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Ersoy S, Kesiktas FN, Sirin B, Bugdayci D, Paker N. The effect of vitamin D treatment on quality of life in patients with fibromyalgia. Ir J Med Sci 2024; 193:1111-1116. [PMID: 37707690 PMCID: PMC10961268 DOI: 10.1007/s11845-023-03521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Fibromyalgia is a syndrome characterized by chronic widespread pain accompanied by fatigue, disrupted sleep quality, cognitive impairments, subjective soft tissue swelling, and somatic symptoms. There are conflicting results in the literature regarding the prevalence of vitamin D deficiency in fibromyalgia patients and the reduction of symptoms after supplementation. AIMS Our study aims to evaluate the effectiveness and reliability of vitamin D supplementation in patients diagnosed with fibromyalgia. METHODS In our cross-sectional clinical study, 180 female patients aged 18 to 65 diagnosed with fibromyalgia according to the 2010 American College of Rheumatology Diagnostic Criteria were included. Oral vitamin D3 replacement of 50,000 IU was administered for 12 weeks. Patients' Fibromyalgia Impact Questionnaire (FIQ)and Visual Analogue Scale (VAS) scores were evaluated before and after the study. RESULTS Significant differences were observed in the FIQ scores of the 180 fibromyalgia patients before and after vitamin D supplementation (p < 0.05). There was also a significant improvement in VAS scores (p < 0.01). A negative correlation between vitamin D and VAS as well as FIQ scores was found in the study. CONCLUSION We determined that vitamin D deficiency is significantly more prevalent in patients diagnosed with fibromyalgia. Vitamin D supplementation was observed to have a positive effect on quality of life and reduction of pain.
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Affiliation(s)
- Sedef Ersoy
- Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastirma Hastanesi, Istanbul, Turkey.
| | - Fatma Nur Kesiktas
- Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Busra Sirin
- Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Derya Bugdayci
- Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Nurdan Paker
- Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastirma Hastanesi, Istanbul, Turkey
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2
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Telli H, Özdemir Ç. Is nociplastic pain, a new pain category, associated with biochemical, hematological, and inflammatory parameters? Curr Med Res Opin 2024; 40:469-481. [PMID: 38204412 DOI: 10.1080/03007995.2024.2304106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE The aim of the study was to evaluate the relationship between biochemical, hematological, and inflammatory parameters and pain in patients with nociplastic pain. METHODS In this cross-sectional study, a total of 8632 patients, aged between 20 and 65, were evaluated according to the nociplastic pain diagnosis criteria determined by IASP. Excluding individuals who did not meet the criteria for nociplastic pain, the study included a total of 660 participants. The biochemical, hematological, and inflammatory parameters of all individuals were examined. The pain levels of the patients were assessed using the Visual Analogue Scale (VAS). The patients were categorized based on nociplastic pain types and pain regions for evaluation. RESULTS In this study, the female gender was more prevalent both in all nociplastic pain categories and in all pain region groups (p < 0.05). In the nociplastic pain categories, it was observed that vitamin D levels were lower in patients with chronic widespread pain, while ferritin and C-reactive protein levels were higher in patients with chronic primary musculoskeletal pain. Among patients with chronic widespread pain with low hemoglobin and/or ferritin levels, the Visual Analog Scale activity score was higher. For patients with chronic widespread pain and low vitamin D levels and/or high erythrocyte sedimentation rate levels, the Visual Analog Scale rest score was higher. In patients with fibromyalgia and high parathyroid hormone levels, the Visual Analog Scale activity score was higher. For patients with fibromyalgia and high Neutrophil/Lymphocyte ratio levels, the Visual Analog Scale rest score was higher. In patients with chronic primary musculoskeletal pain and high erythrocyte sedimentation rate and/or C-reactive protein levels, the Visual Analog Scale activity score was higher. While vitamin B12 levels were found to be lower in patients with widespread pain, no significant relationship was identified between electrolytes, other blood count results, and nociplastic pain. CONCLUSION In our study, it was observed that levels of vitamin D in individuals with nociplastic pain were low, while erythrocyte sedimentation rate, C-reactive protein, and Neutrophil/Lymphocyte ratio were high, and hemoglobin and ferritin levels were elevated. Furthermore, these findings were found to be associated with both the presence of pain and the severity of pain assessed using the visual analog scale.
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Affiliation(s)
- Hilal Telli
- Evliya Çelebi Training and Research Hospital, Physical Therapy and Rehabilitation Clinic, Kütahya Health Sciences University, Kütahya, Turkey
| | - Çağla Özdemir
- Evliya Çelebi Training and Research Hospital, Family Medicine Clinic, Kütahya Health Sciences University, Kütahya, Turkey
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3
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Mikola T, Marx W, Lane MM, Hockey M, Loughman A, Rajapolvi S, Rocks T, O'Neil A, Mischoulon D, Valkonen-Korhonen M, Lehto SM, Ruusunen A. The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2023; 63:11784-11801. [PMID: 35816192 DOI: 10.1080/10408398.2022.2096560] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurosteroid and immunological actions of vitamin D may regulate depression-linked physiology. Meta-analyses investigating the effect of vitamin D on depression have been inconsistent. This meta-analysis investigated the efficacy of vitamin D in reducing depressive symptoms among adults in randomized placebo-controlled trials (RCT). General and clinical populations, and studies of ill individuals with systemic diseases were included. Light therapy, co-supplementation (except calcium) and bipolar disorder were exclusionary. Databases Medline, PsycINFO, CINAHL and The Cochrane Library were searched to identify relevant articles in English published before April 2022. Cochrane risk-of-bias tool (RoB 2) and GRADE were used to appraise studies. Forty-one RCTs (n = 53,235) were included. Analyses based on random-effects models were performed with the Comprehensive Meta-analysis Software. Results for main outcome (n = 53,235) revealed a positive effect of vitamin D on depressive symptoms (Hedges' g = -0.317, 95% CI [-0.405, -0.230], p < 0.001, I2 = 88.16%; GRADE: very low certainty). RoB assessment was concerning in most studies. Notwithstanding high heterogeneity, vitamin D supplementation ≥ 2,000 IU/day appears to reduce depressive symptoms. Future research should investigate possible benefits of augmenting standard treatments with vitamin D in clinical depression. PROSPERO registration number: CRD42020149760. Funding: Finnish Medical Foundation, grant 4120 and Juho Vainio Foundation, grant 202100353.
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Affiliation(s)
- Tuomas Mikola
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Wolfgang Marx
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Melissa M Lane
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Meghan Hockey
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Amy Loughman
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Sanna Rajapolvi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tetyana Rocks
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Adrienne O'Neil
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Minna Valkonen-Korhonen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Anu Ruusunen
- Food & Mood Centre, School of Medicine, Barwon Health, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
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4
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Komba S, Hase M, Kotake-Nara E. Organic Synthesis of New Secosteroids from Fucosterol, Its Intestinal Absorption by Caco-2 Cells, and Simulation of the Biological Activities of Vitamin D. Mar Drugs 2023; 21:540. [PMID: 37888475 PMCID: PMC10608315 DOI: 10.3390/md21100540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
We previously examined the cellular uptake of six types of vitamin D in human intestinal Caco-2 cells. Since vitamins D5-D7 were commercially unavailable, we synthesized these compounds organically before studying them. This process led us to understand that new secosteroids could be generated as vitamin D candidates, depending on the sterol used as the starting material. We obtained two new secosteroids-compounds 3 and 4-from fucosterol in the current study. We investigated the intestinal absorption of these compounds using Caco-2 cells cultured in Transwells and compared the results with vitamin D3, a representative secosteroid. The intestinal absorption of compound 4 was comparable to that of vitamin D3. Compound 3 showed similar uptake levels but transported about half as much as vitamin D3. These compounds demonstrated intestinal absorption at the cellular level. Vitamin D is known for its diverse biological activities manifest after intestinal absorption. Using PASS online simulation, we estimated the biological activity of compound 3's activated form. In several items indicated by PASS, compound 3 exhibited stronger biological activity than vitamins D2-D7 and was also predicted to have unique biological activities.
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Affiliation(s)
- Shiro Komba
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-12 Kannondai, Tsukuba 305-8642, Ibaraki, Japan
| | - Megumi Hase
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-12 Kannondai, Tsukuba 305-8642, Ibaraki, Japan
| | - Eiichi Kotake-Nara
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-12 Kannondai, Tsukuba 305-8642, Ibaraki, Japan
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5
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Santini S, Marinozzi A, Herrera-Pérez M, Tejero S, Wiewiorski M, de Cesar Netto C, Godoy-Santos AL, Valderrabano V. The Classic Three-Month Post-Operative Adaptation Phase in Foot and Ankle Surgery-An Expert Perspective. J Clin Med 2023; 12:6217. [PMID: 37834861 PMCID: PMC10573441 DOI: 10.3390/jcm12196217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Foot and ankle disorders are a common reason for orthopedic surgical intervention. After surgery, specific precautions such as partial weight bearing or complete unloading, and the use of walking aids, coupled with a period of rest, are usually implemented to ensure the surgical outcome. However, when these aids are discontinued and the patients resume load increase and normal daily activities, they may enter a transitional phase characterized by inflammation, swelling, and pain. We call this phenomenon the "classic three-month post-operative adaptation phase" (POAP). It is essential to differentiate this physiological transition phase from other conditions, such as from the immediate post-surgical inflammation, complex pain regional syndrome, or an infection. The objective of this expert opinion is to describe and raise medical awareness of this evidence-based phenomenon, which we commonly observe in our daily practice.
