Much research has been conducted over the past decade to indicate that people suffering from chronic low back pain may find relief by taking supplemental vitamin D and/B12.
How it works
Role of vitamin D in relieving back pain
Vitamin D is essential to maintain normal levels of calcium and phosphorous in the body. It also enhances the absorption of calcium from the intestines.
The absorption and processing of vitamin D is a complex process, but essentially a precursor molecule, known as 7-dehydrocholesterol in the skin is converted to pre-vitamin D3, which is further converted to vitamin D3. Vitamin D3 is absorbed in the blood circulation and its subsequent processing occurs in liver and kidney.
The final form of vitamin D interacts with its target organs, bone and intestine, and regulates calcium metabolism. Deficiency of vitamin D leads to softening of bones, a condition known as osteomalacia in adults and rickets in children.
Studies suggest that chronic lower back pain could be due to osteomalacia. Different research groups have shown the effect of vitamin D supplements on improving back pain.
A 2003 study in Spine (2003;28:177–9) on 360 patients suffering from back pain for over six months showed that 83 per cent of all participants also had low levels of vitamin D in their blood.
A Mayo Clinic research showed how patients of chronic pain who also suffered from inadequate vitamin D levels required much higher (almost double) amounts of pain medication, thereby linking vitamin D and chronic pain relief.
Role of vitamin B12 in relieving back pain
Vitamin B12 is an essential water-soluble vitamin belonging to the B-complex family. It is necessary for blood cell formation and repair, production of DNA and overall maintenance of brain cells. Vitamin B12 helps the body replace nerve cells in the spine and additionally also reduce inflammation, a common cause of chronic back pain.
A study suggests that vitamin B12 can provide relief from back pain due to the role it plays in the nervous system. A study published in the 2000 edition of European Review for Medical and Pharmacological Sciences showed the differential effects of vitamin B12 injection and a placebo on volunteers; vitamin B12 significantly reduced pain levels in most research subjects.
Effects of vitamin D and B12 deficiency
Not getting sufficient vitamin D puts people at risk of developing bone problems, which include rickets in children (which results in skeletal deformities) and osteomalacia (weak bones and muscular weakness) in adults.
Research also points towards a link between vitamin D deficiency and diabetes, heart conditions, asthma and impairment of cognitive functions in older adults.
Populations that are at a high risk of developing vitamin D deficiency include those with limited sun exposure, exclusively breastfed infants, obese individuals and the elderly. Also, persons with inflammatory bowel disease (e.g. Crohn’s disease) or having fat malabsorption syndromes (e.g. cystic fibrosis) are also at risk.
Vitamin B12 deficiency effects include damage to the nervous system in form of numbness in fingers and toes, difficulty in walking, depression and mood changes, and disorientation, dementia and memory loss. Deficiency of vitamin B12 in infants, if not detected and treated, can lead to permanent damage to the nervous system.
Diagnosing of vitamin D and B12 deficiency
A simple blood test can determine if a person is suffering from vitamin D deficiency. Doctors recommend this test for people who show signs of weakened bones or risk factors for vitamin D deficiency. Normal levels of vitamin D in blood are 30-40 ng/mL (nanograms per millilitre).
Vitamin B12 levels in the body are determined through a blood test, and most commonly done to test for a condition known as pernicious anaemia (caused by poor vitamin B12 absorption). Normal values range between 200 and 900 pg/mL (picograms per millilitre).
The following symptoms may signal deficiency of vitamin D and B12:
- Vitamin D deficiency is often clinically silent. However, symptoms, when present may include:
- Chronic muscle aches and pains in adults
- Periosteal bone pain that can be detected by applying firm pressure on the tibia or the sternum
- Children with vitamin D deficiency prefer to sit down for long periods or start walking late
- Bowing of legs in children
- Vitamin B12 deficiency can lead to vitamin B12 deficiency anaemia and may present the following symptoms:
- Weakness, tiredness
- Rapid breathing and heartbeat
- Sore tongue
- Pale skin
- Bleeding gums and easy bruising
- Weight loss, stomach upset
- Constipation or diarrhoea
Treating back pain with vitamin D or B12
Back pain due to vitamin D deficiency can be treated with various supplements. Foods rich in vitamin D include orange juice, fortified milk, breakfast cereals, egg yolk, salmon, tuna and butter.
Getting adequate exposure to sunshine, as little as 10 minutes in a day, is also important in maintaining the required vitamin D dose in the body. It is advisable to consult a physician before taking vitamin supplements, as high doses of vitamin D can be toxic.
Persons with vitamin B12 deficiency must consult with their doctor for prescriptions to vitamin B12 injections. Intake of this vitamin can also be boosted through inclusion of vitamin B12-rich foods like eggs, fatty fish, dairy and fortified cereals.
- Self-administering vitamin D without consulting a doctor can be dangerous and lead to excessive accumulation of calcium in the blood, which can further result in kidney stones.
- Persons afflicted with chronic back pain must ask their doctor to vitamin D levels.
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