A newly published study from the University of Arizona Health Sciences has uncovered a significant connection between micronutrient deficiencies and chronic pain. Appearing in Pain Practice, the research represents a pioneering application of precision medicine on a large scale. By examining the levels of key vitamins and minerals in people with and without chronic pain, the investigators have provided novel insights into how nutrition may influence chronic pain. The study also examined the frequency of pain experienced by individuals with deficiencies, suggesting that micronutrient assessments could inform more personalised pain management strategies in the future.
Senior author Dr Julie Pilitsis, chair of the Department of Neurosurgery at the U of A College of Medicine – Tucson and a member of the Comprehensive Center for Pain & Addiction, underscored the study’s relevance to clinical practice. “I treat chronic pain patients, and oftentimes we don’t come up with a diagnosis,” she said. “But just because there isn’t a surgery that will help you doesn’t mean you’re not in pain. It just means our understanding of pain is limited to date.” Dr Pilitsis emphasised the value of a holistic approach, noting that simple, systemic interventions – such as dietary adjustments – could be more beneficial and less invasive than medications or surgery.
The researchers focused on five micronutrients known to influence pain perception and inflammation: vitamins D, B12, and C, folate, and magnesium. The study population was divided into three groups based on self-reported pain status: individuals with no pain, those experiencing mild-to-moderate chronic pain, and those with severe chronic pain. By comparing their blood nutrient levels, the study aimed to identify trends that could illuminate the role of micronutrients in chronic pain disorders.
Notably, the findings showed a consistent association between severe deficiencies of vitamin D, B12, folate and magnesium and the presence of severe chronic pain. Individuals with chronic pain were significantly more likely to exhibit low or deficient levels of these micronutrients compared to those without pain. Insufficient levels of these nutrients may not only coincide with pain but could also exacerbate or contribute to its severity. This offers compelling evidence for considering nutritional profiles in pain assessment and treatment planning.
However, some of the results defied expectations. Co-author Dr Deborah Morris, a research lab manager in the Department of Neurosurgery, highlighted a surprising demographic pattern: “Asian females with severe chronic pain had the highest vitamin B12 levels overall. We were expecting it to be lower,” she explained. This contrasted with other racial, ethnic, and gender groups, where B12 deficiency was more common. Meanwhile, vitamin C presented a different picture, particularly among men. Males with mild-to-severe chronic pain were found to be more likely to have low or borderline-low vitamin C levels, suggesting a gender-specific vulnerability worth exploring in future studies.
The study leveraged data from the National Institutes of Health’s All of Us Research Database, which benefits from extensive participant enrolment through the University of Arizona-Banner Health programme. Dr Pilitsis stressed the importance of using such large and demographically varied datasets to avoid overgeneralisation in clinical settings. “Findings from complex demographic studies like this one show that we can’t just make assumptions for every patient that walks into the office,” she noted. Dr Morris added that by identifying trends across diverse populations, the research could pave the way for non-opioid, nutrition-based interventions. “Our goal is to improve the quality of life for people with chronic pain and reduce opioid usage,” she said. “These findings have the potential to do that as part of a holistic approach to pain management.”
More information: Julie Pilitsis et al, Micronutrients and Chronic Pain: A Cross-Sectional Analysis, Pain Practice. DOI: 10.1111/papr.70053
Journal information: Pain Practice Provided by University of Arizona Health Sciences
