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Relationship between the Vitamin D and Chronic Pain

This review analyzes a possible relationship between the vitamin D and chronic pain. Some people claim that vitamin D can heal a chronic pain. For this reason, the hypothesis was that vitamin D can heal chronic pain. I chose this hypothesis because it is in line with my PICO question. The PICO question was: Is vitamin D helpful in the treatment of chronic painful conditions in adults? Basing one’s decision on the clinical research, then a single research study is a mistake, because of numerous reasons. Therefore, it is crucial to avoid errors in the course of the study. Errors may be caused by the instruments one is using while conducting the study. They may also be caused by carelessness of the analyst in the course of the study. If one conducts individual research, this may give information that is erroneous. Individual research may have inadequate sample sizes that may detect the clinical importance differences between the treatments; consequently, they may lead to false and negative results. The results may apparently be the same to the studies. Others may vary because of chances, and the most often they have subtle differences in designing the studies and participants that might lead to the differences or even discrepant findings. Another name of the essay review is research overview. It is a rigorous summary of the evidences of research. One of the crucial things that must be done in such an instance is to ensure understanding of the subject matter. This leads to concrete evidence such that one does not seem to gamble with ideas. These evidences relate to some questioning. The questions may include those of diagnosis, causation, or prognosis, but in most cases, they include the intervention effectiveness. Systematic reviews are different from unsystematic ones in all that they tend to attempt and overcome the possible biases at all stages. These follow a rigorous methodology of the search, retrieval research, the retrieved research appraisal for validity and relevance, data synthesis, data extraction and interpretation.

One way to reduce bias is by using of explicit, pre-set criteria. These criteria select studies for the inclusion of the basis of the validity and relevance. The second way is by having two independent people to make the study selection decisions first, then compare the received outcomes and later discuss the discrepancies before analyzing data independently extracted from research conducted. After that, I recorded the details of these methods used in each stage. Mostly all systematic reviews comprise of meta-analysis, which is the qualitative results combinations that are similar to the studies. Moreover, meta-analysis summarizes overall statistics that represent an influence of the inventions in studies. The overall statics is more precise than the size effect in any other contributing study, because such analysis is effective when it comprises of the samples of influencing each of the studies in order to create a larger study.

Systematic reviews obtain the potential to overcome various barriers to investigation on utilization in the clinicians. Most nurses face difficulties of using such research, because of the time and access to retrieve various study reports. They also lack skills to synthesize and appraise the articles when the reader retrieves them. Very often, systematic reviews provide solutions to nurses by the form of research grounded on the knowledge of a topic, taking into account the legitimacy of the study. However, not every review is of the high quality, and critical appraisal step remains vital.

A good, systematic review is dependent on the outset and includes the studies that relate to the best design in answering clinical questions. These questions depend on the effectiveness of the treatment or prevention as the best answered cohort studies. The review must be a part of the randomized trials, compared alarms with no interventions.

In this study, I used individual data to come up with an assessment. To ascertain the treatment effect, there was a clinical review of the Mean 25-OH vitamin D (ng/mL) in the immigrant population. In addition, I made sure that the data collection happens only among the adult population. This was done to ensure consistency of the results. Moreover, I made sure that the treatment effect was large. A large population increases chances of having accurate data. Since one can compare data between various patients. This means that the hypothesis was true to some extent. However, the evidence linking vitamin D in the body to a chronic pain is insufficient. These results only apply to patients belonging to the ethnic, immigrant minority group. One considered all the side effects possible by the administration of a dosage of vitamin D. The researcher found that the lives of the patients were not at risk.

In the average clinical setting, the treatment is not feasible. Despite the research proving the hypothesis positive, this treatment method should be used only after scientists perform further research studies. This is to reveal how the treatment method may be applied to a clinical setting. The systematic review was done on the article that explores the relationship between the vitamin D and treatment of Chronis ailments. Chronic pain is one of disease conditions that have recently been regarded to be associated with deficiency of vitamin D. Certain studies reveal a relationship between the higher occurrence of chronic pain and low level of vitamin D. It can be explained as a result of the relationships between latitudes, seasons and pain.

The analysis that the study presented, however, failed to prove the hypothesis that a vitamin D deficiency causes pain in humans. It also asserted that vitamin D deficiency is not crucial in the reduction of chronic pain as supposed previously before the study. The study assumes that immigrants and members from minority groups are at high risk of chronic pain, due to a deficiency in vitamin D caused by darker skin color, dieting, traditional dressing such as in veiled women and low exposure to the sun. Scientific studies point to the fact that these groups of people have lower vitamin D in their bodies compared to other majority groups also known as natives. More studies touch the idea of increased pain among immigrant communities. This is co-relational to lower levels of vitamin D in the body. In addition, there is a relationship between low levels of vitamin D among minority groups and the occurrence of skeletal pain. One chooses a subgroup if immigrants and members of ethnic minorities are the most severely affected by a deficiency in 25-OH.We also choose a subgroup if we want to prove if there is a link between the vitamin D and chronic pain.

