Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency.

Abstract

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. Patients with nonspecific CWP and vitamin D deficiency (25-OH D3<25ng/mL) were included into the study. Replacement treatments of 50000IU/week oral vitamin D3 for 3months 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. Fifty-eight patients with a mean age of 36.9±9.2years were included into the study. 25-OH D3 levels of patients elevated from 10.6±5.1ng/mL to 46.5±24.0ng/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. 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.