When it comes to the management of chronic pain one of the nutrients I consider in many cases is vitamin D. The idea that there was a link between chronic pain and vitamin D levels came from a paper I read a decade ago (Faraj, 2003) outlining the relationship between non-specific low back pain and vitamin D deficiency. Since then numerous research papers have look at the association between vitamin D levels and various types of chronic pain. I have also in that time, used vitamin D in many cases as part of chronic pain treatment to help improve pain outcomes.
I am really happy to report that a recent systematic review of 19 different randomised controlled trials has been published in the journal Pain Physician supporting the use of vitamin D supplementation to reduce pain scores in those with pain conditions and further suggesting it could have a role in the overall management of chronic pain. Woohoo!
A limitation noted by the researchers of this review is that currently there isn’t enough data to identify the different doses required for pain management, and indeed I have found this to be quite individual in clinic, with some clients requiring significantly more than others. Another important consideration with treatment is establishing a baseline level before treatment because as is often the case, both too much and too little can impact on outcomes.
Supplementation of vitamin D is often necessary where pain is chronic, however, vitamin D is also known as the sunshine nutrient and time spent outside is well spent for topping up or maintaining levels. Exposure to UVB rays is required for the production of vitamin D within the skin. The length of exposure depends on skin colour, the amount of skin exposed, where you live and the time of year. To establish how long you need to spend in the sun for vitamin D production, check out this basic guide.
Due to the variation in the sun’s intensity summer is a perfect time to top up your vitamin D levels. You don’t need to get burnt to achieve this effect and in Australia we need to balance the risk of sun cancer with maintaining good levels of vitamin D. Five (fair skin) to ten minutes (darker skin) is usually enough between 10am and 3pm.
You can also get some of the vitamin D you need from food. Food sources of vitamin D include fatty fish, dairy products, liver, cheese and egg yolks.
For more information about pain management please contact me here or read about my pain management program.
Al Faraj, S. and Al Mutairi, K., 2003. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine, 28(2), pp.177-179.
Wu, Z., Malihi, Z., Stewart, A.W., Lawes, C.M. and Scragg, R., 2016. Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis. Pain physician, 19(7), p.415.