D and Relevance to Physiotherapy

Reference:Heidari B, et al Association between nonspecific skeletal pain and vitamin D deficiency. Int J Rheum Dis. 2010 Oct;13(4):340-6.

In the past decade there have been a number of studies associating Vitamin D deficiency and non-specific persistent musculoskeletal pain, but it seems that clinicians are still hesitant about recommending blood work to test Vitamin D levels and seem even more hesitant about recommending Vitamin D3 supplements or sunshine to their patients.

This extensive review paper published in the American Journal of Physical Medicine and Rehabilitation concluded that there was a direct correlation between vitamin D deficiency and musculoskeletal pain.

“Vitamin D deficiency should be included in the differential diagnosis in the evaluation of musculoskeletal pain complaints in the rehabilitation setting, and treatment of any identified deficiency should be considered a potentially important component of the treatment regimen.”(Heath et al 2006)

Consider Vitamin D deficiency as a potential contributing factor to chronic pain in…

 

  • Your homebound elderly patients
  • You patients with pigmented skin (i.e. Black or brown skin)
  • Those with cultural and social avoidance of the sun (wearing a veil or long sleeves)
  • Patients with existing GI issues as they may also likely have GI malabsorption of vitamin Dand finally…
  • Those who live in the northern latitude during wintertime, which is all of us in Canada!!!The second paper published in 2010 found that Vitamin D deficiency was very strongly associated with non-specific leg pain (P = 0.0001) and arthralgia (P = 0.0001) and widespread pain (P = 0.0001).

    Also, association was stronger in women than in men (P = 0.001).

    What can we conclude? Based on over 100 studies on the role of Vitamin D and pain, we need to seriously consider its role in some of our patients who are non-responsive to PT interventions.
    Posted on: July 05, 2011

    Categories: Modalities / Meds / Supplements

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