iBet uBet web content aggregator. Adding the entire web to your favor.
iBet uBet web content aggregator. Adding the entire web to your favor.



Link to original content: https://doi.org/10.1007/s10067-016-3205-1
Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis | Clinical Rheumatology Skip to main content

Advertisement

Springer Nature Link
Log in

Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis

  • Letter to the Editor
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Chronic nonspecific musculoskeletal pain (CNMP) is an idiopathic condition often seen in general practice and rheumatology clinics, the aetiology of which may include vitamin D deficiency. The objective of the present study is to evaluate the effectiveness of vitamin D supplementation in the management of CNMP through a systematic review and meta-analysis. According to PRISMA guidelines, PubMed, Embase, Web of Science, Cochrane and Scopus electronic databases were searched for randomised controlled trials comparing vitamin D supplementation to a control or placebo in CNMP patients; the search was not limited by language or date. Meta-analysis was performed using the mean and standardised mean difference which was computed with 95 % confidence intervals, and overall effect size was calculated. Both fixed and random effects models were used in meta-analysis to account for heterogeneity in the studies. The initial search identified 107 studies, of which 10 were potentially relevant, with 7 studies excluded because they did not meet selection criteria. Three studies were included in the meta-analysis. We found no effect of vitamin D supplementation (standardised mean difference (SMD) 0.004; 95 % confidence interval (CI) −0.248 to 0.256) on pain in CNMP patients. Forest plot is used to present the results from meta-analysis. Contrary to a widespread clinical view, there is a moderate level of evidence that vitamin D supplementation is not helpful for treating CNMP patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kumar A, Gopal H, Khamkar K et al (2012) Vitamin D deficiency as the primary cause of musculoskeletal complaints in patients referred to rheumatology clinic: a clinical study. Indian J Rheumatol 7:199–203

    Article  Google Scholar 

  2. O’Sullivan P, Beales D, Jensen L, Murray K, Myers T (2011) Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study. Pediatr Rheumatol Online J 9:3

    Article  PubMed  PubMed Central  Google Scholar 

  3. de Vries HJ, Reneman MF, Groothoff JW, Geertzen JHB, Brouwer S (2012) Factors promoting staying at work in people with chronic nonspecific musculoskeletal pain: a systematic review. Disabil Rehabil 34:443–58

    Article  PubMed  Google Scholar 

  4. Konijnenberg AY, Uiterwaal CS, Kimpen JL, van der Hoeven J, Buitelaar JK, Graeff-Meeder ER (2005) Children with unexplained chronic pain: substantial impairment in everyday life. Arch Dis Child 90:680–6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Guite J, Logan D, Sherry D, Rose J (2007) Adolescent self-perception: associations with chronic musculoskeletal pain and functional disability. J Pain 8:379–86

    Article  PubMed  Google Scholar 

  6. de Vries HJ, Reneman MF, Groothoff JW, Geertzen JH, Brouwer S (2013) Self-reported work ability and work performance in workers with chronic nonspecific musculoskeletal pain. J Occup Rehabil 23:1–10

    Article  PubMed  Google Scholar 

  7. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133:581–624

    Article  PubMed  Google Scholar 

  8. Perquin C, Hunfeld J, Hazeborek-Kampschreur A et al (2003) The natural course of chronic benign pain in childhood and adolescence: a two-year population-based follow-up study. Eur J Pain 7:551–9

    Article  PubMed  Google Scholar 

  9. Perquin C, Hunfeld J, Hazeborek-kampschreur A et al (2001) Insights in the use of health care services in chronic benign pain in childhood and adolescence. Pain 94:205–13

    Article  CAS  PubMed  Google Scholar 

  10. El-Metwally A, Salminen JJ, Auvinen A, Kautiainen H, Mikkelsson M (2004) Prognosis of non-specific musculoskeletal pain in preadolescents: a prospective 4-year follow-up study till adolescence. Pain 110:550–9

    Article  PubMed  Google Scholar 

  11. Plotnikoff GA, Quigley JM (2003) Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 73:1463–70

    Article  Google Scholar 

  12. Tague SE, Clarke GL, Winter MK, McCarson KE, Wright DE, Smith PG (2011) Vitamin D deficiency promotes skeletal muscle hypersensitivity and sensory hyperinnervation. J Neurosci 31:13728–38

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Lai Y-H, Fang T-C (2013) The pleiotropic effect of vitamin D. ISRN Nephrol Article ID 898125

  14. Zittermann A (2003) Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr 89:552–72

    Article  CAS  PubMed  Google Scholar 

  15. Lyman D (2005) Undiagnosed vitamin D deficiency in the hospitalized patient. Am Fam Physician 71:299–304

    PubMed  Google Scholar 

  16. Body JJ, Bergmann P, Boonen S et al (2012) Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications. Osteoporos Int 23(Suppl 1):S1–23

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chaudhary WA, Arshad SH, Waqas S et al (2013) Vitamin D supplement as an adjuvant in the management of chronic musculoskeletal pain. Anaesth Pain Intensive Care 17:296–300

    Google Scholar 

  18. Knutsen KV, Brekke M, Gjelstad S, Lagerløv P (2010) Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scand J Prim Health Care 28:166–71

    Article  PubMed  PubMed Central  Google Scholar 

  19. Straube S, Derry S, Straube C, Moore RA (2015) Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev

  20. Guyatt G, Gutterman D, Baumann MH et al (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest 129:174–81

    Article  PubMed  Google Scholar 

  21. Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PloS 6

  22. Jadad AR, Moore A, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  CAS  PubMed  Google Scholar 

  23. Cohen J (2013) Statistical power analysis for the behavioral sciences. Academic Press

  24. Glass GV (1976) Primary, secondary, and meta-analysis of research. Educ Res 5:3–8

    Article  Google Scholar 

  25. Hedges LV, Olkin I (2014) Statistical method for meta-analysis. Academic press

  26. Higgins PT, Green S (2008) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester, England

    Book  Google Scholar 

  27. StataCorp (2011) Stata Statistical Software: Release 12. StataCorp LP, TX

    Google Scholar 

  28. Bailey KR (1987) Inter-study differences: how should they influence the interpretation and analysis of results. Stat Med 6:351–60

