Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial – Source: Annals of Family Medicine, Nov-Dec 2012

[Note: the free full text of this study is available here. The researchers note that: 1) muscle cells have vitamin D receptors; 2) darker complected immigrants living in the relatively low-sun Netherlands are often vitamin D deficient; and 3) many of them, like the patients in this study, are prone to ‘unexplained’ muscle pain/weakness by comparison with lighter skinned residents.]

Purpose: Many non-Western immigrants [to the Netherlands] report musculoskeletal pains that are hard to treat. We studied the effect of high-dose vitamin D3 on nonspecific persistent musculoskeletal complaints in vitamin D-deficient non-Western immigrants and assessed correlation of pain patterns with benefit.

Methods: We conducted a semi-crossover randomized controlled trial between February 2008 and February 2010 in primary care in 84 non-Western immigrants [from the Middle East, Turkey, Northern Africa and Somalia] visiting their general practitioner for nonspecific musculoskeletal pain.

• At baseline, patients were randomized to placebo or vitamin D (150,000 IU vitamin D3 orally);

• At week 6, patients in the original vitamin D group were randomized a second time to receive vitamin D (again) or to switch to placebo,

• Whereas patients in the original placebo group were all switched to vitamin D. The main outcome was self-assessed change in pain after the first 6 weeks.

Results:

• Patients in the vitamin D group were significantly more likely than their counterparts in the placebo group to report pain relief 6 weeks after treatment (34.9% vs 19.5%, P = .04).

• The former [vitamin D group] were also more likely to report an improved ability to walk stairs (21.0% vs 8.4%, P = .008).

• Pain pattern was not correlated with the success of treatment.

• In a nonsignificant trend, patients receiving vitamin D over 12 weeks were more likely to have an improvement than patients receiving it over 6 weeks.

Conclusions: There is a small positive effect 6 weeks after high-dose vitamin D3 on persistent nonspecific musculoskeletal pain. Future research should focus on longer follow-up, higher supplementation doses, and mental health.

Source: Annals of Family Medicine, Nov-Dec 2012. Schreuder F, Bernsen RMD, van der Wouden JC. Department of General Practice, Erasmus MC, Rotterdam, The Netherlands; Department of Community Medicine, United Arab Emirates University, United Arab Emirates. [Email: fschreuder01@planet.nl]

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