Programme no. 462-P
Public Health
The role of vitamin D status in chronic low back pain: a cross-sectional case-control study in Swedish primary care
Andreas Thörneby*1, Else Hellebö Johanson2, Lena Nordeman3
1Research and Development, Primary Health Care,Borås,Sweden, 2Research and Development, Primary Health Care,Borås,Sweden, 3Research and Development, Primary Health Care,Borås,Sweden
* = Presenting author
Objectives: The purpose of this study was to evaluate vitamin D status in individuals with CLBP in a Swedish general population, compared with controls matched for sex and age.
Background: Vitamin D deficiency is common and reported in many chronic pain conditions, including chronic low back pain (CLBP). Evidence for association is conflicting and randomised controlled trials showing effect of vitamin D treatment in chronic pain are few. The role of vitamin D status in CLBP remains unclear.
Results: S-25OHD levels did not differ between individuals with CLBP and matched controls, mean difference 1.1 nmol/L (95% CI -11 to 13), p=0.86. There was no difference between the CLBP group and the control group in number of individuals meeting criteria for vitamin D deficiency using either <25, <50 or <75 nmol/L as cut-off level for S-25OHD. Vitamin D status did not contribute to explain the variance in CLBP.
Material/Methods: Participants (n=44) with self-reported low back pain for at least 3 months and individually sex- and age-matched healthy controls (n=44), were recruited from the general population by random letter of invitation. Venous blood sampling and background data collection by structured forms was performed in single visits in two time periods: 26 March – 27 June and 25 October – 8 November 2012. Analysis of serum 25-hydroxyvitamin D (S-25OHD) levels was made by high-pressure liquid chromatography with tandem mass spectrometry.
Conclusion: This study did not find any association between vitamin D status and the presence of CLBP. Measuring vitamin D for the purpose of finding and treating an underlying cause of pain may be unnecessary in the majority of cases in the management of CLBP in a primary care setting.
Points for discussion: Is the present sample population representative and clinically relevant to the primary care setting? What are the results' implications for the management of CLBP? Can assessment of vitamin D status be important in subsets of CLBP patients? What is the importance of background prevalence of vitamin D deficiency in decision making in a clinical context?