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Affiliation(s)
- Simone Santini
- Swiss Ortho Center, Swiss Medical Network, Schmerzklinik Basel, Hirschgässlein 15, 4010 Basel, Switzerland;
- Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Andrea Marinozzi
- Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Mario Herrera-Pérez
- Foot and Ankle Unit, Orthopaedic Department, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Sergio Tejero
- Foot and Ankle Unit, Orthopedic Surgery and Traumatology Service, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | | | - Cesar de Cesar Netto
- Division of Orthopedic Foot and Ankle Surgery, Department of Orthopedics, Duke University, Durham, NC 27708, USA
| | | | - Victor Valderrabano
- Swiss Ortho Center, Swiss Medical Network, Schmerzklinik Basel, Hirschgässlein 15, 4010 Basel, Switzerland;
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6
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Carey ET, McClurg AB. Evaluation and Medical Management of Chronic Pelvic Pain. Semin Intervent Radiol 2023; 40:372-378. [PMID: 37575343 PMCID: PMC10415055 DOI: 10.1055/s-0043-1770715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Chronic pelvic pain (CPP) is a challenging condition affecting an estimated 15% of females in the United States. Multiorgan system dysfunction results in the complex clinical pain presentation. Similar to other chronic pain syndromes, CPP is influenced by biopsychosocial factors and requires a multimodal approach for optimal pain management. This review summarizes the clinical evaluation and medical management of CPP with a comprehensive approach.
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Affiliation(s)
- Erin T. Carey
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, North Carolina
| | - Asha B. McClurg
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, North Carolina
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7
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Yang CC, Tsai ST, Ting B, Cheng YC, Wang CK, Chang JPC, Su KP. Psychological Outcomes and Quality of Life of Fibromyalgia Patients with Vitamin D Supplementation-A Meta-Analysis. J Clin Med 2023; 12:jcm12072750. [PMID: 37048833 PMCID: PMC10095322 DOI: 10.3390/jcm12072750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
The efficacy of current pharmaceutical treatments for fibromyalgia are limited. Vitamin D has shown promise in relieving pain. However, there is a lack of comprehensive analysis of psychological outcomes with vitamin D supplementation in fibromyalgia. This study aimed to investigate the impact of vitamin D supplementation on psychological outcomes and quality of life in fibromyalgia patients, given the unmet clinical need for effective treatment options. A meta-analysis of randomized controlled trials comparing vitamin D to placebo and prospective studies examining changes before and after vitamin D supplementation for patients with fibromyalgia was conducted to evaluate the effects of vitamin D on psychological outcomes, quality of life, and pain scores in patients with fibromyalgia. Databases were searched for relevant articles published from earliest available date to October 31, 2022. (PROSPERO number, CRD42022369889). We included 8 trials with a total of 694 participants and found that vitamin D supplementation had significant positive effects on physical function (standard mean differences (SMD) = 0.44, 95% CI = [0.10, 0.77 ]), role limitations due to emotional health (SMD = 0.57, 95% CI = [0.32, 0.82]), social function (SMD = 0.50, 95% CI = [0.08, 0.93]), and general health (SMD = 0.36, 95% CI = [0.11, 0.61]). Improvement of the Fibromyalgia Impact Questionnaire (FIQ) scores was noted (SMD = -0.414, 95% CI = [-0.808, -0.021]), but not on the Visual Analog Scale (VAS) (SMD = -0.15, 95% CI = [-0.771, 0.471]) and the Beck's Depression Inventory (BDI) scores (SMD = -0.456, 95% CI = [-1.27, 0.30]). In conclusion, vitamin D supplementation might be an alternative option for improvement of psychological outcomes and quality of life in patients with fibromyalgia.
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Grants
- 109-2320-B-038-057-MY3 Ministry of Science and Technology, Taiwan
- 110-2321-B-006-004 Ministry of Science and Technology, Taiwan
- 110-2811-B-039-507 Ministry of Science and Technology, Taiwan
- 110-2320-B-039-048-MY2 Ministry of Science and Technology, Taiwan
- 110-2320-B-039-047-MY3 Ministry of Science and Technology, Taiwan
- 110-2813-C-039-327-B Ministry of Science and Technology, Taiwan
- 110-2314-B-039-029-MY3 Ministry of Science and Technology, Taiwan
- 111-2321-B-006-008 Ministry of Science and Technology, Taiwan
- 109-31 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 109-40 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-13 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-26 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-44 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-45 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-27 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-28 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-47 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-48 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-52 An-Nan Hospital, China Medical University, Tainan, Taiwan
- CMRC-CMA-2 Higher Education Sprout Project by the Ministry of Education (MOE), Taiwan
- 110-AWARD-02 China Medical University, Taichung, Taiwan
- 110-N-17 China Medical University, Taichung, Taiwan
- 1110-SR-73 China Medical University, Taichung, Taiwan
- DMR-106-101 China Medical University Hospital, Taichung, Taiwan
- DMR-106-227 China Medical University Hospital, Taichung, Taiwan
- DMR-109-102 China Medical University Hospital, Taichung, Taiwan
- DMR-109-244 China Medical University Hospital, Taichung, Taiwan
- DMR-110-124 China Medical University Hospital, Taichung, Taiwan
- DMR-111-245 China Medical University Hospital, Taichung, Taiwan
- DMR-112-097 China Medical University Hospital, Taichung, Taiwan
- DMR-112-086 China Medical University Hospital, Taichung, Taiwan
- DMR-112-109 China Medical University Hospital, Taichung, Taiwan
- DMR-112-232 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-109-11 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-109-12 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-110-10 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-111-8 China Medical University Hospital, Taichung, Taiwan
- CMUH-C1110812016-11 China Medical University Hospital, Taichung, Taiwan
- NSTC 111-2314-B-039-041-MY3 National Science and Technology Council, Taiwan
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Affiliation(s)
- Chia-Chun Yang
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan 330, Taiwan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
| | - Sheng-Ta Tsai
- School of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taichung 404, Taiwan
| | - Berne Ting
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu 302, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
| | - Chin-Kun Wang
- Department of Nutrition, Chung Shan Medical University, Taichung 402, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
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Merle B, Haesebaert J, Viprey M, Bellouere C, Champiat L, Comtat J, Drujon d'Astros S, Magaud L, Dupraz C, Schott AM. Chronic pain and vitamin D: A randomized controlled trial in primary care medecine in France, the Dovid study. Int J Rheum Dis 2023. [PMID: 36737404 DOI: 10.1111/1756-185x.14582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023]
Affiliation(s)
| | - Julie Haesebaert
- INSERM U1290 RESHAPE, Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Recherche et épidémiologie clinique, Lyon, France
| | - Marie Viprey
- INSERM U1290 RESHAPE, Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Recherche et épidémiologie clinique, Lyon, France
| | - Charlotte Bellouere
- Collège Universitaire de Médecine Générale, Université de Lyon, Lyon, France
| | - Lucie Champiat
- Collège Universitaire de Médecine Générale, Université de Lyon, Lyon, France
| | - Julie Comtat
- Collège Universitaire de Médecine Générale, Université de Lyon, Lyon, France
| | | | - Laurent Magaud
- Hospices Civils de Lyon, Pôle Santé Publique, Recherche et épidémiologie clinique, Lyon, France
| | - Christian Dupraz
- Collège Universitaire de Médecine Générale, Université de Lyon, Lyon, France
| | - Anne-Marie Schott
- INSERM U1290 RESHAPE, Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Recherche et épidémiologie clinique, Lyon, France
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9
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Oxidative Stress in Fibromyalgia: From Pathology to Treatment. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1582432. [PMID: 36246401 PMCID: PMC9556195 DOI: 10.1155/2022/1582432] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/23/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain associated with sleep problems, fatigue, depression, and anxiety. The persistence of pain, impairment of cognitive function, and negative impact on the psychological state have caused a detrimental effect on the patients' quality of life. However, to date, the treatment and mechanisms of this disease are yet to be established. Oxidative stress might play a critical role in FM pathophysiology. Increased levels of prooxidative factors such as nitric oxide, lipid peroxidation, and mitophagy can cause pain sensitization in fibromyalgia. Numerous studies have supported the hypothesis of beneficial antioxidative effects in FM. Due to the lack of effective therapy for fibromyalgia, many treatments are sought to reduce pain and fatigue and improve patients' quality of life. This manuscript discusses the impact of various antioxidative procedures that can diminish fibromyalgia symptoms, such as hyperbaric oxygen therapy, modification of dietary habits, and physical activity.
