New research suggests that low levels of certain vitamins and minerals may contribute to chronic pain, and addressing those deficiencies could offer a new tool for personalized, nutrition-focused pain management.
In a large cross-sectional study published in Pain Practice, researchers found that people with chronic pain were more likely to have deficiencies in several key micronutrients, including vitamins D, B12 and C, folate and magnesium. The study analyzed data from the National Institutes of Health’s All of Us Research Database and included a racially and ethnically diverse population.
“This study is a novel way to approach chronic pain treatment, where you are looking at the patient holistically to see what could be going on systemically that is easily modifiable — changes in diet as opposed to medications or other things,” said senior author Dr. Julie Pilitsis, chair of the Department of Neurosurgery at the University of Arizona College of Medicine – Tucson.
The researchers evaluated micronutrient levels across three groups: people without pain, people with mild to moderate pain and people with severe chronic pain. They found that lower levels of vitamin D, B12, folate and magnesium were more common among those reporting more severe pain. They also saw a pattern in the reverse direction: people with severe chronic pain were more likely to have deficiencies in those same nutrients.
One unexpected result came from the analysis of vitamin B12.
“The finding that surprised us the most was that Asian females had higher vitamin B12 levels than expected,” said co-author Dr. Deborah Morris, a research laboratory manager in the Department of Neurosurgery. “Asian females with severe chronic pain had the highest vitamin B12 levels overall. We were expecting it to be lower.”
For vitamin C, results varied by gender. Men with chronic pain were more likely to have low or borderline-low vitamin C levels than those without pain.
“Our study across various chronic pain conditions in a large, diverse population found that certain vitamin and mineral deficiencies are more frequent in people with chronic pain, and particularly in some specific racial and ethnic groups,” Morris said.
Chronic pain affects nearly 25% of U.S. adults, according to the Centers for Disease Control and Prevention. It is linked to reduced quality of life, increased anxiety and depression, and high rates of opioid use.
“The findings that are coming from complex demographic studies such as this one show that we can’t just make assumptions for every patient that walks in the office,” Pilitsis said.
Morris added that improving quality of life and reducing opioid use remain key goals, and that findings like these may help support more holistic pain care.
The study was led by researchers at the University of Arizona Health Sciences in collaboration with institutions in the United States, Romania and Belgium.
The research was approved by the Florida Atlantic University Health Sciences Institutional Review Board. Pilitsis receives research funding from several organizations, including the National Institutes of Health, Medtronic, Boston Scientific, Abbott and the Focused Ultrasound Foundation. She also serves as a medical advisor for a medical robotics company and holds stock in that company. Dr. Lisa Goudman, a co-author, is supported by the Research Foundation Flanders in Belgium.