Open Access Highly Accessed Research article

Association of back pain with hypovitaminosis D in postmenopausal women with low bone mass

Ariane Viana de Souza e Silva1, Paulo Gustavo Sampaio Lacativa2*, Luis Augusto Tavares Russo2, Luiz Henrique de Gregório2, Renata Alexandra Calixto Pinheiro2 and Lizanka Paola Figueiredo Marinheiro1

Author Affiliations

1 Instituto Fernandes Figueira / Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil

2 CCBR Brasil - Center for Clinical and Basic Research, Rua Mena Barreto 33 Botafogo, Rio de Janeiro, Brazil

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BMC Musculoskeletal Disorders 2013, 14:184  doi:10.1186/1471-2474-14-184

Published: 12 June 2013



Back pain is a major public health problem due to its high frequency, to the resulting activity constraint, and the need for surgery in many cases. Back pain is more frequent in women than men, mainly in postmenopausal women. High prevalence of hypovitaminosis D has been detected in postmenopausal women, and it is associated with decreased bone mass, sarcopenia, vertebral fractures, and inflammation, which can be related to back pain.


The relation between back pain and hypovitaminosis D was evaluated in this study, as well the difference regarding the number of bedridden days, number of days away from work, and daily activities limitation between women with and without hypovitaminosis D. This study reviewed baseline data from an interventional phase III multicenter trial in low bone mass postmenopausal women. The study included demographic data, 25OHD determinations, Newitt/Cummings questionnaire on back pain, and vertebral fracture identified thought X-ray evaluation.


The trial included 9354 participants, but only 9305 underwent all the evaluations. The age median was 67 (60 - 85 years old) and age at menopause was 49 (18 - 72 years). Hypovitaminosis D was found in 22.5% of the subjects, 15.3% of them had vertebral fractures, 67.5% with back pain, and 14.8% reduced their daily activities in the previous six months. Subjects with hypovitaminosis D, compared to those without hypovitaminosis D, reported more back pain (69.5 v 66.9%, p: 0.022), more cases of severe back pain (8.5% v 6.8%, p: 0,004), higher limitation in their daily activities (17.2 v 14.0%, p: 0.001), and more fractures (17.4 v 14.6%, p: 0,002); also, they had more trouble to perform daily activities addressed in the Newwit/Cummings questionnaire.


Hypovitaminosis D was related to back pain, to its severity, and to difficulty in perform daily activities.

Trial registration NCT00088010

Hypovitaminosis D; Back pain; Newwit/Cummings questionnaire