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Vitamin D Deficiency and Chronic Low Back Pain in Saudi Arabia

Al Faraj, Saud, MD*; Al Mutairi, Khalaf, MD


Study Design. Initial assessment involved 360 patients (90% women and 10% men) attending spinal and internal medicine clinics over a 6-year period who had experienced low back pain that had no obvious cause for more than 6 months. The patients ranged in age from 15 to 52 years.

Objectives. To investigate the contribution of vitamin D deficiency as a cause for idiopathic chronic low back pain, to find a simple and sensitive test for screening patients with low back pain for vitamin D deficiency, and to determine the correlation between the vitamin deficiency and pain.

Methods. A biochemical assay of serum calcium, phosphate, alkaline phosphatase, and 25-hydroxy vitamin D level was performed before and after treatment with vitamin D supplements.

Results. Findings showed that 83% of the study patients (n = 299) had an abnormally low level of vitamin D before treatment with vitamin D supplements. After treatment, clinical improvement in symptoms was seen in all the groups that had a low level of vitamin D, and in 95% of all the patients (n = 341).

Conclusions. Vitamin D deficiency is a major contributor to chronic low back pain in areas where vitamin D deficiency is endemic. Screening for vitamin D deficiency and treatment with supplements should be mandatory in this setting. Measurement of serum 25-OH cholecalciferol is sensitive and specific for detection of vitamin D deficiency, and hence for presumed osteomalacia in patients with chronic low back pain.

From the Departments of *Medicine

and †Spinal Surgery, Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia.

Acknowledgment date: December 12, 2001.

First revision date: April 16, 2002.

Acceptance date: June 3, 2002.

Device status/drug statement: The submitted manuscript does not contain information about medical devices or drugs.

Conflict of interest: No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.

Address reprint requests to Dr. Saud Al Faraj, Department of Medicine, Riyadh Armed Forces Hospital, Saudi Arabia. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.