Low Vitamin D Levels Linked to Chronic Low Back Pain

By Pat Anson

Low levels of Vitamin D are a leading cause of disability worldwide and have been associated with fibromyalgia, rheumatoid arthritis, migraines, and musculoskeletal problems. 

A new study in India suggests the “sunshine vitamin” may also play a role in the development of chronic low back pain.

Researchers at a teaching hospital in eastern India took blood samples from 75 adult patients with chronic low back pain and found a remarkably high rate of low vitamin D serum levels – a condition known as hypovitaminosis D.

Over two-thirds of the patients (69.3%) had “deficient” levels of Vitamin D, while the remaining ones had serum levels that were below normal and considered “insufficient.” 

“Notably, none of the participants had sufficient serum vitamin D levels. These findings are in agreement with existing literature reporting a high prevalence of hypovitaminosis D in the Indian population, even in regions with adequate sunlight exposure,” wrote lead author SK Imran Ali, MD, an orthopaedic surgeon at Dr. Bidhan Chandra Roy Hospital in Haldia. 

Ultraviolet rays in sunlight are the principal source of Vitamin D for most people. India usually gets a significant amount of sunshine, especially from October to May, so why would Vitamin D levels be so low?

Vitamin D deficiency rates on the Indian subcontinent range from 50% to as high as 95%, a phenomenon attributed to darker skin pigmentation, poor diets, and increasingly sedentary (indoor) lifestyles with little sun exposure.

While researchers found an association between chronic low back pain and hypovitaminosis D, they did not establish a causal link. Pain severity and disability levels were about equal between the “deficient” and “insufficient” groups, and between men and women.

Researchers did find that patients from lower socioeconomic classes were statistically more likely to have inadequate Vitamin D levels compared to those in the upper class.

“This observation aligns with existing evidence indicating that socioeconomic factors influence nutritional status, sun exposure, dietary quality, and access to healthcare services, all of which may affect vitamin D levels,” researchers found. “Individuals from lower socioeconomic backgrounds may have limited access to vitamin D-rich foods, reduced opportunities for outdoor activity, and decreased healthcare access, thereby increasing the risk of hypovitaminosis D.”  

In addition to sunshine, you can increase your Vitamin D levels by eating oily fish and eggs. Vitamin D has a wide range of positive health effects, such as strengthening bones and teeth, and inhibiting the growth of some cancers. Vitamin D also improves immune function and reduces inflammation.

Documentary Looks at Pain Relief as Human Right

By Steve Weakley

A new documentary calls pain relief a basic human right.  That is one of the tantalizing premises of “Hippocratic,” a film about the life of one of the pioneers of palliative care in India, Dr. M.R. Rajagopal.  

For over 20 years, Rajagopal has battled conditions that cause palliative care patients in India to suffer needlessly. Despite being home to most of the world’s legally grown opium, morphine and other opioid medications are often inaccessible in India to patients dying of cancer and other chronic illnesses.   

Rajagopal points out that the Indian Narcotics Act of 1987 reduced prescriptions of opiates in his country by 94 percent in just 12 years.  Under that law, even a minor mistake in prescribing opioids could send a doctor to prison for 10 years. 

“When you torture someone for political reasons, they can sign a confession and escape.  Here, (pain patients) don’t even have that option… they can’t fight back.  It’s a very one-sided war,” says Rajagopal.

In “Hippocratic,” Rajagopal points out that medicine and the profit motive compound the lack of effective pain care.  About 80 percent of the healthcare industry in India is privatized, and when doctors prescribe opiates they often steer patients toward expensive name brand drugs, when nearly identical generics cost only pennies.  He warns against unchecked medical profits and makes a passionate plea for universal health care.

The 88-minute film is most moving in the moments where it demonstrates the power of compassion as the primary purpose of treatment.  A four-year old girl, writhing and screaming in unbearable pain, is seen reaching up and kissing Rajagopal on his forehead after he administers her medicine.

You can watch a trailer for “Hippocratic” below:

In 2014, Rajagopal won an award for extraordinary activism from Human Rights Watch, a non-profit that has done extensive work on human rights abuses and the suffering of palliative care patients worldwide.

As PNN has reported, Human Rights Watch is now investigating the treatment of chronic pain patients in the United States.

“People we interviewed who didn’t have access to appropriate medications for their pain were essentially giving testimony that was almost exactly the same as the testimony we were getting from the victims of police torture,” said Diederik Lohman, Director of Health and Human Rights for Human Rights Watch.  “People were facing tremendous suffering that actually could be relieved pretty easily through very inexpensive palliative care and pain management.”

“Hippocratic” had a limited release in U.S. theaters last month, but can still be seen in New York City, Seattle, Fresno and a handful of other cities. It can also be rented online by clicking here.