Assessment of Vitamin D status In Patients of Chronic Low Back Pain of Unknown Etiology

Low back pain is very disabling and dispiriting because of the physical impediment it causes and its psychological effects. Innumerable factors have been implicated in its etiology. In spite of improvements in diagnostic modalities, a considerable number of such cases fall in the ambiguous zone of unknown etiology or 'idiopathic.'Early diagnosis of low back pain will allow effective prevention and treatment to be offered. This study was conducted to assess the contribution of vitamin D levels and other biochemical factors to chronic low back pain in such cases. All patients attending the orthopedics OPD for low back pain in whom a precise anatomical cause could not be localized, were prospectively enrolled in this study. We measured serum levels of glucose, calcium, phosphorus, uric acid, rheumatoid factor, C reactive protein, alkaline phosphatase, total protein, albumin and 25 (OH) D concentrations in 200 cases and 200 control samples. The patients showed significantly lower vitamin D levels compared to controls with p value < 0.0001. The maximum number of low back pain patients were in the age group of 31-50 years (42 %).The average BMI was 23.27 ± 5.17 kg/sq m, 73 % of total patient population were females and 27 % were known case of type 2 diabetes mellitus. Calcium, alkaline phosphatase, was positively correlated with vitamin D and glucose showed a negative correlation with vitamin D in the patient population. The problem of low back pain provides a challenge to health care providers. The problem in developing countries is compounded by ignorance to report for early treatment and occupational compulsions in rural areas and sedentary lifestyle in urban youth. The authors strongly recommend early frequent screening for vitamin D along with glucose, protein, albumin, calcium, phosphorus, CRP as part of general health checkup for non-specific body pain, especially low back pain.