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10
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Nutraceuticals: A source of benefaction for neuropathic pain and fibromyalgia. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Kundakci B, Kaur J, Goh SL, Hall M, Doherty M, Zhang W, Abhishek A. Efficacy of nonpharmacological interventions for individual features of fibromyalgia: a systematic review and meta-analysis of randomised controlled trials. Pain 2022; 163:1432-1445. [PMID: 34813518 DOI: 10.1097/j.pain.0000000000002500] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/15/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Fibromyalgia is a highly heterogeneous condition, but the most common symptoms are widespread pain, fatigue, poor sleep, and low mood. Nonpharmacological interventions are recommended as first-line treatment of fibromyalgia. However which interventions are effective for the different symptoms is not well understood. The objective of this study was to assess the efficacy of nonpharmacological interventions on symptoms and disease-specific quality of life. Seven databases were searched from their inception until June 1, 2020. Randomised controlled trials comparing any nonpharmacological intervention to usual care, waiting list, or placebo in people with fibromyalgia aged >16 years were included without language restriction. Fibromyalgia Impact Questionnaire (FIQ) was the primary outcome measure. Standardised mean difference and 95% confidence interval were calculated using random effects model. The risk of bias was evaluated using the modified Cochrane tool. Of the 16,251 studies identified, 167 randomised controlled trials (n = 11,012) assessing 22 nonpharmacological interventions were included. Exercise, psychological treatments, multidisciplinary modality, balneotherapy, and massage improved FIQ. Subgroup analysis of different exercise interventions found that all forms of exercise improved pain (effect size [ES] -0.72 to -0.96) and depression (ES -0.35 to -1.22) except for flexibility exercise. Mind-body and strengthening exercises improved fatigue (ES -0.77 to -1.00), whereas aerobic and strengthening exercises improved sleep (ES -0.74 to -1.33). Psychological treatments including cognitive behavioural therapy and mindfulness improved FIQ, pain, sleep, and depression (ES -0.35 to -0.55) but not fatigue. The findings of this study suggest that nonpharmacological interventions for fibromyalgia should be individualised according to the predominant symptom.
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Affiliation(s)
- Burak Kundakci
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- cCentre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Jaspreet Kaur
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Siew Li Goh
- Sports Medicine Unit, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Hall
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Division of Physiotherapy and Rehabilitation Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Michael Doherty
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Weiya Zhang
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Abhishek Abhishek
- Academic Rheumatology, Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, Nottingham, United Kingdom
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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12
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The Efficacy of Vitamin D Supplementation in the Treatment of Fibromyalgia Syndrome and Chronic Musculoskeletal Pain. Nutrients 2022; 14:nu14153010. [PMID: 35893864 PMCID: PMC9330000 DOI: 10.3390/nu14153010] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023] Open
Abstract
Fibromyalgia syndrome (FMS) and chronic widespread musculoskeletal pain (CMP) are diffuse suffering syndromes that interfere with normal activities. Controversy exists over the role of vitamin D in the treatment of these diseases. We carried out a systematic literature review of randomized controlled trials (RCT) to establish whether vitamin D (25OHD) deficiency is more prevalent in CMP patients and to assess the effects of vitamin D supplementation in pain management in these individuals. We searched PubMed, Physiotherapy Evidence Database (PEDro), and the Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published in English from 1 January 1990 to 10 July 2022. A total of 434 studies were accessed, of which 14 satisfied the eligibility criteria. In our review three studies, of which two had the best-quality evidence, a correlation between diffuse muscle pain and 25OHD deficiency was confirmed. Six studies, of which four had the best-quality evidence, demonstrated that appropriate supplementation may have beneficial effects in patients with established blood 25OHD deficiency. Eight studies, of which six had the best-quality evidence, demonstrated that 25OHD supplementation results in pain reduction. Our results suggest a possible role of vitamin D supplementation in alleviating the pain associated with FMS and CMP, especially in vitamin D-deficient individuals.
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13
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Scaturro D, Vitagliani F, Tomasello S, Filippetti M, Picelli A, Smania N, Letizia Mauro G. Can the Combination of Rehabilitation and Vitamin D Supplementation Improve Fibromyalgia Symptoms at All Ages? J Funct Morphol Kinesiol 2022; 7:jfmk7020051. [PMID: 35736022 PMCID: PMC9224733 DOI: 10.3390/jfmk7020051] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Several studies have indicated a correlation between vitamin D deficiency and widespread chronic pain syndromes, such as fibromyalgia. During this study, the effect of supplementation with vitamin D in association with physical exercise in patients with fibromyalgia was evaluated, in terms of improvement of pain, functional capacity and quality of life, also evaluating the presence of any differences in age. A single-center, observational, comparative study was conducted in 80 fibromyalgia patients. They are randomized into 2 groups: Group A, consisting of patients ≤50 years; and group B, consisting of patients >50 years. Both received weekly supplementation with 50,000 IU cholecalciferol for 3 months in association with a rehabilitation protocol. Patients were assessed at enrollment (T0), 3 months (T1), and 6 months (T2) from the initial assessment with blood vitamin D dosage and administration of rating scales (NRS, FIQ, and SF-12). From the comparison between the two groups, we have seen that in young people, supplementation with high-dose vitamin D improves short-term musculoskeletal pain and long-term functional capacity. Conversely, musculoskeletal pain and long-term quality of life improve in the elderly. Supplementing with high doses of vitamin D in fibromyalgia patients improves the quality of life and pain in the elderly and also the functional capacity in the young.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90127 Palermo, Italy;
- Correspondence:
| | - Fabio Vitagliani
- Faculty of Medicine and Surgery, University of Catania, 90121 Catania, Italy;
| | - Sofia Tomasello
- Faculty of Medicine and Surgery, University of Palermo, 90127 Palermo, Italy;
| | - Mirko Filippetti
- Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, 37100 Verona, Italy; (M.F.); (A.P.); (N.S.)
| | - Alessandro Picelli
- Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, 37100 Verona, Italy; (M.F.); (A.P.); (N.S.)
- Neuromotor and Cognitive Rehabilitation Research Center, Physical and Rehabilitation Medicine Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Nicola Smania
- Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, 37100 Verona, Italy; (M.F.); (A.P.); (N.S.)
- Neuromotor and Cognitive Rehabilitation Research Center, Physical and Rehabilitation Medicine Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90127 Palermo, Italy;
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14
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Qu K, Li MX, Zhou YL, Yu P, Dong M. The efficacy of vitamin D in treatment of fibromyalgia: a meta-analysis of randomized controlled studies and systematic review. Expert Rev Clin Pharmacol 2022; 15:433-442. [PMID: 35596576 DOI: 10.1080/17512433.2022.2081151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent studies have found potential benefits of vitamin D in relieving pain, while the results from randomized controlled trials of vitamin D for fibromyalgia have been promising. We conducted a systematic review and meta-analysis to evaluate the efficacy of vitamin D in the treatment of fibromyalgia. RESEARCH DESIGN AND METHODS PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched. The language used was limited to English. We selected only randomized controlled studies that reported vitamin D versus placebo-controlled cure for fibromyalgia. After extracting valid data, a meta-analysis was performed using Stata version 12.0. The major outcome in the pooled analysis was the Fibromyalgia Impact Questionnaire and Visual Analogue Scale (VAS) changes in fibromyalgia patients before and after treatment. The pooled effects were analyzed as mean differences and 95% confidence intervals. RESULTS : Five studies including 315 participants were identified. These studies found that vitamin D was effective in reducing Fibromyalgia Impact Questionnaire scores compared with that in the control group, with significant differences (weighted mean difference = -7.82, 95% confidence interval: -12.05 to -3.59, P < 0.001). However, there was no statistical difference in VAS between the two groups (weighted mean difference = -0.60, 95% confidence interval: -1.38 to 0.17, P > 0.05). CONCLUSIONS Data from randomized controlled studies suggest that vitamin D supplementation may be an effective fibromyalgia therapeutic approach.
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Affiliation(s)
- Kang Qu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ming-Xi Li
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yu-Ling Zhou
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Peng Yu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Ming Dong
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, Jilin, China
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15
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Migliorini F, Maffulli N, Eschweiler J, Knobe M, Tingart M, Colarossi G. Pharmacological management of fibromyalgia: a Bayesian network meta-analysis. Expert Rev Clin Pharmacol 2022; 15:205-214. [DOI: 10.1080/17512433.2022.2044792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Filippo Migliorini
- Department of Orthopedics, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi (SA), Italy
- School of Pharmacy and Bioengineering, Keele University School of Medicine, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise MedicineQueen Mary University of London, London E1 4DG, England
| | - Jörg Eschweiler
- Department of Orthopedics, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Matthias Knobe
- Department of Orthopedics and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Markus Tingart
- Department of Orthopedics, RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Giorgia Colarossi
- Department of Orthopedics, RWTH Aachen University Clinic, 52074 Aachen, Germany
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16
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Ali OME. Prevalence of Vitamin D Deficiency and Its Relationship with Clinical Outcomes in Patients with Fibromyalgia: a Systematic Review of the Literature. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:38. [PMID: 35071984 PMCID: PMC8760589 DOI: 10.1007/s42399-021-01105-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 04/18/2023]
Abstract
Fibromyalgia is a debilitating chronic condition which poses a therapeutic challenge to the clinician. With a large backlog in patient flow subsequent to the COVID-19 pandemic and rising numbers of patients with post-acute sequelae of COVID-19 (PASC) presenting with fibromyalgia-like clinical features, there is an increasingly pressing need to identify broad cost-effective interventions. Low levels of vitamin D have previously been reported in patients with fibromyalgia, though any causative link has been difficult to establish. A systematic literature review on the association between vitamin D deficiency and fibromyalgia was performed examining retrospective evidence both for and against an association between vitamin D deficiency (VDD) and fibromyalgia and evaluating the therapeutic benefit from supplementation. A group of six studies were selected based on relevance, use of controls, quality of research and citations. Four primary studies assessing the prevalence of VDD in fibromyalgia patients versus controls were evaluated with a total 3,496 subjects. Three included females only and one larger study assessed males. Two (n = 313) concluded the presence of a statistically significant association, and two (n = 161) found none. Two randomised controlled trials assessing the effect of vitamin D supplementation in a total of 80 subjects found conflicting results, with pain reduction in one and none in the other. It is likely there exists an association between VDD deficiency and fibromyalgia in a large subset of patients, although establishing primary causation is difficult. There is a need for larger randomised controlled trial designs with more effective comparison with healthy subjects and control for confounding factors. Given VDD is a major problem in the general population, we recommend supplementation be recommended by healthcare professionals to fibromyalgia patients for the purpose of maintaining bone health given their potentially increased susceptibility to developing deficiency and its sequelae.
