title: Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Yoncali Physical Medicine and Rehabilitation Hospital, Kutahya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Yilmaz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Salli
authors.affiliation: Department of Physical Medicine and Rehabilitation, Seydisehir State Hospital, Konya, Turkey.
authors.forename: Havva Turac
authors.initials: HT
authors.lastname: Cingoz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Kucuksen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Ugurlu
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002112:Calcifediol / Q000097:blood*; D002118:Calcium / Q000097:blood; D002762:Cholecalciferol / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D010710:Phosphates / Q000097:blood; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D010710:Phosphates; D002762:Cholecalciferol; D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium
keywords: chronic pain; depression; fibromyalgia; quality of life; vitamin D deficiency