scholarly journals High Prevalence of Hypovitaminosis D in Indian Chronic Low Back Patients

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E853-E862
Author(s):  
Dipika Bansal
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Pain Clinic ◽  
Care Hospital ◽  
Low Back

Background: Vitamin D has a significant role to play in bone metabolism and neuromuscular function. Several researchers have indicated that Vitamin D deficiency may be possibly related to chronic musculoskeletal pain including chronic low back pain (CLBP). Objectives: The present study was conducted to determine the prevalence of hypovitaminosis D and its contribution to chronic lower back pain. Study Design: Controlled study Setting: Outpatient pain clinic of tertiary care hospital. Methods: Data presented in this manuscript are from patients who were screened for inclusion in an open label, single arm clinical trial aimed to assess the effectiveness of vitamin D supplementation in patients with CLBP. Consecutive patients visiting the outpatient pain clinic of a tertiary care hospital with a diagnosis of CLBP with or without leg pain were recruited. A visual analogue scale (VAS) was used to measure low back pain intensity, and the Modified Oswestry disability questionnaire (MODQ) was used to measure functional ability. Plasma 25-OHD levels of all patients were measured and the prevalence of hypovitaminosis D was calculated. The multivariate logistic regression model was used to investigate the association between vitamin D deficiency and patient characteristics. Results: A total of 328 patients were included in the study. Mean age of the study population was 43.8 years. Two hundred eighty-two (86%) (men 153/172 [89%], women 129/156 [83%]) of patients had below normal plasma vitamin D levels. Among these, 217 (66%) (men 126 [73%], women 91 [58%]) were found to be deficient and 65 (20%) (men 27 [16%], women 38 [24%]) were had insufficient levels. Multivariate regression analysis found that men were significantly more prone to have deficiency as compared to women (OR = 1.78 (1.10 – 2.88), P = 0.02). We also found a significantly positive relationship between vitamin D deficiency and increased functional disability (OR = 1.53 (1.24 – 1.87), P = 0.01). However, we did not find any relationship with pain severity, presence of other co-morbidities and educational level. Limitations: Not possible to access a good quality data on sun exposure and vitamin D dietary inake dieat in study population. No bone scans were performed. Conclusion: The result of this study provides a message about the high prevalence of hypovitaminosis D in the Indian CLBP population. Clinical guidelines for managing CLBP should include assessment of vitamin D status, together with advice on appropriate vitamin D supplementation in those found to be deficient. Clinical trial registration: CTRI/2014/03/004459 Key words: Chronic low back pain, disability, hypovitaminosis D, India, pain severity, prevalence, vitamin D, visual analogue scale

scholarly journals Assessment of Vitamin D Levels in Patients Presenting With Chronic Low Back Pain at a Tertiary Care Hospital

Cureus ◽  
2020 ◽  
Author(s):  
Mukesh Kumar ◽  
Masroor Ahmed ◽  
Ghulam Hussain ◽  
Muhammad Bux ◽  
Naveed Ahmed ◽  
...  
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Vitamin D Levels

scholarly journals Mapping the Association between Vitamin D and Low Back Pain: A Systematic Review and MetaAnalysis of Observational Studies

2017 ◽  
Vol 7 (20;7) ◽  
pp. 611-640
Author(s):  
Joshua Zadro
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Low Back ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels

Background: Low back pain (LBP) is the highest contributor to disability worldwide, with current intervention strategies only providing small to moderate analgesic effects. The use of vitamin D supplementation for LBP has gained interest due to its proposed anti-inflammatory and neuromodulatory properties. However, it is still unclear whether vitamin D levels differ between those with and without LBP or if vitamin D levels are associated with pain intensity. Objectives: We aim to investigate the association between vitamin D levels and LBP and to determine if vitamin D levels correlate with pain intensity in individuals with LBP. Study Design: This study was conducted in accordance with the guidelines for performing a Metaanalysis and Systematic Review Of Observational Studies in Epidemiology (MOOSE). Methods: We performed electronic database searches combined keywords relating to vitamin D and LBP in MEDLINE, CINAHL, EMBASE, AMED, WEB OF SCIENCE, and SCOPUS from the earliest record to March 2017. Studies were included if they reported any quantitative measure of vitamin D, such as serum 25-hydroxyvitamin D [25(OH)D], with adequate data in patients with and without LBP or adequate data on pain intensity in patients with LBP. No restriction on the type or duration of LBP, nor the age and gender of patients was applied. Two reviewers independently performed the selection of studies, extracted data, and assessed the methodological quality of the included studies using a modified 15-item Downs and Black checklist. Results: After the removal of duplicates and the screening of titles and abstracts, 105 full texts were evaluated. There were 29 articles included in this systemic review (22 entered into a meta-analysis), including 19 cross-sectional studies, 9 case-control studies, and one single-arm surgical trial where the pre-operative data were used in our analyses. The pooled results from 19 studies showed that individuals with LBP were more likely to have vitamin D deficiency (pooled OR = 1.60, 95% CI: 1.20 - 2.12, P = 0.001, n = 19), severe deficiency (pooled OR = 2.08, 95% CI: 1.19 - 3.64, P = 0.010, n = 7), and lower serum concentrations of 25(OH)D (weighted MD = 3.86, 95% CI: 0.20 - 7.52, P = 0.039, n = 12) compared to those without LBP (where “n” is the number of studies). The association between vitamin D deficiency (pooled OR = 1.83, 95% CI: 1.26 - 2.66, P = 0.002, n = 9) or serum 25(OH)D (weighted MD = 7.64, 95% CI: 4.02 - 11.26, P < 0.001, n = 4) and LBP was stronger for women but failed to be statistically significant for men (pooled OR = 1.06, 95% CI: 0.62 - 1.81, P = 0.213, n = 3). In addition, there were strong associations between vitamin D deficiency and LBP in patients < 60 years old (particularly women). We found minimal evidence to support an association between vitamin D levels and pain intensity in patients with LBP. Limitations: We were unable to investigate whether vitamin D deficiency increases the risk of developing LBP as there were no longitudinal studies included in this review. Conclusion: Vitamin D deficiency is associated with LBP, with stronger associations observed in younger women and those with severe levels of deficiency. The association between vitamin D levels and pain intensity is inconsistent. These results may guide the implementation of future studies on vitamin D supplementation for LBP. PROSPERO Registration No: CRD42016046874. Key words: Vitamin D, low back pain, deficiency, pain intensity, serum 25-hydroxyvitamin D, supplementation, cross-sectional study, case-control study

scholarly journals EFFICACY AND TOLERABILITY OF FLUPIRTINE VERSUS TRAMADOL IN THE TREATMENT OF MODERATE CHRONIC LOW BACK PAIN

2019 ◽  
pp. 84-87
Author(s):  
VINEELA KARTHIK NAGURI ◽  
RAVI BABU KOMARAM ◽  
TAMILISETTI VIDYA SAGAR
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Drug Reactions ◽  
Study Results ◽  
Group A ◽  
Group B

Objective: The objective of the study was to assess and compare the efficacy and tolerability of flupirtine versus tramadol in patients with chronic moderate low back pain (LBP). Materials and Methods: A prospective study was conducted in the outpatient department of orthopaedics at tertiary care hospital, Rajamahendravarm. After meeting the inclusion criteria, a total of 60 patients were randomly allocated to tablet flupirtine 100 mg in Group A and tablet tramadol 50 mg in Group B. The efficacy of the study drugs was assessed at baseline and the end of treatment by numerical rating scale11, visual analog scale-100 mm, physician’s, and patient’s global assessment. Statistical analysis was done using paired and unpaired t-test and data were presented as mean±standard deviation. Adverse drug reactions were monitored during the treatment. Results: The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild. Conclusion: Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group.

scholarly journals Vitamin D Deficiency Is Associated with Muscle Atrophy and Reduced Mitochondrial Function in Patients with Chronic Low Back Pain

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Katarzyna Patrycja Dzik ◽  
Wojciech Skrobot ◽  
Katarzyna Barbara Kaczor ◽  
Damian Jozef Flis ◽  
Mateusz Jakub Karnia ◽  
...  
Keyword(s):  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Protein Content ◽  
Vitamin D Deficiency ◽  
Muscle Atrophy ◽  
Mitochondrial Function ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Multifidus Muscle

Recent studies show that vitamin D deficiency may be responsible for muscle atrophy. The purpose of this study was to investigate markers of muscle atrophy, signalling proteins, and mitochondrial capacity in patients with chronic low back pain with a focus on gender and serum vitamin D level. The study involved patients with chronic low back pain (LBP) qualified for posterior lumbar interbody fusion (PLIF). Patients were divided into three groups: supplemented (SUPL) with vitamin D (3200 IU/day for 5 weeks), placebo with normal levels of vitamin D (SUF), and the placebo group with vitamin D deficiency (DEF). The marker of muscle atrophy including atrogin-1 and protein content for IGF-1, Akt, FOXO3a, PGC-1α, and citrate synthase (CS) activity were determined in collected multifidus muscle. In the paraspinal muscle, IGF-1 levels were higher in the SUF group as compared to both the SUPL and DEF groups (p<0.05). In the SUPL group, we found significantly increased protein content for pAkt (p<0.05) and decreased level of FOXO3a (p<0.05). Atrogin-1 content was significantly different between men and women (p<0.05). The protein content of PGC-1α was significantly higher in the SUF group as compared to the DEF group (p<0.05). CS activity in the paraspinal muscle was higher in the SUPL group than in the DEF group (p<0.05). Our results suggest that vitamin D deficiency is associated with elevated oxidative stress, muscle atrophy, and reduced mitochondrial function in the multifidus muscle. Therefore, vitamin D-deficient LBP patients might have reduced possibilities on early and effective rehabilitation after PLIF surgery.

Vitamin D Deficiency and Chronic Low Back Pain in Saudi Arabia

Spine ◽  
2003 ◽  
Vol 28 (2) ◽  
pp. 177-179 ◽  
Author(s):  
Saud Al Faraj ◽  
Khalaf Al Mutairi
Keyword(s):  
Vitamin D ◽  
Saudi Arabia ◽  
Low Back Pain ◽  
Back Pain ◽  
Vitamin D Deficiency ◽  
Chronic Low Back Pain ◽  
Low Back

Vitamin D supplementation attenuates oxidative stress in paraspinal skeletal muscles in patients with low back pain

2017 ◽  
Vol 118 (1) ◽  
pp. 143-151 ◽  
Author(s):  
Katarzyna Dzik ◽  
Wojciech Skrobot ◽  
Damian Jozef Flis ◽  
Mateusz Karnia ◽  
Witold Libionka ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Vitamin D ◽  
Low Back Pain ◽  
Back Pain ◽  
Skeletal Muscles ◽  
Vitamin D Supplementation ◽  
Low Back

scholarly journals A clinical registry of multisystemic presentation of hypovitaminosis D in hospital attendees in Kolkata

2022 ◽  
Vol 13 (1) ◽  
pp. 60-65
Author(s):  
Jayati Roy Choudhury ◽  
Debasmita Bandyopadhyay ◽  
Kheya Mukherjee ◽  
Debojyoti Bhattacharjee
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Age Groups ◽  
Hypovitaminosis D ◽  
The Body ◽  
Care Hospital ◽  
Low Back ◽  
Significant Difference ◽  
Study Population ◽  
Multisystemic Disorders

Background: Vitamin D (Vit D) is a steroid hormone essential for maintaining functional homeostasis in the body. Hypovitaminosis D has been a recognized worldwide problem affecting all age groups and sex. Its prevalence is very high in South Asia. Aims and Objectives: Therefore, this study was aimed to determine the spectrum of presentation of biochemical levels of hypovitaminosis D in Indian population in terms of age, sex, and multisystemic disorders. Materials and Methods: A cross-sectional study carried out on selective study population attending a tertiary care hospital from July 2019 to December 2020 with clinical presentations suspected to arise due to Vit D deficiency. Serum 25OH Vit D level was estimated by chemiluminescence method. Data were analyzed using GraphPad Prism 8. Results: Of the study population (n = 685), average serum 25(OH)D level in females and males was 24.13 ng/ml and 28.59 ng/ml, respectively. Significant difference in mean value of Vit D existed in males and females in the 21–40 years age group (p = 0.0048). Females in the Vit D deficient group (Vit D level<20) mostly presented with mastalgia (20.45%), low back pain (17.61%), and joint pain (11.36%). Common clinical presentation in males with Vit D levels less than 20 ng/ml was diabetes mellitus without CKD (18.34%), non-diabetic CKD (19.27%), and low back pain (16.51%). Conclusion: Low Vit D levels manifest itself as signs and symptoms involving various multisystemic disorders involving different age groups in both sexes. Early recognition and replacement can prevent the progress of complications which Vit D deficiency makes us prone to develop.

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