Does Vitamin D Status Influence Lumbar Disc Degeneration, Low Back Pain in Postmenopausal Women?

Vitamin D deficiency is associated with more severe lumbar disc degeneration and greater back pain, according to a study published in Menopause.

Previous studies have shown the effect of oestrogen 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 oestrogen concentrations, vitamin D deficiency is common during the postmenopause period.

For the current study, the researchers measured serum concentrations of bone turnover markers using electrochemiluminescence assays in 232 women aged 55 to 75 years between July 2017 and December 2018. Disc degeneration was evaluated using the Pfirrmann grading system. Other variables were assessed using relevant questionnaires.

The prevalence of severe vitamin D deficiency (<10 ng/mL) was 12.9% and normal status (>30 ng/mL) was 12.5%. The severely deficient group had higher visual analog scale (VAS) scores for lumbar disc degeneration (P = .002) and lower bone mineral density T scores (P = .004) than the other groups.

Lower vitamin D concentration (<10 ng/mL) was significantly associated with more severe lumbar disc degeneration in the lumbosacral region (L4-S1, L1-S1; P< .05), but less so in the upper lumbar region.

There was an inverse relationship between vitamin D concentration and the severity of disc degeneration (L2-L3, L4-S1, L1-S1; P< .05).

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 in postmenopausal women (P< .05).

“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,” said Stephanie Faubion, North American Menopause Society, Cleveland, Ohio. “Although not all women need vitamin D supplementation, this speaks to the importance of avoiding severe vitamin D deficiency states.”