Hand Numbness among Patients with Musculoskeletal Pain:A link to Neck Pain and Vitamin D deficiency—A Case-controlstudy
Main Article Content
Keywords
vitamin D, neck pain, arm numbness, musculoskeletal pain
Abstract
Objective: Peripheral neuropathy is common in the general population. A pinched nerve in the neck typically causes neck pain, a widespread musculoskeletal complaint worldwide. Preliminary observations revealed a high prevalence of neck pain and arm numbness in patients with musculoskeletal pain (MSP) and vitamin D deficiency. This study aimed to determine the prevalence of self-reported peripheral neuropathy in relation to neck pain among patients with MSP. Study Design: Case‐control study. Methods: A total of 232 patients with MSP and age- and sex-matched controls participated in this study. Serum plasma vitamin D (VitD), plasma parathyroid hormone (PTH), and serum calcium (S. Ca) levels were measured. Results: A significantly higher prevalence of vitamin D deficiency was observed in MSP patients (91.3%) compared to controls (51.7%) (p < 0.001). Elevated PTH levels were found in 50% of the cases, while most had normal S. Ca levels. Females comprised 85.3% (n = 198) of the participants. Weakness was reported by 74.1% of patients with MSP, compared to 0.0% in controls. Neck pain was present in 72.8% of the cases, while numbness in the hand, fingers, or palm was reported in 55.2%. Binary logistic regression identified neck pain as the only predictor of hand numbness (OR = 2.108, 95% CI: 1.130–3.93, p = 0.019). Several published studies strongly support the benefits of vitamin D and calcium supplementation in patients with MSP. Conclusion: Vitamin D deficiency, neck pain and arm numbness are prevalent among patients with MSP. Arm numbness was associated with neck pain. These findings underscore the importance of assessing patients with neck pain and hand numbness for vitamin D deficiency and related symptoms. Additionally, the evidence highlights the potential benefits of vitamin D and calcium supplementation for patients with multi-site MSP including those with neck pain.
References
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26. Abdul-Razzak KK, Alshogran OY, Altawalbeh SM, Al-Ghalayini IF, Al-Ghazo MA, Alazab RS, et al. Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium. Neurourol Urodyn. 2019. Epub 2019/03/15. doi: 10.1002/nau.23975. PubMed PMID: 30869826.
27. Abdul-Razzak KK, Kofahi RM. Carpel tunnel syndrome: A link with vitamin D and calcium. Biomed Rep. 2020;13(3):15. Epub 2020/08/09. doi: 10.3892/br.2020.1322. PubMed PMID: 32765854; PubMed Central PMCID: Pmc7391289.
28. Alkhatatbeh MJ, Abdul-Razzak KK, Amara NA, Al-Jarrah M. Non-cardiac Chest Pain and Anxiety: A Possible Link to Vitamin D and Calcium. J Clin Psychol Med Settings. 2019;26(2):194-9. Epub 2018/08/29. doi: 10.1007/s10880-018-9579-2. PubMed PMID: 30151664.
29. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clinic proceedings. 2003;78(12):1463-70. Epub 2003/12/10. doi: 10.4065/78.12.1463. PubMed PMID: 14661675.
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31. Straube S, Derry S, Straube C, Moore RA. Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev. 2015(5):CD007771. Epub 2015/05/07. doi: 10.1002/14651858.CD007771.pub3. PubMed PMID: 25946084.
32. Sindiani AM, Alkhatatbeh MJ, Abdul-Razzak KK. Hot Flashes in Adolescence and Young Adult Females: a Link to Vitamin D and Calcium. Med Arch. 2022;76(3):202-8. Epub 2022/10/07. doi: 10.5455/medarh.2022.76.202-208. PubMed PMID: 36200110; PubMed Central PMCID: PMC9478824.
33. Waltman NL, Ott CD, Twiss JJ, Gross GJ, Lindsey AM. Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. Cancer nursing. 2009;32(2):143-50. Epub 2009/01/07. doi: 10.1097/01. ncc.0000339262.44560.92. PubMed PMID: 19125120; PubMed Central PMCID: PMC2671887.
34. Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. Prevalence of musculoskeletal pain in association with serum 25-hydroxyvitamin D concentrations in patients with type 2 diabetes mellitus. Biomed Rep. 2018;8(6):571-7. Epub 2018/06/16. doi: 10.3892/br.2018.1093. PubMed PMID: 29904613; PubMed Central PMCID: PMC5996843.
35. Nadeem S, Munim TF, Hussain HF, Hussain DF. Determinants of Vitamin D deficiency in asymptomatic healthy young medical students. Pak J Med Sci. 2018;34(5):1248-52. Epub 2018/10/23. doi: 10.12669/pjms.345.15668. PubMed PMID: 30344585; PubMed Central PMCID: PMC6191788.
36. Mansoor S, Habib A, Ghani F, Fatmi Z, Badruddin S, Mansoor S, et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clin Biochem. 2010;43(18):1431-5. Epub 2010/09/30. doi: 10.1016/j. clinbiochem.2010.09.022. PubMed PMID: 20875809.
37. Castaldo M, Ge HY, Chiarotto A, Villafane JH, Arendt-Nielsen L. Myofascial trigger points in patients with whiplash-associated disorders and mechanical neck pain. Pain Med. 2014;15(5):842-9. Epub 2014/03/20. doi: 10.1111/pme.12429. PubMed PMID: 24641263.
38. Huang W, Shah S, Long Q, Crankshaw AK, Tangpricha V. Improvement of pain, sleep, and quality of life in chronic pain patients with vitamin D supplementation. Clin J Pain. 2013;29(4):341-7. Epub 2012/06/16. doi: 10.1097/AJP.0b013e318255655d. PubMed PMID: 22699141.
39. Le Goaziou MF, Bodier E, Souweine G, Moreau A, Perdrix C, Flori M, et al. [Musculoskeletal chronic pains and Vitamin D deficiency. Study before after in general practice]. Presse Med. 2013;42(4 Pt 1):e106-13. Epub 2013/01/22. doi: 10.1016/j. lpm.2012.09.021. PubMed PMID: 23332894.
40. National Health institute OoDs. Calcium dietary supplement fact sheet 2016 [updated November 17, 2016 cited 2016 Accessed June 14, 2016].
41. Manish Suneja HAM. Hypocalcaemia Clinical Presentation [updated Jul 26, 2016June 7th, 2017]. Available from: http:// emedicine.medscape.com/article/241893-clinical.
42. Abdul-Razzak KK, Obeidat BA, Al-Farras MI, Dauod AS. Vitamin D and PTH status among adolescent and young females with severe dysmenorrhea. J Pediatr Adolesc Gynecol. 2014;27(2):78-82. Epub 2014/01/11. doi: 10.1016/j.jpag.2013.07.005. PubMed PMID: 24405636.
43. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86(3):1212-21. Epub 2001/03/10. doi: 10.1210/jcem.86.3.7327. PubMed PMID: 11238511.
2. Childress MA, Becker BA. Nonoperative Management of Cervical Radiculopathy. Am Fam Physician. 2016;93(9):746-54. Epub 2016/05/14. PubMed PMID: 27175952.
3. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81(1):33-40. Epub 2010/01/08. PubMed PMID: 20052961.
4. Magnus W, Viswanath O, Viswanathan VK, Mesfin FB. Cervical Radiculopathy. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Omar Viswanath declares no relevant financial relationships with ineligible companies. Disclosure: Vibhu Krishnan Viswanathan declares no relevant financial relationships with ineligible companies. Disclosure: Fassil Mesfin declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright © 2024, StatPearls Publishing LLC.; 2024.
5. Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. Open Orthop J. 2014;8:326-45. Epub 2014/10/21. doi: 10.2174/1874325001408010326. PubMed PMID: 25328557; PubMed Central PMCID: PMC4200875.
6. Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag. 2021;11(1):75-87. Epub 2020/11/26. doi: 10.2217/pmt-2020-0046. PubMed PMID: 33234017.
7. Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, et al. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022;23(1):26. Epub 2022/01/05. doi: 10.1186/s12891-021-04957-4. PubMed PMID: 34980079; PubMed Central PMCID: PMC8725362.
8. Friedman MH, Nelson AJ, Jr. Head and neck pain review: traditional and new perspectives. J Orthop Sports Phys Ther. 1996;24(4):268-78. Epub 1996/10/01. doi: 10.2519/jospt.1996.24.4.268. PubMed PMID: 8892141.