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Affiliation(s)
- Omar M. E. Ali
- School of Medical Education, Newcastle University, 2 Faversham Court, Newcastle upon Tyne, NE3 2XN UK
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17
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18
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Haddad HW, Mallepalli NR, Scheinuk JE, Bhargava P, Cornett EM, Urits I, Kaye AD. The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review. Pain Ther 2021; 10:827-848. [PMID: 33909266 PMCID: PMC8586285 DOI: 10.1007/s40122-021-00266-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The multifaceted clinical presentation of fibromyalgia (FM) supports the modern understanding of the disorder as a more global condition than one simply affecting pain sensation. The main pharmacologic therapies used clinically include anti-epileptics and anti-depressants. Conservative treatment options include exercise, myofascial release, psychotherapy, and nutrient supplementation. METHODS Narrative review. RESULTS Nutrient supplementation is a broadly investigated treatment modality as numerous deficiencies have been linked to FM. Additionally, a proposed link between gut microbiome patterns and chronic pain syndromes has led to studies investigating probiotics as a possible treatment. Despite positive results, much of the current evidence regarding this topic is of poor quality, with variable study designs, limited sample sizes, and lack of control groups. CONCLUSIONS The etiology of FM is complex, and has shown to be multi-factorial with genetics and environmental exposures lending influence into its development. Preliminary results are promising, however, much of the existing evidence regarding diet supplementation is of poor quality. Further, more robust studies are needed to fully elucidate the potential of this alternative therapeutic option.
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Affiliation(s)
| | - Nikita Reddy Mallepalli
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - John Emerson Scheinuk
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Pranav Bhargava
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Elyse M. Cornett
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
- Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
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Kucuk A, Baykara RA, Tuzcu A, Omma A, Cure MC, Cure E, Acet GK, Dogan E. Could ferritin, vitamin B 12, and vitamin D play a role in the etiopathogenesis of fibromyalgia syndrome? ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2021; 59:384-393. [PMID: 34142515 DOI: 10.2478/rjim-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Indexed: 02/07/2023]
Abstract
Introduction. Fibromyalgia syndrome (FS) comprises general body pain, sleep disturbances, and fatigue. Vitamin B12 (VB), vitamin D (VD), and iron deficiencies lead to similar complaints. First, this study aimed to evaluate the VB, VD, and ferritin levels of patients with FS. Second, it aimed to investigate whether there was a relationship between these parameters and FS severity. Material and methods. The study included 58 female patients with FS and 58 healthy females as a control group. The patients completed the Fibromyalgia Impact Questionnaire (FIQ), Visual Analog Scale (VAS), fatigue questionnaire, Pittsburgh sleep quality scale, and the Short Form-36 (SF-36). This study examined the VD, VB, and ferritin levels of the patient and control groups. Results. The VB (240.0 [110.0-394.0] vs 291.0 [210.0-609.0] pg/ml, p<0.001), VD (12.5 [3.0-45.0] vs 20.0 [5.0-54.0] ng/ml, p=0.013), and ferritin levels (21.2 [4.0-86.0] vs 32.0 [7.1-120.0], ng/ml, p=0.009) of the FS patients were determined to be significantly lower than those of the control group. A negative correlation was determined between the number of tender points and VB, VD, and ferritin levels. In the regression analysis, we found low ferritin levels (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.015-1.058, p<0.001) and VB (OR 1.010, CI 1.002-1.018, p=0.010) to be an independent risk factor for FS. Conclusions. There may be a relationship between VB, VD, and ferritin levels and the number of tender points in patients with FS. Levels of iron and VB may play a vital role in FS etiopathogenesis. However, VD levels may not be a risk factor for FS etiopathogenesis.
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Affiliation(s)
- Adem Kucuk
- Department of Rheumatology, Necmettin Erbakan University, Konya, Turkey
| | - Rabia Aydogan Baykara
- Department of Physical Medicine and Rehabilitation, School of Medicine, Turgut Ozal University, Malatya, Turkey
| | - Ayca Tuzcu
- Department of Biochemistry, School of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Ahmet Omma
- Division of Rheumatology, Department of Internal Medicine, Numune Education and Research Hospital, Ankara, Turkey
| | - Medine Cumhur Cure
- Department of Biochemistry, Private Kucukcekmece Hospital, Istanbul, Turkey
| | - Erkan Cure
- Department of Internal Medicine, Ota&Jinemed Hospital, Istanbul, Turkey
| | - Gunseli Karaca Acet
- Department of Physical Medicine and Rehabilitation, Malatya Education and Research Hospital, Malatya, Turkey
| | - Erdal Dogan
- Department of Physical Medicine and Rehabilitation, Malatya Park Private Hospital, Malatya, Turkey
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20
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Migliorini F, Maffulli N, Eschweiler J, Betsch M, Tingart M, Colarossi G. Placebo effect in pharmacological management of fibromyalgia: a meta-analysis. Br Med Bull 2021; 139:73-85. [PMID: 34296741 DOI: 10.1093/bmb/ldab015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The management of fibromyalgia involves a combination of pharmacological and non-pharmacological treatments. SOURCE OF DATA Recently published literature in PubMed, Google Scholar and Embase databases. AREAS OF AGREEMENT Several pharmacological and non-pharmacological strategies have been proposed for the management of fibromyalgia. However, the management of fibromyalgia remains controversial. The administration of placebo has proved to be more effective than no treatment in many clinical settings and evidence supports the 'therapeutic' effects of placebo on a wide range of symptoms. AREAS OF CONTROVERSY The placebo effect is believed to impact the clinical outcomes, but its actual magnitude is controversial. GROWING POINTS A meta-analysis comparing pharmacological management versus placebo administration for fibromyalgia was conducted. AREAS TIMELY FOR DEVELOPING RESEARCH Drug treatment resulted to be more effective than placebo administration for the management of fibromyalgia. Nevertheless, placebo showed a beneficial effect in patients with fibromyalgia. Treatment-related adverse events occurred more frequently in the drug treatment. LEVEL OF EVIDENCE I, Bayesian network meta-analysis of double-blind randomized clinical trials.
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Affiliation(s)
- Filippo Migliorini
- Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi (Salerno) 84081, Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, ST5 5BG Stoke on Trent, UK.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK
| | - Jörg Eschweiler
- Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Marcel Betsch
- Department of Orthopedics and Trauma Surgery, University Medical Center Mannheim of the University Heidelberg, Ludolf-Krehl-Straße 13-17, 68167 Mannheim, Germany
| | - Markus Tingart
- Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Giorgia Colarossi
- Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany
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21
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Marchesi N, Govoni S, Allegri M. Non-drug pain relievers active on non-opioid pain mechanisms. Pain Pract 2021; 22:255-275. [PMID: 34498362 DOI: 10.1111/papr.13073] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review is aimed to summarize the pain-relieving effect of non-drug substances, mostly prescribed as integrators in treatment of pain, including especially in chronic postoperative pain (CPSP) and in chronic back pain after acute episodes. Their use reflects the fact that the current treatments for these syndromes continue to pose problems of unsatisfactory responses in a significant portion of patients and/or of an excess of side effects like those noted in the present opioid crisis. As integrators are frequently introduced into the market without adequate clinical testing, this review is aimed to collect the present scientific evidence either preclinical or clinical for their effectiveness. In particular, we reviewed the data on the use of: B vitamins; vitamin C; vitamin D; alpha lipoic acid (ALA); N-acetylcysteine; acetyl L-carnitine; curcumin; boswellia serrata; magnesium; coenzyme Q10, and palmitoylethanolamide. The combination of preclinical findings and clinical observations strongly indicate that these compounds deserve more careful attention, some of them having interesting clinical potentials also in preventing chronic pain after an acute episode. In particular, examining their putative mechanisms of action it emerges that combinations of few of them may exert an extraordinary spectrum of activities on a large variety of pain-associated pathways and may be eventually used in combination with more traditional pain killers in order to extend the duration of the effect and to lower the doses. Convincing examples of effective combinations against pain are vitamin B complex plus gabapentin for CPSP, including neuropathic pain; vitamin B complex plus diclofenac against low back pain and also in association with gabapentin, and ALA for burning mouth syndrome. These as well as other examples need, however, careful controlled independent clinical studies confirming their role in therapy.
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Affiliation(s)
| | - Stefano Govoni
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Massimo Allegri
- Pain Therapy Service, Policlinico Monza, Monza, Italy.,Italian Pain Group, Monza-Brianza, Italy
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22
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Beling A, Hresko MT, DeWitt L, Miller PE, Pitts SA, Emans JB, Hedequist DJ, Glotzbecker MP. Vitamin D levels and pain outcomes in adolescent idiopathic scoliosis patients undergoing spine fusion. Spine Deform 2021; 9:997-1004. [PMID: 33683641 DOI: 10.1007/s43390-021-00313-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 02/14/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Prior research has indicated adolescent idiopathic scoliosis (AIS) patients have lower bone mineral density and lower vitamin D levels than healthy peers. Vitamin D deficiency has been associated with higher levels of pain. This study investigated whether vitamin D-deficient AIS patients had higher pain before or immediately after posterior spine fusion (PSF) surgery. METHODS 25-Hydroxy vitamin D levels were tested in all AIS patients at their pre-operative appointment. Patients were grouped by serum 25-hydroxy vitamin D level: deficient, < 20 ng/mL; insufficient, 20-29 ng/mL; sufficient, ≥ 30 ng/mL. Primary outcomes included pre-operative Scoliosis Research Society Health-Related Quality of Life (SRS-30) and numeric rating scale (NRS) scores (0-10) up to 72 h post-operatively, and analyzed using ANOVA and linear mixed modeling, respectively. 176 patients undergoing PSF were included. Intra-operative characteristics by vitamin D status were also assessed. The cohort was 82% female and an average of 15.2 years (range 10.6-25.3 years) at fusion. Average major curve was 60 (range 40-104) degrees pre-operatively. RESULTS Forty-five (26%) patients were deficient in vitamin D, 75 (43%) were insufficient, and 56 (32%) were sufficient. Patients with vitamin D deficiency had lower average household income by zip code (p < 0.01) and higher secondhand smoke exposure (p < 0.001). There were no differences in pre-operative SRS-30 score, pre- and post-operative major curve angles, or estimated blood loss across vitamin D groups. Trajectories of NRS indicated no differences in pain during the first 72 h after surgery. CONCLUSION Vitamin D deficiency in this population is associated with potential markers of lower socioeconomic status; however, it does not influence AIS PSF patients' experience of pain before or immediately after spine fusion surgery. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Alexandra Beling
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - M Timothy Hresko
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Leah DeWitt
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Patricia E Miller
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Sarah A Pitts
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - John B Emans
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Daniel J Hedequist
- Department of Orthopedics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Michael P Glotzbecker
- Department of Orthopedics, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
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23
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Haddad HW, Jumonville AC, Stark KJ, Temple SN, Dike CC, Cornett EM, Kaye AD. The Role of Vitamin D in the Management of Chronic Pain in Fibromyalgia: A Narrative Review. Health Psychol Res 2021; 9:25208. [PMID: 35106398 PMCID: PMC8801481 DOI: 10.52965/001c.25208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 09/15/2023] Open
Abstract
INTRODUCTION Fibromyalgia (FM) is a complex disorder characterized primarily by chronic, widespread musculoskeletal pain. Currently, the Food and Drug Administration (FDA) has approved the use of three medications to treat FM: pregabalin, duloxetine, and milnacipran. The pharmaceutical intervention has lacked consistent pain relief among all patients. Therefore, the investigation into alternative treatment options has grown in interest. This narrative review aims to evaluate the evidence regarding vitamin D for the treatment of FM. METHODS Narrative review. RESULTS Low serum vitamin D has been linked to various chronic pain states. An association between vitamin D deficiency and FM has been reported but is controversial in the literature. Some studies have documented the beneficial effects of vitamin D supplementation on reducing pain symptoms and improving the overall quality of life in those with FM. Despite these positive findings, many of the studies regarding this topic lack adequate power to make substantial conclusions about the effects of vitamin D on FM. CONCLUSION Existing studies provide promising results. However, additional high-quality data on vitamin D supplementation is needed before recommendations for pain management can be made. Vitamin D supplementation is inexpensive, has minimal side effects, and can benefit FM patients regardless of its efficacy in pain control. Additionally, high-quality studies are warranted to fully elucidate the potential of vitamin D to manage chronic pain in FM.
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Affiliation(s)
- Hannah W Haddad
- Kansas City University of Medicine and Biosciences, Kansas City, MO
| | | | | | | | - Chukwudum C Dike
- University of Medicine and Health Sciences St. Kitts, Camps, Basseterre, St. Kitts
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Shreveport, LA
| | - Alan D Kaye
- Department of Anesthesology, Louisiana State University Health Shreveport, LA
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24
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Migliorini F, Maffulli N, Eschweiler J, Tingart M, Driessen A, Colarossi G. BMI but not age and sex negatively impact on the outcome of pharmacotherapy in fibromyalgia: a systematic review. Expert Rev Clin Pharmacol 2021; 14:1029-1038. [PMID: 33990169 DOI: 10.1080/17512433.2021.1929923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The impact of sex, age, body mass index (BMI) in fibromyalgia is still unclear. A systematic review was conducted to investigate whether sex, age and BMI influence the clinical outcomes and rate of adverse events. METHODS The present study was performed according to the PRISMA guidelines. The literature search was performed in February 2021. All the RCTs investigating pharmacological strategies for fibromyalgia were accessed. RESULTS Data from 51 RCTs (17,311 patients) were collected. Short Form 36 emotional, Social function and physical role subscales showed evidence of a negative association with BMI (P = 0.02, P = 0.002 and P = 0.0001, respectively). Depression and anxiety subscales of the Hospital Anxiety and Depression score demonstrated evidence of a positive association with age (P = 0.04 and P = 0.001, respectively) and sex (P = 0.00005 and P = 0.0001, respectively). Visual analog scale evidenced a positive association with BMI (P = 0.04). Clinical Global Impression Severity scale demonstrated evidence of a negative association with BMI (P = 0.02). CONCLUSION Irrespective from the pharmacological approach, a higher BMI is negatively associated with a favorable outcome in patients with fibromyalgia. The association with sex and age remains controversial. LEVEL OF EVIDENCE I, systematic review of RCTs.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London, UK
| | - Jörg Eschweiler
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Markus Tingart
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Arne Driessen
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
| | - Giorgia Colarossi
- Department of Orthopedics, RWTH Aachen University Clinic, Aachen, Germany
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Food for Special Medical Purposes and Nutraceuticals for Pain: A Narrative Review. Pain Ther 2021; 10:225-242. [PMID: 33594594 PMCID: PMC8119521 DOI: 10.1007/s40122-021-00239-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/30/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction The present paper focuses on the possible contribution of food compounds to alleviate symptomatic pains. Chronic pain can more easily be linked to anticipatory signals such as thirst and hunger than it is to sensory perceptions as its chronicity makes it fall under the behavioural category rather than it does senses. In fact, pain often negatively affects one’s normal feeding behavioural patterns, both directly and indirectly, as it is associated with pain or because of its prostrating effects. Nutritional Compounds for Pain Several nutraceuticals and Foods for Special Medical Purposes (FSMPs) are reported to have significant pain relief efficacy with multiple antioxidant and anti-inflammatory properties. Apart from the aforementioned properties, amino acids, fatty acids, trace elements and vitamins may have a role in the modulation of pain signals to and within the nervous system. Conclusion In our opinion, this review could be of great interest to clinicians, as it offers a complementary perspective in the management of pain. Trials with well-defined patient and symptoms selection and a robust pharmacological design are pivotal points to let these promising compounds become better accepted by the medical community.
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Efficacy and safety of weekly vitamin D 3 in patients with fibromyalgia: 12-week, double-blind, randomized, controlled placebo trial. Clin Rheumatol 2021; 40:3257-3264. [PMID: 33570701 DOI: 10.1007/s10067-021-05640-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION FM is a chronic musculoskeletal disorder characterized by the presence of generalized pain. There are contradictory results regarding the prevalence and supplementation effect of vitamin D deficiency on FM patients. We aim to determine the safety and efficacy of a 12-week vitamin D supplementation on FM patients. METHODS We conducted a randomized, placebo-controlled, double-blind clinical trial. We included female participants of 18 years old or older, who met 1990 or 2010 ACR criteria for fibromyalgia. The Spanish validated FIQ and the VAS of pain were applied at baseline. The participants were then randomized to receive placebo or 50,000 IU of Vitamin D3 PO, weekly for 12 weeks. RESULTS We included 80 patients. There was no statistical difference in the initial and final FIQ between both groups. The FIQ delta also did not prove to be different at the end of the study. The increase in vitamin D levels in the intervention group was corroborated. Regarding serious adverse effects, none was reported in both groups. There was no statistical difference in minor adverse events. CONCLUSION In this double-blind placebo-controlled randomized study conducted to measure the efficacy and safety of vitamin D exclusively in patients with FM, we found that there is no evidence of a trend in favor of vitamin D treatment, since we did not observe improvement in the VAS of pain or FIQ. TRIAL REGISTRY Clinical Trials.gov number: NCT03369379 Key Points • There are conflicting results in vitamin D to treat fibromyalgia. • In this double-blind, randomized controlled trial, we did not find a difference in the VAS nor FIQ with vitamin D supplementation. • The increase in vitamin D levels in the intervention group was corroborated.
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Mauck MC, Barton CE, Tungate A, Shupp JW, Karlnoski R, Smith DJ, Williams FN, Jones SW, McGrath KV, Cairns BA, McLean SA. Peritraumatic Vitamin D levels predict chronic pain severity and contribute to racial differences in pain outcomes following Major Thermal Burn Injury. J Burn Care Res 2021; 42:1186-1191. [PMID: 33564878 DOI: 10.1093/jbcr/irab031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Major thermal burn injuries result in approximately 40,000 hospitalizations in the United States each year. Chronic pain affects up to 60% of burn survivors, Black Americans have worse chronic pain outcomes than White Americans. Mechanisms of chronic pain pathogenesis after burn injury, and accounting for these racial differences, remain poorly understood. Due to socioeconomic disadvantage and differences in skin absorption, Black Americans have an increased prevalence of Vitamin D deficiency. We hypothesized that peritraumatic Vitamin D levels predict chronic pain outcomes after burn injury and contribute to racial differences in pain outcomes. Among burn survivors (n=77, 52% White, 48% Black, 77% male), peritraumatic Vitamin D levels were more likely to be deficient in Blacks vs. Whites (27/37 (73%) vs. 14/40 (35%), p<.001). Peritraumatic Vitamin D levels were inversely associated with chronic post-burn pain outcomes across all burn injury survivors, including those who were and were not Vitamin D deficient, and accounted for approximately 1/3 of racial differences in post-burn pain outcome. Future studies are needed to evaluate potential mechanisms mediating the effect of Vitamin D on post-burn pain outcomes and the potential efficacy of Vitamin D in improving pain outcomes and reducing racial differences.