    Article  CAS  PubMed  Google Scholar 

  29. Sakalli H, Arslan D, Yucel AE (2012) The effect of oral and parenteral vitamin D supplementation in the elderly: a prospective, double-blinded, randomized, placebo-controlled study. Rheumatol Int 32:2279–83

    Article  CAS  PubMed  Google Scholar 

  30. Schreuder F, Bernsen RM, van der Wouden JC (2012) Vitamin D supplementation for nonspecific musculoskeletal pain in non-western immigrants: a randomized controlled trial. Ann Fam Med 10:547–55

    Article  PubMed  PubMed Central  Google Scholar 

  31. Warner AE, Arnspiger SA (2008) Diffuse musculoskeletal pain is not associated with low vitamin D levels or improved by treatment with vitamin D. J Clin Rheumatol 14

  32. Gendelman O, Itzhaki D, Makarov S, Bennun M, Amital H (2015) A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus 24:483–9

    Article  CAS  PubMed  Google Scholar 

  33. Guyatt G, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Br Med J 336:924

    Article  Google Scholar 

  34. Grace PM, Hutchinson MR, Maier SF, Watkins LR (2014) Pathological pain and the neuroimmune interface. Nat Rev Immunol 14:217–31

    Article  CAS  PubMed  Google Scholar 

  35. Woolf CJ (2014) What to call the amplification of nociceptive signals in the central nervous system that contribute to widespread pain? Pain 155:1911–2

    Article  PubMed  Google Scholar 

  36. Moseley GL, Vlaeyen JWS (2015) Beyond nociception: the imprecision hypothesis of chronic pain. Pain 156:35–8

    Article  PubMed  Google Scholar 

  37. Vlaeyen JWS, Linton SJ (2012) Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 153:1144–7

    Article  PubMed  Google Scholar 

  38. Moseley GL, Butler DS (2015) Fifteen years of explaining pain: the past, present, and future. J Pain 16:807–13

    Article  PubMed  Google Scholar 

  39. Butler DS, Moseley GL (2013) Explain pain, 2nd edn. Noigroup Publications, Adelaide

    Google Scholar 

  40. Meulders A, Harvie DS, Bowering JK, Caragianis S, Vlaeyen JW, Moseley GL (2014) Contingency learning deficits and generalization in chronic unilateral hand pain patients. J Pain 15:1046–56

    Article  PubMed  Google Scholar 

  41. Ryan PJ (2007) Vitamin D therapy in clinical practice. One dose does not fit all. Int J Clin Pract 61:1894–9

    Article  CAS  PubMed  Google Scholar 

  42. Moseley GL (2006) Do training diaries affect and reflect adherence to home programs? Arthritis Rheum 55:662–4

    Article  PubMed  Google Scholar 

  43. Abbasi M, Hashemipour S, Hajmanuchehri F, Kazemifar AM (2013) Is vitamin D deficiency associated with non specific musculoskeletal pain? Glob J Health Sci 5

  44. O’Connell NE, Moseley GL, McAuley JH, Wand BM, Herbert RD (2015) Interpreting effectiveness evidence in pain: short tour of contemporary issues. Phys Ther 95:1087–94

    Article  PubMed  Google Scholar 

  45. Pop LC, Shapses SA, Chang B, Sun W, Wang X (2015) Vitamin D-binding protein in healthy pre- and postmenopausal women: relationship with estradiol concentrations. Endocr Pract 21:936–42

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kanwar G, Sharma N, Shekhawat M, Sharma P, Hada R, Chandel CS (2015) Comparison of vitamin D levels in pre and post menopausal type 2 diabetic females. IOSR-JDMS 14:70–3

    Google Scholar 

  47. Kendall JM (2003) Designing a research project: randomised controlled trials and their principles. Emerg Med J 20:164–8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Sim J, Reid N (1999) Statistical inference by confidence intervals: issues of interpretation and utilization. Phys Ther 79:186–95

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

MG is funded by Australian Postgraduate Award for her PhD. MNM is funded by John Lynch’s NHMRC Australian Fellow funding (ID 478115). GLM is supported by a Principal Research Fellowship from the NHMRC ID 1061279.

Author information

Authors and Affiliations

  1. Discipline of General Practice, School of Medicine, University of Adelaide, Level 11, Terrace Towers, 178 North Terrace, Adelaide, 5005, Australia

    M. Gaikwad, S. Vanlint & N. Stocks

  2. School of Public Health, University of Adelaide, Level 7, Terrace Towers, 178 North Terrace, Adelaide, 5005, Australia

    M. Mittinity

  3. Sansom Institute for Health Research, University of South Australia, Centenary Building C5-7, City East Campus, Adelaide, 5000, Australia

    G. L. Moseley

Authors
  1. M. Gaikwad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Vanlint
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Mittinity
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. L. Moseley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N. Stocks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Gaikwad.

Ethics declarations

Conflict of interest

MG, SV, MM and NS declare that they have no conflict of interest. GLM—Noigroup Publications royalties, speaker’s fees and Pfizer consultancy. This research received no grant from any funding agency in the public, commercial or not-for-profit sectors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaikwad, M., Vanlint, S., Mittinity, M. et al. Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis. Clin Rheumatol 36, 1201–1208 (2017). https://doi.org/10.1007/s10067-016-3205-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3205-1

Keywords

Search

Navigation