In our health-conscious society that has developed in the last 30 years, great focus has been placed on taking steps to prevent medical problems like heart disease, cancer, diabetes, etc. With skin cancer being directly linked to sun exposure and frequent sunburns, a number of methods have arisen to reduce these factors: high SPF level sunblock, avoiding direct sunlight exposure, etc. May weather in Shanghai is beautiful and sunny, but how many time have you seen people use umbrellas to avoid the sun? While this may be keeping the sunburn away, it is also contributing to keeping you in pain.
How does pain relate to sunlight exposure you might say? In the past 10 years, a focus of research has been done on how Vitamin D deficiency can contribute to people experiencing chronic musculoskeletal pain symptoms. As opposed to the majority of other vitamins that are primarily supplied by dietary intake, the main source of Vitamin D for humans is sunlight exposure. In many peoples’ minds, they automatically look to milk as the best source of Vitamin D, but it only accounts for about 15% of your daily requirement (even less so in China due to the pasteurization issues).
The exact mechanism of how Vitamin D affects pain levels is unclear. We believe it has some effect on how people sense pain, whether related to increased inflammation, changing the nerve pathways that control pain, etc. Previously, Vitamin D deficiency has most closely been associated with people who develop rickets and osteoporosis. Along with calcium, Vitamin D is very important in maintaining healthy bone structure. Additionally, current scientific research has linked its deficiency with multiple sclerosis, asthma, prostate cancer, immune function (body’s ability to fight infection), and other diseases. While the science behind how Vitamin D affects pain is unclear, the research is not.
In 2003, a study was published in Spine evaluating 360 patients in Saudi Arabia with chronic low back pain of unknown cause. 83% of patients were noted to have low vitamin D levels. After 3 months of treatment with high dose oral supplementation, all patients with deficiency reported decreased levels of pain. In 2004, a report was published in the Mayo Clinic Proceedings, noting higher levels of Vitamin D deficiency in patients with unexplained diffuse muscle and skeletal pain. In 2009, scientists found that patients with Vitamin D deficiency required higher doses of pain killers to achieve relief compared to those with normal levels. In 2012, Italian researchers reported on how a single dose of Vitamin D can provide women with significant pain relief during menstrual periods in the Archives of Internal Medicine.
Now, given all this information, does this mean that sunbathing and tanning beds can be a form of pain treatment? Unfortunately, no. Here are the necessary steps to improve you Vitamin D levels and by doing so, possibly improve pain levels:
- The first step is to determine if your Vitamin D levels are low. If you are deficient, several months of high dose supplementation is required to achieve a normal level. This requires evaluation with a physician who is familiar with managing chronic pain, guidelines for Vitamin D supplementation, use of appropriate medication, etc.
- Once you achieve normal levels, sunlight is the maintenance dose for anyone under 50 (over the age of 50, daily oral medication is required).
- For people with fair skin, fifteen minutes of direct sunlight to the face and arms twice a week in the spring and summer (longer in fall and winter) is sufficient to maintain Vitamin D levels.
- For people with darker skin, less vitamin D is produced with sunlight, so one hour a day of direct sunlight exposure may be needed.
- Make sure to get direct sunlight exposure before applying sunblock, as even an SPF of 8 will reduce vitamin D production by 95%.