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Affiliation(s)
- Matthew C Mauck
- Institute for Trauma Recovery.,Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Chloe E Barton
- Institute for Trauma Recovery.,Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Andrew Tungate
- Institute for Trauma Recovery.,Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Jeffrey W Shupp
- The Burn Center, MedStar Washington Hospital Center, Washington, DC
| | - Rachel Karlnoski
- Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - David J Smith
- Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | | | - Samuel W Jones
- Jaycee Burn Center, University of North Carolina Chapel Hill, NC
| | - Kyle V McGrath
- Institute for Trauma Recovery.,Anesthesiology, University of North Carolina, Chapel Hill, NC
| | - Bruce A Cairns
- Jaycee Burn Center, University of North Carolina Chapel Hill, NC
| | - Samuel A McLean
- Institute for Trauma Recovery.,Anesthesiology, University of North Carolina, Chapel Hill, NC.,Emergency Medicine, University of North Carolina, Chapel Hill, NC
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KARABULUT İ, KOCAMAZ D, TURHAN B. Fibromiyalji hastalarında d vitamini eksikliğinin fiziksel semptomlara etkisinin incelenmesi: Sistematik derleme. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.818963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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The relationship between vitamin 25(OH)D level and hematological parameters in newly diagnosed women with fibromyalgia syndrome. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.746743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lowry E, Marley J, McVeigh JG, McSorley E, Allsopp P, Kerr D. Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis. Nutrients 2020; 12:E2664. [PMID: 32878326 PMCID: PMC7551150 DOI: 10.3390/nu12092664] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with Chlorella green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.
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Affiliation(s)
- Ethan Lowry
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
| | - Joanne Marley
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
| | - Joseph G. McVeigh
- School of Clinical Therapies, University College Cork, Douglas Street, Cork T12 YN60, Ireland;
| | - Emeir McSorley
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (E.M.); (P.A.)
| | - Philip Allsopp
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (E.M.); (P.A.)
| | - Daniel Kerr
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
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Nutritional Interventions in the Management of Fibromyalgia Syndrome. Nutrients 2020; 12:nu12092525. [PMID: 32825400 PMCID: PMC7551285 DOI: 10.3390/nu12092525] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The management of FM requires a multidisciplinary approach combining both pharmacological and nonpharmacological strategies. Among nonpharmacological strategies, growing evidence suggests a potential beneficial role for nutrition. This review summarizes the possible relationship between FM and nutrition, exploring the available evidence on the effect of dietary supplements and dietary interventions in these patients. Analysis of the literature has shown that the role of dietary supplements remains controversial, although clinical trials with vitamin D, magnesium, iron and probiotics' supplementation show promising results. With regard to dietary interventions, the administration of olive oil, the replacement diet with ancient grains, low-calorie diets, the low FODMAPs diet, the gluten-free diet, the monosodium glutamate and aspartame-free diet, vegetarian diets as well as the Mediterranean diet all appear to be effective in reducing the FM symptoms. These results may suggest that weight loss, together with the psychosomatic component of the disease, should be taken into account. Therefore, although dietary aspects appear to be a promising complementary approach to the treatment of FM, further research is needed to provide the most effective strategies for the management of FM.
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Martins YA, Cardinali CAEF, Ravanelli MI, Brunaldi K. Is hypovitaminosis D associated with fibromyalgia? A systematic review. Nutr Rev 2020; 78:115-133. [PMID: 31397485 DOI: 10.1093/nutrit/nuz033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Recent findings have suggested a high prevalence of vitamin D deficiency or insufficiency in fibromyalgia (FM) patients despite the lack of clinical and pathophysiological evidence. OBJECTIVE A systematic review was conducted to examine the association between vitamin D status and FM, including the effect of vitamin D supplementation. DATA SOURCE PubMed, LILACS, Scopus, SciELO, Cochrane, and EMBASE were searched, from January 2000 to July 2018, using the descriptors "Fibromyalgia" and "Vitamin D." STUDY SELECTION Trials including FM patients in whom vitamin D levels were assessed were eligible for inclusion. DATA EXTRACTION Data comprised age, gender, country, aims, bias, diagnosis criteria, cutoff point, and status of vitamin D, together with FM symptoms and vitamin D supplementation protocol. RESULTS A total of 26 articles were selected. Most of the studies were found to present unreliable control groups and small samples. Experimental data on vitamin D supplementation indicated improvement in certain FM symptoms. CONCLUSION Prevalence of hypovitaminosis D in the FM population and the cause-effect relationship were inconclusive. Nevertheless, vitamin D supplementation may be considered as a co-adjuvant in FM therapy.
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Affiliation(s)
- Yandara A Martins
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Camila A E F Cardinali
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Maria Ida Ravanelli
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Kellen Brunaldi
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
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Boyd C, Crawford C, Berry K, Deuster P. Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers. PAIN MEDICINE 2020; 20:1430-1448. [PMID: 30986301 PMCID: PMC6611527 DOI: 10.1093/pm/pnz051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Approximately 55-76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. METHODS A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use. RESULTS Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced. CONCLUSIONS The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers.
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Affiliation(s)
- Courtney Boyd
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Cindy Crawford
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Kevin Berry
- Thought Leadership and Innovation Foundation, McLean, Virginia, USA
| | - Patricia Deuster
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA
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Low levels of serum vitamin D3 are associated with fibromyalgia syndrome in pre-menopausal women: A pilot study. Turk J Phys Med Rehabil 2020; 66:67-72. [PMID: 32318677 DOI: 10.5606/tftrd.2020.2928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 11/05/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the prevalence of fibromyalgia syndrome (FMS) among patients with low and adequate vitamin D levels in premenopausal women. Patients and methods Between October 2012 and April 2013, a total of 80 premenopausal patients (mean age 38.1±7.1 years; range, 18 to 50 years) with non-specific musculoskeletal symptoms were included in the study. The determination of 25-hydroxyvitamin D3 (25(OH)D3) deficiency was based on a reference value of 25 ng/mL. Patients with deficient serum 25(OH)D3 levels (<25 ng/mL, n=40) comprised the patient group, while those with adequate serum 25(OH)D3 levels (≥25 ng/mL, n=40) comprised the control group. Data including demographic characteristics, laboratory parameters (i.e., calcium, phosphorus, alkaline phosphatase [ALP], and parathyroid hormone [PTH]), and clinical findings (i.e., proximal muscle weakness [PMW] and periarticular sensitivity [PAS]) were recorded and compared between the groups. Pain severity was evaluated using the visual analog scale (VAS), psychological status was evaluated using the Beck Depression Inventory (BDI), and quality of life (QoL) was evaluated using the Short Form 36 (SF-36). The diagnosis of FMS was made based on the 2010 criteria of the American College of Rheumatology. Results Although there were no statistically significant differences in the demographic characteristics between the groups, ALP and PTH levels were higher in the patient group (p<0.05). The VAS, frequency of FMS, PMW, and PAS were also significantly higher in the patient group (p<0.05). Depression and the mental and physical component scores of the SF-36 did not significantly differ between the two groups (p<0.05). Conclusion Our study results suggest that patients with low 25(OH)D3 levels may more frequently experience FMS and pain than healthy individuals.
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Kenis-Coskun O, Giray E, Gunduz OH, Akyuz G. The effect of vitamin D replacement on spinal inhibitory pathways in women with chronic widespread pain. J Steroid Biochem Mol Biol 2020; 196:105488. [PMID: 31589918 DOI: 10.1016/j.jsbmb.2019.105488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/05/2019] [Accepted: 09/30/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D replacement helps in pain reduction in patients with chronic widespread pain (CWP). But the current literature lack studies that investigate its mechanism. Cutaneous silent period (CSP) is the electrophysiologic analog of the spinal inhibitory pathways and an objective method to document their involvement. This study aims to show if vitamin D replacement has an effect on the spinal inhibitory pathways through CSP parameters. Female patients who have CWP with vitamin D deficiency were included. Patients received an 8-week replacement therapy of vitamin D. Patients' pain were evaluated using the visual analog scale (VAS) and Leeds assessment of neuropathic symptoms and signs pain scale (LANSS). Quality of life with Nottingham Health Profile (NHP) and CSP parameters were also recorded before and after treatment. A total of 51 patients were included in the final analyses. The mean age of the patients was 44.3 ± 12.7 (minimum 18-maximum 65). Mean symptom duration was 13.1 ± 6.7 (minimum3-maximum 24) months. Patients' mean BMI was 21.6 ± 3.9 (minimum 18.0 maximum 29.1). Patients' median VAS and LANSS scores decreased significantly (p < 0.01) and NHP scores improved significantly in all subsets (p < 0.01). Vitamin D replacement did not significantly change CSP latency and duration (p = 0.06 and p = 0.12).Vitamin D replacement does not seem to work via modifying the spinal inhibitory pathways that are involved in the formation of the cutaneous silent period. This is the first study to objectively investigate the effect of vitamin D replacement on central sensitization mechanisms.
