Lumbar disc degeneration is a common musculoskeletal disease that often causes lower back pain. Previous studies have shown the effect of estrogen on disc degeneration, which partially explains why degeneration is more severe in postmenopausal women than in men of the same age. In addition to lower estrogen concentrations, vitamin D deficiency is common during the postmenopause period.
Vitamin D is critical in maintaining levels of calcium and phosphorus, helping to prevent bone diseases such as rickets and osteoporosis. Recent studies have shown that vitamin D deficiency is associated with lower back pain and that supplementation can relieve this pain and improve musculoskeletal strength. But few studies have been conducted regarding the role of vitamin D in spinal degeneration, especially in postmenopausal women.
This new study concluded that vitamin D deficiency is highly prevalent in postmenopausal women and that a serum concentration of vitamin D less than 10 ng/mL, indicating severe deficiency, should be considered an indicator of severe disc degeneration and lower back pain.
Dr. Stephanie Faubion, NAMS medical director, said: "This study shows that very low vitamin D levels were linked to a greater likelihood of moderate to severe lower back pain and more severe lumbar disc degeneration, possibly because of the beneficial effects vitamin D has on nerve and muscle pain sensitivity, muscle strength and mass, and inflammation. Although not all women need vitamin D supplementation, this speaks to the importance of avoiding severe vitamin D deficiency states."
Between July 2017 and December 2018, 232 participants were retrospectively enrolled. Serum concentrations of bone turnover markers were measured using electrochemiluminescence assays. Disc degeneration was evaluated using the Pfirrmann grading system. Other variables were assessed using relevant questionnaires.
The mean age of the women was 65.6. The prevalences of severe vitamin D deficiency (<10 ng/mL) and normal status (>30 ng/mL) were 12.9% and 12.5%, respectively.
The severely deficient group had higher visual analog scale (VAS) scores for lower back pain and lower bone mineral density T scores than the other groups.
Lower vitamin D concentration (<10 ng/mL) was significantly associated with more severe lumbar disc degeneration in the lumbosacral region, but less so in the upper lumbar region.
There was an inverse relationship between vitamin D concentration and the severity of disc degeneration.
After adjustment for confounding factors, smoking, vitamin D deficiency, lack of vitamin D supplementation, high body mass index, and low bone mineral density T score were associated with higher incidence of moderate-to-severe pain.
De-Sheng. W., et al
"Does vitamin D status influence lumbar disc degeneration and low back pain in postmenopausal women? A retrospective single-center study"