Material and Methods

A computer, required books and the internet were needed for the study. I had to search Medline (PubMed) using different search terms for the vitamin D. These included: vitamin D1; vitamin D2; various types of vitamin D3 I.e1,25-dihydroxycholecalciferol, 25 hydroxycholecalciferol,1-alpha hydroxyl calciferol, 1,25-dihydroxy, 25-hydroxyvitamin D, alfacalcidol, calciferol, cholecalciferol, calcitriol, calcidiol, calcifediol and ergocalciferol. The study also set the limits in PubMed to “humans”. I researched in articles and retrieved some of them that had a relationship with what one was searching for. I looked for reports that spoke about the occurrence of chronic pain in humans. Moreover, I read articles that involved minority immigrant subjects who were experiencing the chronic pain. They were to give values for the 25-OH vitamin D levels, as well as the pain outcomes after dosage with vitamin D. Any dose of vitamin D supplementation was acceptable. In the methodology, one does not mention any individual case reports. Then I recorded this information, and later compiled it in a report, chronologically event after another. The results were written and after analyzing of them, a powerful conclusion was made.

I also made sure that I compared data between populations in the same category. This brings out consistency. For instance, the requirements of vitamin D in children are different from the requirements in adults. Vitamin D is a crucial component in the body as it helps to build strong body components such as bones. The requirements are different since children require more vitamin D than adults. To this effect, I did not compare the vitamin D levels in these two populations. One only studied adult populations in the preview. In addition, one defined chronic pain broadly so as to uncover any associations. As a matter of fact, osteomalacias, a human condition that may result from a deficiency in vitamin D in adults. It may also occur in musculoskeletal pain. Vitamin D deficiency may cause chronic pain by certain mechanisms, such as changes in the markers of bone metabolism. Moreover, this may be coincidental. For this reason, one did not exclude the studies of patients with osteomalacia. However, it was crucial that for anybody to be included in the category, they must have been suffering from chronic pain.

Besides the review, it is necessary to find out the possible effects of the administration of the treatment on people. If the effects are negative, it is crucial to do away with the procedure on humans. If there are no possible side effects, then the treatment method can be used. Using an unproven method to treat people may bring disaster. It may also cause deaths. It is crucial that studies are performed to determine how to go about administering drugs and dealing with patients should the method be used.

Results

I identified seven relevant studies. The results are as shown in the table below. They include the reference, which states from where one obtained the material. They also includes the study type, the location where the study happened, the study population, the number of immigrants patients, the mean 25-OH vitamin D content found in the populations and the outcome after treatment with vitamin D. The table below shows the summary of the results.

Reference

Study type

Location

Condition

Study population

Numbers of immigrant/ethnic minority patients with painful conditions and data on vitamin D levels

Mean 25-OH vitamin D (ng/mL) in immigrant/ethnic minority patients

Outcome of vitamin D treatment

Lowenthal and Shany 1994

Case series

Beer Sheva, Israel

Osteomalacia (with bone pain)

Bedouin Arab women (an ethnic minority in Israel)

12

4.1

Symptoms resolved in all patients

Nellen et al.1996 [21]

Case series

 

Hypovitaminosis D osteopathy (with musculoskeletal pain)

Immigrant women

6

8.1

Symptoms resolved in all patients

Plotnikoff and Quigley 2003 [24

Cross-sectional study

Amsterdam, Netherlands

Musculoskeletal pain

Immigrant and nonimmigrant patients

83

12.4

 

De Torrenté de la Jara et al. 2004 [22]

Case series

Minneapolis, Minnesota, USA

Hypovitaminosis D (with musculoskeletal pain)

Female asylum seekers

11

4.4

Pain disappeared in 10/11 within three months and in all patients within seven month

Benson et al. 2006 [3]

Case-control study

Lausanne, Switzerland

Muscle pain

Australian Aborigines

8

16.4

Pain disappeared in 10/11 within three months and in all patients within seven month

Helliwell et al. 2006 [25]

Case-control study

Adelaide, Australia

Musculoskeletal pain

Patients of South Asian ethnicity

127

6.9

Pain disappeared in 10/11 within three months and in all patients within seven month

Bartley 2008 [26

Cross-sectional study

Leeds, UK

Chronic pain

Ethnic minority and European ethnicity patients

58

21.2

Pain disappeared in 10/11 within three months and in all patients within seven month

(Data obtained from http://www.hindawi.com/journals/ije/2010/753075/)

Discussion

One can see that the 25-OH vitamin D levels are higher in ethnic minority groups of people and immigrants than in the native western populations. There is also evidence that low levels of 25-OH vitamin D have a relationship with chronic pain. However, there was little evidence linking the treatment of chronic pain with vitamin D. This was in spite of the fact that the search strategy one used was extremely broad. The matter may be left for further studies to reveal to one the connection between the vitamin D and chronic pain. If there is a direct relationship, then it would be easier to treat chronic pain. It is a common condition that especially affects immigrant minority groups. However, current treatment procedures seem not to be working. The available methods only help to reduce pain.

Conclusion

There is little evidence that can confirm a link between chronic pain in immigrant ethnic, minority populations and 25-OH vitamin D levels. However, one cannot conclude that there is no association between the vitamin D and chronic pain. This should be left out for further research, so as to come up with a solution. Further research should also provide us with statement if the above established methods can be used for treatment. If yes, it should go further and explain some possible side effects of the treatment procedure.