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Affiliation(s)
- Ozge Kenis-Coskun
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey.
| | - Esra Giray
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey
| | - Osman Hakan Gunduz
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey
| | - Gulseren Akyuz
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department, Turkey
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ALdaoseri HA, Zubairi MB. Vitamin D deficiency and treatment in Iraqi patients with primary fibromyalgia syndrome. THE EGYPTIAN RHEUMATOLOGIST 2020. [DOI: 10.1016/j.ejr.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Qvist N, Bergström I, Åkerstedt T, Persson J, Konradsen H, Forss A. From being restrained to recapturing vitality: non-western immigrant women's experiences of undergoing vitamin D treatment after childbirth. Int J Qual Stud Health Well-being 2019; 14:1632111. [PMID: 31232674 PMCID: PMC6598479 DOI: 10.1080/17482631.2019.1632111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 10/27/2022] Open
Abstract
Purpose: Vitamin D deficiency is a complex topic in human health and ill-health and has been studied in a variety of contexts and populations. Few studies examine Vitamin D deficiency among non-western immigrant women and even fewer examine women's perspective on daily life while living with low vitamin D levels after childbirth and undergoing vitamin D treatment. The aim was, therefore, to explore health and ill-health among non-western immigrant women living with low vitamin D levels after childbirth and reaching normalized levels after one year of vitamin D treatment. Method: An explorative qualitative study using qualitative content analysis. Six women aged 25 to 38 years, diagnosed with low 25-hydroxyvitamin D levels during pregnancy, were recruited after having undergone vitamin D treatment. Results: The women told about living a restrained life which gradually transformed into an experience of recaptured vitality. They also experienced a need for continuity in medication, as an interruption of treatment meant returning symptoms. Conclusion: In this study, non-western immigrant women described benefits in everyday life, increased strength, relieved pain and improved sleep quality. The findings can provide valuable knowledge for healthcare providers meeting women with physical weakness, musculoskeletal pain and/or poor sleep quality after childbirth. Further studies using a longitudinal design and larger samples are warranted.
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Affiliation(s)
- Ninni Qvist
- Osteoporosis Center, Inflammation & Infection Theme, Karolinska University Hospital Huddinge, Sweden
| | - Ingrid Bergström
- Osteoporosis Center, Inflammation & Infection Theme, Karolinska University Hospital Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Sweden
| | - Torbjörn Åkerstedt
- Stress Research Institute, Stockholm University, Sweden
- Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jan Persson
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Sweden
- Behavioral Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | - Anette Forss
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Department of Philosophy, Stony Brook University, New York, USA
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Serum Analysis in Patients with Temporomandibular Disorders: A Controlled Cross-Sectional Study in Norway. Pain Res Manag 2019; 2019:1360725. [PMID: 31687055 PMCID: PMC6800918 DOI: 10.1155/2019/1360725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/15/2019] [Accepted: 09/13/2019] [Indexed: 02/07/2023]
Abstract
Temporomandibular disorder (TMD) is characterized by pain and dysfunction in the temporomandibular join (TMJ) and the masticatory apparatus. Associations with autoimmune diseases, inflammatory conditions, and nutrition deficiencies have been reported in previous studies of TMD patients. To evaluate essential proteins, hormones, electrolytes, and vitamins in serum from TMD patients, a standard blood sample analysis was performed in 60 TMD patients and 60 healthy controls matched for age and gender, retrieving 19 different analyses. We found that TMD patients had significantly higher values of hemoglobin (p=0.036), cobalamin (p=0.023), albumin (p=0.005), parathyroid hormone (PTH) (p=0.038), and vitamin D (p=0.005), and significantly lower values of creatinine (p=0.006) and potassium (p=0.011), compared to controls. In the TMD group, most of the determinants had a wider range, and several subjects, compared to the control group, had values outside the normal reference area. However, most of the TMD patients and controls had values within normal biological range. Our findings could not associate any severe systemic disease, malnutrition, or systemic inflammation with the TMD. Results from our study suggest that serum analyses should neither be used as a biomarker of TMD nor a diagnostic tool for an individual subject with TMD.
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Abstract
Vitamin D, a fat-soluble vitamin, plays a role not only in calcium and phosphate homeostasis but also in several other functions, including cell growth and neuromuscular and immune function. The deficiency of vitamin D is highly prevalent throughout the world and has been suggested to be associated with an enhanced risk of major depressive disorder (MDD) and anxiety disorders. Therefore, vitamin D supplementation has been investigated for the prevention and treatment of these disorders. This review presents preclinical and clinical evidence of the effects of vitamin D supplementation in these disorders. Although preclinical studies provide limited evidence on the possible mechanisms underlying the beneficial effects of vitamin D for the management of these disorders, most of the clinical studies have indicated that vitamin D supplementation is associated with the reduction of symptoms of depression and anxiety, particularly when the supplementation was carried out in individuals with an MDD diagnosis (of the 13 studies in which MDD diagnosis was established, 12 had positive results with vitamin supplementation). However, some heterogeneity in the outcomes was observed and might be associated with an absence of overt psychiatric symptoms in several studies, genetic polymorphisms that alter vitamin D metabolism and bioavailability, differences in the supplementation regimen (monotherapy, adjunctive therapy, or large bolus dosing), and levels of 25-hydroxyvitamin D3 (25(OH)D) at baseline (individuals with low vitamin D status may respond better) and attained after supplementation. Additionally, factors such as sex, age, and symptom severity also need to be further explored in relation to the effects of vitamin D. Therefore, although vitamin D may hold significant potential for mental health, further preclinical and clinical studies are clearly necessary to better understand its role on mood/affect modulation.
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Cholecalciferol (Vitamin D 3) Reduces Rat Neuropathic Pain by Modulating Opioid Signaling. Mol Neurobiol 2019; 56:7208-7221. [PMID: 31001801 DOI: 10.1007/s12035-019-1582-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/21/2019] [Indexed: 01/13/2023]
Abstract
The impact of vitamin D on sensory function, including pain processing, has been receiving increasing attention. Indeed, vitamin D deficiency is associated with various chronic pain conditions, and several lines of evidence indicate that vitamin D supplementation may trigger pain relief. However, the underlying mechanisms of action remain poorly understood. We used inflammatory and non-inflammatory rat models of chronic pain to evaluate the benefits of vitamin D3 (cholecalciferol) on pain symptoms. We found that cholecalciferol supplementation improved mechanical nociceptive thresholds in monoarthritic animals and reduced mechanical hyperalgesia and cold allodynia in a model of mononeuropathy. Transcriptomic analysis of cerebrum, dorsal root ganglia, and spinal cord tissues indicate that cholecalciferol supplementation induces a massive gene dysregulation which, in the cerebrum, is associated with opioid signaling (23 genes), nociception (14), and allodynia (8), and, in the dorsal root ganglia, with axonal guidance (37 genes) and nociception (17). Among the identified cerebral dysregulated nociception-, allodynia-, and opioid-associated genes, 21 can be associated with vitamin D metabolism. However, it appears that their expression is modulated by intermediate regulators such as diverse protein kinases and not, as expected, by the vitamin D receptor. Overall, several genes-Oxt, Pdyn, Penk, Pomc, Pth, Tac1, and Tgfb1-encoding for peptides/hormones stand out as top candidates to explain the therapeutic benefit of vitamin D3 supplementation. Further studies are now warranted to detail the precise mechanisms of action but also the most favorable doses and time windows for pain relief.
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Farajzadeh A, Bathaie SZ, Arabkheradmand J, Ghodsi SM, Faghihzadeh S. Different Pain States of Trigeminal Neuralgia Make Significant Changes in the Plasma Proteome and Some Biochemical Parameters: a Preliminary Cohort Study. J Mol Neurosci 2018; 66:524-534. [DOI: 10.1007/s12031-018-1183-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 09/24/2018] [Indexed: 01/03/2023]
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Ellis SD, Kelly ST, Shurlock JH, Hepburn ALN. The role of vitamin D testing and replacement in fibromyalgia: a systematic literature review. BMC Rheumatol 2018; 2:28. [PMID: 30886978 PMCID: PMC6390590 DOI: 10.1186/s41927-018-0035-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 08/29/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fibromyalgia is a debilitating condition, characterized by extensive muscular pain and fatigue. Vitamin D is essential for overall health, with ubiquitous involvement in various inflammatory and pain pathways. Little is known about its role in fibromyalgia. We performed a systematic literature review to determine if vitamin D contributes to the pathology and disability of patients with fibromyalgia, and to assess the role of vitamin D supplementation in disease management. METHODS We searched Medline, EMBASE and the Cochrane Library for clinical studies and randomized controlled trials published in English during January 2000 to June 2017, using the terms vitamin D or hypovitaminosis D combined with fibromyalgia or FMS. References were reviewed manually and articles were only included if they were specific in their diagnosis of fibromyalgia and used appropriate control groups. RESULTS Four hundred and sixty-six studies were retrieved, of which fourteen fulfilled the inclusion criteria. Six studies, of which two had the best quality evidence, found that patients with fibromyalgia have low levels of vitamin D compared to healthy controls. Conflicting results were obtained on the effect of vitamin D on pain or symptom control, with no clear consensus as to the role of supplementation in the management of fibromyalgia. CONCLUSIONS Our results highlight an association between vitamin D deficiency and fibromyalgia. However, its role in the pathophysiology of fibromyalgia and the clinical relevance of identifying and treating this requires further elucidation with appropriately controlled studies.
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Affiliation(s)
- Shawn D. Ellis
- Department of Oncology, Royal Berkshire Hospital, Reading, RG1 5AN UK
| | - Sam T. Kelly
- Department of Medicine, Royal Sussex County Hospital, Brighton, BN2 5BE UK
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Bjørklund G, Dadar M, Chirumbolo S, Aaseth J. Fibromyalgia and nutrition: Therapeutic possibilities? Biomed Pharmacother 2018; 103:531-538. [DOI: 10.1016/j.biopha.2018.04.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 12/25/2022] Open
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Sommer C, Alten R, Bär KJ, Bernateck M, Brückle W, Friedel E, Henningsen P, Petzke F, Tölle T, Üçeyler N, Winkelmann A, Häuser W. [Drug therapy of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles]. Schmerz 2018; 31:274-284. [PMID: 28493231 DOI: 10.1007/s00482-017-0207-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A literature search for systematic reviews of randomized controlled drug trials from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. RESULTS AND CONCLUSION Amitriptyline and duloxetine are recommended in the case of comorbid depressive disorders or generalized anxiety disorder and pregabalin in the case of generalized anxiety disorder. Off-label use of duloxetine and pregabalin can be considered if there are no comorbid mental disorders or no generalized anxiety disorder. Strong opioids are not recommended.
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Affiliation(s)
- C Sommer
- Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
| | - R Alten
- Schlosspark-Klinik, Universitätsmedizin Berlin, Berlin, Deutschland
| | - K-J Bär
- Klinik für Psychiatrie und Psychotherapie, Friedrich-Schiller-Universität Jena, Jena, Deutschland
| | - M Bernateck
- Zentrum für Schmerzmedizin, Hannover, Deutschland
| | - W Brückle
- Rheumatologikum, Hannover, Deutschland
| | - E Friedel
- Medis Research GmbH, Bad Kissingen, Deutschland
| | - P Henningsen
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, München, Deutschland
| | - F Petzke
- Schmerzmedizin, Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - T Tölle
- Klinik für Neurologie, Technische Universität München, München, Deutschland
| | - N Üçeyler
- Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland
| | - A Winkelmann
- Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, München, Deutschland
| | - W Häuser
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, München, Deutschland.,Innere Medizin I, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland
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Effects of vitamin D optimization on quality of life of patients with fibromyalgia: A randomized controlled trial. Med J Islam Repub Iran 2018; 32:29. [PMID: 30159280 PMCID: PMC6108287 DOI: 10.14196/mjiri.32.29] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Numerous studies have been conducted to evaluate the frequency of hypovitaminosis D in patients with fibromyalgia syndrome (FMS) and its association with FMS symptoms. This study aimed at assessing the effect of hypovitaminosis D on the symptoms and quality of life of patients with fibromyalgia.
Methods: A total of 74 FMS patients with hypovitaminosis D were randomly assigned into group A (Trazodone 25 mg at bedtime + vitamin D 50 000 IU weekly) and group B (Trazodone 25 mg at bedtime + placebo). Serum vitamin D level, Widespread Pain Index (WPI), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), and Short Form Health Survey (SF-36) were used at the beginning of the treatment and 4 and 8 weeks post treatment.
Results: Significant improvements were observed in WPI, FIQ, and PSQI scores in both groups. Moreover, combination of vitamin D and Trazodone resulted in significant improvement of SF-36 scores compared to Trazodone therapy. Improvement in pain-related indices including the WPI and the physical component score (PCS) fraction of SF-36 was more noticeable in vitamin D/Trazodone combination therapy.
Conclusion: This study suggests that vitamin D supplementation has significant therapeutic benefits in the management of FMS, especially in pain reduction of patients with fibromyalgia. According to our results, a combination of vitamin D supplements and a conventional antidepressant, when given to vitamin D-deficient fibromyalgia patients, could significantly improve both physical and psychological symptoms
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Srivastava S, Bhatia MS, Gautam P. 25 Hydroxyvitamin D levels, quality of life, and disability in long-standing patients of somatization. Ind Psychiatry J 2018; 27:87-91. [PMID: 30416297 PMCID: PMC6198590 DOI: 10.4103/ipj.ipj_73_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Somatization disorder is a debilitating condition, in which patients have multiple physical complaints with no explained cause and no relief even after consultations. AIM The present study examined the association of 25-hydroxyvitamin D (25[OH]D) levels, quality of life, disability, and symptom profile in long standing with somatization disorder. METHODS One-hundred three patients of somatization disorder suffering for ≥2 years, visiting psychiatry outpatient clinic during two consecutive summer season (April to June) of 2015-2016 were recruited. Symptom profile was studied using Patient-Health-Questionnaire (PHQ-15) items (somatic symptoms), PHQ-9 items (depressive symptoms), Generalized Anxiety Disorder-7 (GAD-7) item (anxiety symptoms).quality of life was assessed using the World Health Organization Quality of Life BREF 26 item, and disability measure was World Health Organization Disability Assessment Schedule (WHODAS) 2.0. 25(OH) D levels were estimated using chemiluminescence binding assay. RESULTS The poor quality of life in somatization disorder was significantly associated with disability, symptom profile using PHQ-15, PHQ-9, and GAD-7. 25(OH)D levels were deficient in 56.31% of the study population. CONCLUSION The high somatic symptom severity in majority of patients suffering from somatization disorder needs more attention from psychiatrists across cultures so that functional status and quality of life can be improved. Routine estimation of Vitamin D levels and correction of its deficiency may bring about symptomatic relief at an early stage, thereby reducing the morbidity associated with the disorder.
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Affiliation(s)
- Shruti Srivastava
- Department of Psychiatry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, India
| | - Manjeet Singh Bhatia
- Department of Psychiatry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, India
| | - Priyanka Gautam
- Department of Psychiatry, Guru Teg Bahadur Hospital, University College of Medical Sciences, New Delhi, India
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Malihi Z, Wu Z, MM Lawes C, Scragg R. Noncalcemic adverse effects and withdrawals in randomized controlled trials of long-term vitamin D2 or D3 supplementation: a systematic review and meta-analysis. Nutr Rev 2017; 75:1007-1034. [DOI: 10.1093/nutrit/nux059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci 2017; 18:E2170. [PMID: 29057787 PMCID: PMC5666851 DOI: 10.3390/ijms18102170] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 09/29/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is a hormone synthesized in the skin in the presence of sunlight. Like other hormones, vitamin D plays a role in a wide range of processes in the body. Here we review the possible role of vitamin D in nociceptive and inflammatory pain. In observational studies, low vitamin D levels have been associated with increased pain and higher opioid doses. Recent interventional studies have shown promising effects of vitamin D supplementation on cancer pain and muscular pain-but only in patients with insufficient levels of vitamin D when starting intervention. Possible mechanisms for vitamin D in pain management are the anti-inflammatory effects mediated by reduced cytokine and prostaglandin release and effects on T-cell responses. The recent finding of vitamin D-mediated inhibition of Prostaglandin E2 (PGE2) is especially interesting and exhibits a credible mechanistic explanation. Having reviewed current literature, we suggest that patients with deficient levels defined as 25-hydroxyvitamin D (25-OHD) levels <30 nmol/L are most likely to benefit from supplementation, while individuals with 25-OHD >50 nmol/L probably have little benefit from supplementation. Our conclusion is that vitamin D may constitute a safe, simple and potentially beneficial way to reduce pain among patients with vitamin D deficiency, but that more randomized and placebo-controlled studies are needed before any firm conclusions can be drawn.
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Affiliation(s)
- Maria Helde-Frankling
- ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.
| | - Linda Björkhem-Bergman
- ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.
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Demiryurek BE, Gundogdu AA. The effect of vitamin D levels on pain in carpal tunnel syndrome. Orthop Traumatol Surg Res 2017; 103:919-922. [PMID: 28552837 DOI: 10.1016/j.otsr.2017.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 05/06/2017] [Accepted: 05/11/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) and vitamin D deficiency are two discrete common clinical pictures that can cause chronic pain. In this study, we aimed to evaluate the association of 25 (OH) D deficiency with electrophysiological findings and severity of pain in patients with mild CTS. METHOD The consecutive patients admitted to our laboratory with the symptoms of CTS between May 2016 and August 2016 were enrolled in this study. According to their electrophysiological examination results, only the patients with normal conduction results and ones with mild grade CTS were included. Demographic data, the results of the electrophysiological studies, vitamin D levels (our laboratory normal is>20ng/mL), duration of pain and pain intensity due to CTS, which was assessed with visual analog scale, were collected. RESULTS Totally, 76 patients (36 patients with mild CTS and 40 without CTS) were included. In the mild CTS patients, vitamin D levels were significantly lower than those electrophysiologically normal patients (P=0.003). The relationship between gender, duration of pain and vitamin D levels were evaluated in the normal and mild CTS group. There was no significant relationship between the pain and vitamin D levels in the normal group, while vitamin D level was significantly lower in the mild CTS group (P=0.730 and P=0.002; respectively). DISCUSSION Vitamin D deficiency increases the pain intensity in patients with CTS. Treatment of vitamin D deficiency in these patients may play a role in pain relief. Further studies involving analyses of post-vitamin D replacement therapy are warranted to confirm the association between vitamin D deficiency and pain due to CTS.
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Affiliation(s)
- B E Demiryurek
- Sakarya Training and Research Hospital, Sakarya, Turkey.
| | - A A Gundogdu
- Sakarya Training and Research Hospital, Sakarya, Turkey
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