The sun is shining; it’s warmed up; time to take your clothes off!
If you are suffering from ongoing back pain, then you could be deficient in Vitamin D. This hormone is responsible for a wide range of processes in the body including bone and muscle function. A commonly missed cause of back pain is Vitamin D deficiency, especially over a long winter. At least 50% of people in the UK show signs of vitamin D deficiency and many will have increased back pain as a result.
Common signs of vitamin D deficiency
- muscle and bone aching
- pain sensitisation, lower pain threshold
- fatigue
- depression
- weakness
- muscle soreness after exercise
Vitamin D is essential for bone formation as it helps your body absorb calcium from food. If you don’t have enough Vitamin D you can get a condition called osteomalacia. The dull, aching pain associated with osteomalacia most commonly affects the lower back, pelvis, hips, legs and ribs. This pain can be worse at night, or when you’re weight-bearing. Vitamin D deficiency may cause morning back pain in some people too.
How much Vitamin D is enough?
There are various ideas about what the minimum blood levels for Vitamin D are required. This is a measure in nanomoles per litre of blood (nmol/L). Severe deficiency is anything below 25nmol/L, but anyone below 50nmol/L is considered deficient. Optimum health is often thought of a being above 85 nmol/L although more than 125nmol/L can be required for some people.
How can you get enough Vitamin D?
Fortunately, it is easy to get enough Vitamin D for free as you make it in your skin. Sunlight contains ultraviolet (UVB) rays that stimulate Vitamin D production. UVB rays also cause sunburn, however, so it is important to avoid over-exposure. If you cover up or use sunscreen, you will not produce Vitamin D so only aim for short exposure.
A sensible approach is to aim for 10-30 minutes exposure on as much bare skin as you dare, depending on how sensitive your skin is, several times a week when the sun is strong enough; in the UK that is from April to September. Full body sun exposure with no sunscreen will produce up to 20,000iu (500 μg) in 30 minutes. More importantly, once you have made enough Vitamin D your skin stops producing it so you can’t get too much.
Vitamin D supplements
Over the winter or for if you are severely deficient then supplements are the only way to go. In your diet, oily fish such as salmon, mackerel and sardines provide some vitamin D but you would, for example, need to eat 20 tins of salmon a day to get 5000iu.
Here at Sundial we recommend a liquid Vitamin D supplement which is highly absorbable and inexpensive. The chewable calcium-based supplements from ordinary shops are often too low in Vitamin D to help much.
Summary
- Vitamin D deficiency is common and can cause back pain
- Safe sun exposure on bare skin from April to September is beneficial
- Taking a good quality supplement over the winter prevents deficiency
Update:
Latest research show Vitamin D can also help migraines. A group of 80 chronic migraine sufferers were split into two groups. One group got 2000iu of Vitamin D3, the other group got a placebo. Hey presto, the Vitamin D group experienced fewer pain days, less severe pain and shorter episodes even at a relatively low dose. The boffins found that a key inflammatory marker was significantly lower in the VitaminD group which means this was the probable mechanism for the benefit. It would be interesting to see if a higher dose of 5000iu a day would do even better.
For more information and references:
https://www.nhs.uk/live-well/healthy-body/how-to-get-vitamin-d-from-sunlight/
https://www.skincancer.org/prevention/uva-and-uvb
https://www.hsph.harvard.edu/nutritionsource/vitamins/vitamin-d/#new-vitamin-d-research
https://www.healthline.com/nutrition/9-foods-high-in-vitamin-d#section2
Update
Vitamin D3 might improve headache characteristics and protect against inflammation in migraine