Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency

Int J Rheum Dis. 2016 Dec;19(12):1255-1262. doi: 10.1111/1756-185X.12960. Epub 2016 Nov 11.

Abstract

Aim: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency.

Method: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3 < 25 ng/mL) were included into the study. Replacement treatments of 50 000 IU/week oral vitamin D3 for 3 months were given to the patients. Patients were assessed pre- and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction.

Results: Fifty-eight patients with a mean age of 36.9 ± 9.2 years were included into the study. 25-OH D3 levels of patients elevated from 10.6 ± 5.1 ng/mL to 46.5 ± 24.0 ng/mL after replacement treatment (P < 0.001). Marked decrease in VAS-pain, VAS-asthenia, severity of waking unrefreshed, TPC, and BDI and an evident increase in subgroups of SF-36 were established in patients after treatment (P < 0.001). The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P = 0.013); 85% of patients stated satisfaction with the treatment.

Conclusions: Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.

Keywords: chronic pain; depression; fibromyalgia; quality of life; vitamin D deficiency.

MeSH terms

  • Adult
  • Alkaline Phosphatase / blood
  • Calcifediol / blood*
  • Calcium / blood
  • Cholecalciferol / adverse effects
  • Cholecalciferol / therapeutic use*
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy*
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology
  • Depression / prevention & control
  • Depression / psychology
  • Dietary Supplements* / adverse effects
  • Female
  • Fibromyalgia / diagnosis
  • Fibromyalgia / drug therapy*
  • Fibromyalgia / physiopathology
  • Fibromyalgia / psychology
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / diagnosis
  • Musculoskeletal Pain / drug therapy*
  • Musculoskeletal Pain / physiopathology
  • Musculoskeletal Pain / psychology
  • Pain Measurement
  • Phosphates / blood
  • Quality of Life
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy*

Substances

  • Phosphates
  • Cholecalciferol
  • Alkaline Phosphatase
  • Calcifediol
  • Calcium