Ben Tolson, one of our Sports Injury Therapists and Acupuncturists writesbout Vitamin D deficiency:
“Chronic muscle pain is a common problem throughout the world and obviously is frequently encountered in the clinic. Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing. Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle. The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying cause(s) of persistent or chronic muscle pain in order to develop a specific treatment plan.
Manual and physical therapists often use a postural-structural-biomechanical (PSB) model to ascertain the causes of various musculoskeletal conditions. It is believed that postural deviations, body asymmetries and pathomechanics are the predisposing/maintaining factors for many musculoskeletal conditions. The PSB model also plays an important role in clinical assessment and management, including the choice of manual techniques and the exercise prescribed.
Precipitating or perpetuating causes of chronic pain, myofascial or otherwise may include structural or mechanical fault finding but also patients sometimes fail to respond to manual therapy or do not make a full recovery as expected. On some occasions a correction of an underlying vitamin deficiency is all that is needed to resolve the condition.
Figures show up to a quarter of the population has low levels of vitamin D in their blood and the majority of pregnant women do not take vitamin D supplements. In the UK around 1 in 5 adults, and around 1 in 6 children, may have low vitamin D status – an estimated 10 million people across England. This can be clearly seen as over the past few years, with the increase of rickets in British Asian children and recent immigrants to the UK. Particularly in second generation Black-African or Caribbean parents from socially and economic deprived areas.
The following groups of people are at risk of vitamin D deficiency:
- all pregnant and breastfeeding women, especially teenagers and young women
- infants and young children under 5 years of age
- older people aged 65 years and over
- people who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods
- people who have darker skin, for example people of African, African-Caribbean and South Asian origin, because their bodies are not able to make as much vitamin D
People with darker skin are particularly at risk – during winter months nearly 75% of adults from Asian or African and Caribbean backgrounds may have low vitamin D levels.
Vitamin D is naturally obtained through exposure to sunlight and from foods such as oily fish, eggs, fortified fat spreads and some fortified breakfast cereals. But it’s difficult to get enough from food alone. In musculoskeletal pain its a key component that determines neuromuscular functioning. Quigley found that 89% of subjects with chronic musculoskeletal pain were deficient in Vitamin D. Vitamin D deficiency is associated with musculoskeletal pain, loss of type II muscle fibres, and proximal muscle atrophy.”