Vitamin D for the treatment of chronic painful conditions in adults

Abstract

Background This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2010) on 'Vitamin D for the treatment of chronic painful conditions in adults'. Vitamin D is produced in the skin a er exposure to sunlight and can be obtained through food. Vitamin D deficiency has been linked with a range of conditions, including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic painful conditions. Objectives To assess the e icacy and safety of vitamin D supplementation in chronic painful conditions when tested against placebo or against active comparators. Search methods For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to February 2015. This was supplemented by searching the reference lists of retrieved articles, reviews in the field, and online trial registries. Selection criteria We included studies if they were randomised double-blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic painful conditions in adults. Data collection and analysis Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. We did not undertake pooled analysis due to the heterogeneity of the data. Primary outcomes of interest were pain responder outcomes, and secondary outcomes were treatment group average pain outcomes and adverse events. Main results We included six new studies (517 participants) in this review update, bringing the total of included studies to 10 (811 participants). The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, the dose of vitamin D given, co-interventions, and the outcome measures reported. Only two studies reported responder pain outcomes; the other studies reported treatment group average outcomes only. Overall, there was no consistent pattern that vitamin D treatment was associated with greater e icacy than placebo in any chronic painful condition (low quality evidence). Adverse events and withdrawals were comparatively infrequent, with no consistent di erence between vitamin D and placebo (good quality evidence).

Association of self-reported symptoms with serum levels of vitamin D and multivariate cytokine profile in healthy women

“…Several studies have reported positive associations between serum levels of vitamin D or its supplementation and well-being,1–9,21–23 while others have shown a minor or no relation 33–35. The controversy goes further to question if vitamin D deficiency has anything to do with patients’ complaints and symptoms, or whether these are simply related to poor diet and reduced sunlight exposure 36…”

“…Several studies have reported the prevalence of severe hypovitaminosis D in patients with persistent, nonspecific self-reported musculoskeletal pain,2,20 which was relieved in the majority of patients by vitamin D supplementation 21–23. Certain pro-inflammatory cytokines, such as IL-1β, IL-6, and TNF-α have also been suggested to be involved in the process of pathological pain 14,17…”

A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain

“…[15][16][17][18][19][20][21][22][23][24][25] Despite the understanding of these needs, many patients believe that their current therapy is unsatisfactory; in recent surveys it was shown that 28% of patients suffering from chronic pain reported that their therapy was insufficient, and almost 80% mentioned that better modalities should be pursued. 26,27 Therefore there is much research effort invested in new agents which are safe and more efficacious.…”

Supplements und Injektionen bei Arthrose und Knorpelschäden

“…Eine aktuelle Metaanalyse belegt einen Zusammenhang zwischen einem insuffizienten Vitamin-D-Serumspiegel und der Arthroseprogression bei Gonarthrose [10]. Daneben belegt ein systematisches Cochrane-Review die signifikante klinische Wirksamkeit bei der Schmerzreduktion [43]. Die tägli-che Aufnahme von 15-20 μg/Tag ist für die Erhaltung des normalen Spiegels erforderlich.…”