Vitamin D deficiency and chronic low back pain in Saudi Arabia.
METHODS
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.


OBJECTIVE
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.
Al Faraj
Saud
S
Department of Medicine, Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia. alfaraj@yahoo.com
Al Mutairi
Khalaf
K
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002112:Calcifediol / Q000097:blood / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D012529:Saudi Arabia; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D010710:Phosphates; D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium