Study of hypovitaminosis D as a cause of chronic widespread pain in patients presenting to rheumatology clinic


  • Binit Vaidya Alka Hospital, Jawalakhel, Kathmandu
  • Shweta Nakarmi Alka Hospital, Jawalakhel, Kathmandu
  • Arvind Chaudhary Alka Hospital, Jawalakhel, Kathmandu
  • Poojan Batajoo Nepal Medical College, Kathmandu
  • Nija Rajbhandari Nepal Medical College, Kathmandu



Chronic pain, fibromyalgia, vitamin D deficiency


Background and aims: Hypovitaminosis D is common in south-east Asian countries. Deficient vitamin-D level is likely to be associated with chronic muscular pains. We do not have data from our country regarding the magnitude of this problem.

Methods: A prospective open labeled study at rheumatology opd from December 2009 to December 2012. Patients with chronic widespread pain and bone pains of >3 months duration were included in the study. Hypothyroidism, chronic renal failure and other rheumatological diagnosis except fibromyalgia were excluded. Visual analogue score (VAS) for pain and serum Vitamin-D levels were measured. Patients with low Vitamin-D were given oral Vitamin-D 60,000IU for 6 months. Response to therapy was evaluated using improvement in VAS.

Results: Among 1680 patients, 66?2% were females. Hypovitaminosis-D was seen in 1388(82?6%), of which 27?5% had severe deficiency with Vitamin D levels <10ng/ml. Fibromyalgia overlap present in 25?7%. Mean initial VAS score was 8?7, 8?2 and 7?4 for patients in severe deficiency, mild deficiency and insufficiency group respectively. At 6 months follow-up, the VAS scores were 0, 2?1 and 3?6 respectively. After 6 months of treatment, no improvement was seen in 196 patients (11?6%) and all non-responders had fibromyalgia overlap. Vitamin- D level was checked again in non-responders and repeat vitamin-D levels were still low in 10 of them.

Conclusions: Hypovitaminosis-D can be a significant cause of Chronic widespread pain in the general population and seems to aggravate the pain of fibromyalgia. Improvement was rapid and better in severe cases.


Journal of Advances in Internal Medicine 2014;03(01):1-4


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How to Cite

Vaidya, B., Nakarmi, S., Chaudhary, A., Batajoo, P., & Rajbhandari, N. (2014). Study of hypovitaminosis D as a cause of chronic widespread pain in patients presenting to rheumatology clinic. Journal of Advances in Internal Medicine, 3(1), 1–4.



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