Vitamin D deficiency and chronic low back pain in Saudi Arabia

Spine (Phila Pa 1976). 2003 Jan 15;28(2):177-9. doi: 10.1097/00007632-200301150-00015.


Study design: Initial assessment involved 360 patients (90% women and 10% men) attending spinal and internal medicine clinics over a 6-year period who had experienced low back pain that had no obvious cause for more than 6 months. The patients ranged in age from 15 to 52 years.

Objectives: To investigate the contribution of vitamin D deficiency as a cause for idiopathic chronic low back pain, to find a simple and sensitive test for screening patients with low back pain for vitamin D deficiency, and to determine the correlation between the vitamin deficiency and pain.

Methods: A biochemical assay of serum calcium, phosphate, alkaline phosphatase, and 25-hydroxy vitamin D level was performed before and after treatment with vitamin D supplements.

Results: Findings showed that 83% of the study patients (n = 299) had an abnormally low level of vitamin D before treatment with vitamin D supplements. After treatment, clinical improvement in symptoms was seen in all the groups that had a low level of vitamin D, and in 95% of all the patients (n = 341).

Conclusions: Vitamin D deficiency is a major contributor to chronic low back pain in areas where vitamin D deficiency is endemic. Screening for vitamin D deficiency and treatment with supplements should be mandatory in this setting. Measurement of serum 25-OH cholecalciferol is sensitive and specific for detection of vitamin D deficiency, and hence for presumed osteomalacia in patients with chronic low back pain.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Alkaline Phosphatase / blood
  • Calcifediol / blood
  • Calcifediol / therapeutic use
  • Calcium / blood
  • Chronic Disease
  • Female
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / drug therapy
  • Low Back Pain / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Mass Screening
  • Middle Aged
  • Phosphates / blood
  • Saudi Arabia
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / drug therapy


  • Phosphates
  • Alkaline Phosphatase
  • Calcifediol
  • Calcium