Special Article
Pleiotropic effects of vitamin D on pain: review of mechanism of action and evidence of efficacy in chronic pain
Efectos pleiotrópicos de la vitamina D en dolor: revisión del mecanismo de acción y evidencia de su eficacia en dolor crónico
2022;2. DOI: 10.20986/mpj.2022.1032/2022
español
Esperanza Regueras1, Luis Miguel Torres2, Ignacio Velazquez3
1U Navarra, 2H Puerta Mar de Cádiz, 3Hospital de Guadix
Recepción: 27 junio 2022
Aceptación: 1 agosto 2022
Publicación: 3 noviembre 2022
Abstract
Vitamin D is a hormone involved in multiple physiological processes both at the musculoskeletal level and in other organs and tissues. The pleiotropic (ex-bone) effects of vitamin D have shown great interest in recent years, having accumulated numerous evidence about its benefits in pathologies in which immune and/or inflammatory processes are involved. There is a broad consensus on the anti-inflammatory and immunomodulatory role of vitamin D. Considering the wide range of pleiotropic effects of vitamin D and in particular the beneficial effects it has demonstrated at the level of the central nervous system (CNS) along with its anti-inflammatory potential, its role in the treatment of pain is raised as a possibility. To this end a review of the possible mechanism of action of vitamin D in the pathophysiology of pain and the evidence of its beneficial effects on pain from clinical studies or meta-analyses has been carried out.
There is evidence of the role of vitamin D in nociception, as well as in the regulation of inflammation. The reviewed clinical evidence shows a potential benefit of vitamin D in the management of various types of pain, such as in chronic generalized pain, rheumatoid arthritis, headache, migraine, osteoarthritis pain, back pain, other types of musculoskeletal pain or diabetic neuropathy. Specifically, evidence suggests a correlation between blood vitamin D levels and the presence or intensity of pain, so monitoring and correcting these levels could result in a benefit for patients.
Keywords: Vitamin D, chronic pain, back pain, osteoarthritis, migraine.
Resumen
La vitamina D es una hormona implicada en múltiples procesos fisiológicos, tanto a nivel musculoesquelético como en otros órganos y tejidos. Los efectos pleiotrópicos (ex-óseos) de la vitamina D han despertadoun gran interés en los últimos años, habiéndose acumulado numerosa evidencia sobre sus beneficios en patologías en las que los procesos inmunes y/o inflamatorios están implicados. Considerando el amplio abanico de efectos pleiotrópicos de la vitamina D y, en concreto, los efectos beneficiosos que ha demostrado a nivel del sistema nervioso central (SNC), se plantea analizar el papel que esta hormona pueda tener en el tratamiento del dolor. Para ello se ha realizado una revisión del posible mecanismo de acción de la vitamina D en la fisiopatología del dolor y se han estudiado sus efectos beneficiosos en dolor en base a la evidencia clínica disponible en estudios clínicos y metanálisis.
Existe una evidencia del papel de la vitamina D en la nocicepción, así como en la regulación de la inflamación. La evidencia clínica revisada muestra un potencial beneficio de la vitamina D en el manejo de varios tipos de dolor como, por ejemplo, en el dolor crónico generalizado, la artritis reumatoide, el dolor de cabeza, la migraña, el dolor por osteoartritis, el dolor de espalda, otros tipos de dolor musculoesquelético o la neuropatía diabética. En concreto, la evidencia sugiere una correlación entre los niveles de vitamina D en sangre y la presencia o la intensidad del dolor, por lo que la monitorización y corrección de estos niveles podría resultar en un beneficio para los pacientes.
Palabras clave: Vitamina D, dolor crónico, dolor de espalda, osteoartritis, migraña.
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Regueras E, Torres L, Velazquez I. Pleiotropic effects of vitamin D on pain: review of mechanism of action and evidence of efficacy in chronic pain. MPJ. 2022;2 DOI: 1020986/mpj20221032/2022


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