Racial Differences in 25-Hydroxy Vitamin D and Self-Reported Pain Severity in a Sample of Individuals Living with Non-Specific Chronic Low Back Pain

Demario S Overstreet,1,&ast; Larissa J Strath,1,&ast; Fariha N Hasan,2 Robert E Sorge,1 Terence Penn,1 Deanna D Rumble,1 Edwin N Aroke,3 Asia M WIggins,1 Jonas G Dembowski,1 Eeshaan K Bajaj,1 Tammie L Quinn,1 D Leann Long,4 Burel R Goodin1 1Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA; 2School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA; 3School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, & Continuing Care, University of Alabama at Birmingham, Birmingham, AL, USA; 4School of Public Health, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA&ast;These authors contributed equally to this workCorrespondence: Demario S Overstreet, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 45 Francis Street, MRB 6-11, Boston, MA, 02115, USA, Email doverstreet@bwh.harvard.eduIntroduction: Considerable evidence suggests that there are significant ethnic/racial differences in the experience of pain among individuals suffering from chronic musculoskeletal conditions. Additionally, low levels of vitamin D have been associated with pain severity. Further, vitamin D deficiency is more prevalent in Non-Hispanic Black (NHB) individuals compared to Non-Hispanic Whites (NHW).Objective: The aim of this study was to investigate the associations among race, pain severity, and serum levels of vitamin D in a sample of patients with chronic low back pain (cLBP).Methods: All study participants (n = 155) self-identified their race/ethnicity as either NHB or NHW. Blood samples were collected to assess circulating levels of serum 25- hydroxy vitamin D. Vitamin D levels were categorized as optimal (≥ 20 ng/mL), insufficient (12– 19 ng/mL) or deficient (< 12 ng/mL). Participants then self-reported their pain severity using the Brief Pain Inventory – Short Form.Results: Results showed that a greater proportion of NHB versus NHW participants were categorized as Vitamin D deficient (χ2 (2, N = 155) = 16.79, p < 0.001). An analysis of covariance (ANCOVA) revealed that NHBs reported significantly greater pain severity relative to NHWs (F(1150) = 6.45) p = 0.012. Further, self-reported pain severity significantly differed according to Vitamin D clinical categories (F(2150) = 4.19, p = 0.013). Participants with deficient vitamin D reported significantly greater pain severity in comparison to participants with optimal vitamin D (F(1101) = 7.28, p = 0.008).Conclusion: The findings suggest that Vitamin D deficiency may be linked to greater pain severity in a sample of individuals with cLBP, especially for those who identify as NHB.Keywords: race, pain, vitamin D, disparities