Correlation between Vitamin D and Low Back Pain in a Person of Eastern Terai of Nepal

Abstract

Skin exposure to sunlight is the main pathway by which vitamin D is synthesized. Differently pigmented populations are at different risk of hypovitaminosis D. A hospital-based cross-sectional study was conducted from March/2025 to July/2025 at the department of orthopedics and spine surgery, Saptakoshi Neuro Hospital Pvt.Ltd (SNH), Inaruwa, Sunsari. Patients with low back pain between the ages of 18 and 80 years who met the inclusion criteria were enrolled in this study. 200 patients (53 males and 147 females) ranging from 18 to 75 years old (average 46 years) with low back pain had undergone screening. The patients with low back pain were divided into three groups (i.e, acute, sub-acute, chronic) on the basis of onset of pain. 58 patients had an acute onset, 54 patients had a sub-acute onset, and 88 patients had a chronic onset. Blood investigations like Serum vitamin D level, Serum Calcium level, and inflammatory markers like CRP and ESR were measured. Visual analogue scale (VAS) and Oswestry disability index, nepali version (NV-ODI)7 were used for evaluation of low back pain and functional disability during the visit to the hospital. Mean serum concentrations of vitamin D in acute, sub-acute, and chronic low back pain groups were 27.96 ± 10.78, 27.34 ± 8.54, and 23.29 ± 6.67 ng/ml, respectively (P ≈ 0.002). Mean serum concentration of calcium in acute, sub-acute, and chronic low back pain groups was 8.89 ± 1.23, 8.74 ± 0.95, and 8.49 ± 0.91 mg/dl, respectively (P ≈ 0.067). Serum concentration of inflammatory marker C-reactive protein (CRP) in acute low back pain were ≤ 6 mg/L (100%), sub-acute low back pain were ≤ 6 mg/L (98.1%) and > 6 mg/L(1.9%), and chronic low back pain groups were ≤ 6 mg/L (90.9%) and >6 mg/L (9.1%), respectively (P ≈ 0.019). Mean serum concentration of inflammatory marker erythrocyte sedimentation rate (ESR) in acute, sub-acute, and chronic low back pain groups was 21.93 ± 6.99, 23.54 ± 5.14, and 27.07 ± 5.42 mm/Hr, respectively (P < 0.001). The study concluded that the prevalence of LBP is high among individuals with a low level of serum vitamin D and a low concentration of serum calcium level.