Inflammation and the problem of chronic pain

Current studies suggest that up to 100 million of us here in the US have some form of chronic pain.  This doesn’t always mean that the pain is there all the time, but rather that it is an ongoing problem for the person.  The lasting results of trauma, episodic bouts of gout or migraine, low back, hip or knee arthritis, irritable bowel, diabetic neuropathy and a hundred other health problems may not have definitive medical therapy that prevents some degree of chronic pain.

For almost every type of pain, inflammation of the involved tissues is an underlying and promotional part of the problem.  There are drug and non-drug therapies that try to reduce specific forms of inflammation, or to dull the peripheral and central nervous system’s perception of the pain.  As you no doubt are aware, many of these treatments have significant side effects.

I’d like to review recent research on a simple, yet very useful method of reducing inflammation, and pain; no matter where in the body it originates.

In September, an article in the journal Pain Physician reviewed randomized, controlled studies looking at the use of Vitamin D to reduce chronic pain.   Eight of these studies, involving over 2400 people, showed significant reductions of chronic pain, as compared to placebo.  What I found particularly interesting is that the study did not discriminate on the types of pain that were reduced; these were basically ‘all comers’ studies as to the reported versions of pain.

This also mirrors what I’ve seen in my practice over the years.  I’ve been monitoring Vitamin D levels for my patients for over 15 years, and have found numerous examples of pain reduction with optimization of the Vitamin D level.  I must admit that most of the time such a positive result was unintentional.  The advice on optimizing Vitamin D levels was usually for improving bone strength, or immune system response; but during the period of Vitamin D improvement, the chronic pain was often improved, sometimes dramatically.

This ‘meta-study’ in Pain Physician did not specify the before and after Vitamin D levels for those responding with pain relief, versus those not feeling improved.  It would have been interesting to see those numbers.  However, around 10% of Americans are clearly Vitamin D3 deficient, and another 30-50% are most likely below optimal support levels (at the 50-70 level).  I would not be surprised to see the best response, as defined by reduced pain, to be in the patients who had the greatest Vit D deficits initially.

How can one nutrient have so many benefits?

While the emerging scientific literature continues to astound us with the potential benefits of Vitamin D, it can also provoke an understandable skepticism as to how one nutrient can do some many different things for our health.  I’ve heard the phrase, and maybe even said to myself in the past: ‘Does everything, huh?  Sounds like snake oil to me…’.  But the evidence keeps piling up.  As we further investigate the source of these health benefits, we are finding that many of Vitamin D’s effects involve the modulation of gene expression.  So far, we have found that Vitamin D has positive effects on the functions of over 200 different genes.  These genes are involved in immune function, energy production, healing of inflammation and many other key cellular tasks.  It makes sense that better gene expression of cell repair can reduce the inflammation that drives many pain problems.

Step one: know your number

If you have chronic pain, have your doctor check your Vitamin D3 level, and get a plan to augment your level.  And not just up to the ‘OK and barely normal’ lab level of 30, but aiming at the more optimal 50-80 range.  Plan to be in that range for at least three months to gauge results on any pain issues.  It takes time for gene expression to result in measurable clinical improvement.  While no one can guarantee that you will be a Vitamin D responder for chronic pain, these recent studies show that the odds are in your favor.

Although we always advise undertaking new therapy in conjunction with your personal physician, you can also get more information about self-testing for Vitamin D at Grassroots Health

Wu Z, Malihi Z, Stewart AW, Lawes CM, Scragg R. Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016;19(7):415-427.



Print Friendly, PDF & Email
This entry was posted in Doctor's Corner, Integrative Insights and tagged , , . Bookmark the permalink.

Comments are closed.