9. Vos C, Verhagen A, Passchier J, Koes B. Management of acute neck pain in general practice: a prospective study. Br J Gen Pract. 2007;57(534):23-8. Epub 2007/01/25. PubMed PMID: 17244420; PubMed Central PMCID: PMC2032696.
10. Douglass AB, Bope ET. Evaluation and treatment of posterior neck pain in family practice. J Am Board Fam Pract. 2004;17 Suppl:S13-22. Epub 2004/12/03. PubMed PMID: 15575026.
11. McCabe PS, Pye SR, Beth JM, Lee DM, Tajar A, Bartfai G, et al. Low vitamin D and the risk of developing chronic widespread pain: results from the European male ageing study. BMC Musculoskelet Disord. 2016;17:32. Epub 2016/01/18. doi: 10.1186/ s12891-016-0881-6. PubMed PMID: 26774507; PubMed Central PMCID: Pmc4715359.
12. Bikle D. Nonclassic actions of vitamin D. J Clin Endocrinol Metab. 2009;94(1):26-34. Epub 2008/10/16. doi: 10.1210/jc.2008-
1454. PubMed PMID: 18854395; PubMed Central PMCID: PMC2630868.
13. Norman AW. Minireview: vitamin D receptor: new assignments for an already busy receptor. Endocrinology. 2006;147(12):5542-
8. Epub 2006/09/02. doi: 10.1210/en.2006-0946. PubMed PMID: 16946007.
14. Simpson RU, Thomas GA, Arnold AJ. Identification of 1,25-dihydroxyvitamin D3 receptors and activities in muscle. J Biol Chem. 1985;260(15):8882-91. Epub 1985/07/25. PubMed PMID: 2991224.
15. Cantorna MT. Vitamin D and multiple sclerosis: an update. Nutr Rev. 2008;66(10 Suppl 2):S135-8. Epub 2008/12/05. doi: 10.1111/j.1753-4887.2008.00097.x. PubMed PMID: 18844840; PubMed Central PMCID: PMC3712128.
16. Tanner SB, Harwell SA. More than healthy bones: a review of vitamin D in muscle health. Ther Adv Musculoskelet Dis. 2015;7(4):152-9. Epub 2015/08/20. doi: 10.1177/1759720x15588521. PubMed PMID: 26288665; PubMed Central PMCID: PMC4530385.
17. Pfeifer M, Begerow B, Minne HW. Vitamin D and muscle function. Osteoporos Int. 2002;13(3):187-94. Epub 2002/05/07. doi: 10.1007/s001980200012. PubMed PMID: 11991436.
18. Dietary Reference Intakes for Calcium and Vitamin D. Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Washington DC: National Academy of Sciences.; 2011.
19. Ceglia L. Vitamin D and skeletal muscle tissue and function. Mol Aspects Med. 2008;29(6):407-14. Epub 2008/08/30. doi: 10.1016/j.mam.2008.07.002. PubMed PMID: 18727936. 20. de Torrente de la Jara G, Pecoud A, Favrat B. Musculoskeletal pain in female asylum seekers and hypovitaminosis D3. BMJ. 2004;329(7458):156-7. Epub 2004/07/20. doi: 10.1136/bmj.329.7458.156. PubMed PMID: 15258072; PubMed Central PMCID: PMC478229.
21. Sheikh A, Saeed Z, Jafri SA, Yazdani I, Hussain SA. Vitamin D levels in asymptomatic adults--a population survey in Karachi, Pakistan. PLoS One. 2012;7(3):e33452. doi: 10.1371/journal.pone.0033452. PubMed PMID: 22457762; PubMed Central PMCID: PMC3311638.
22. Sievenpiper JL, McIntyre EA, Verrill M, Quinton R, Pearce SH. Unrecognised severe vitamin D deficiency. Bmj. 2008;336(7657):1371-4. Epub 2008/06/17. doi: 10.1136/bmj.39555.820394.BE. PubMed PMID: 18556320; PubMed Central PMCID: PMC2427091.
23. Abdul-Razzak KK, Ajlony MJ, Khoursheed AM, Obeidat BA. Vitamin D deficiency among healthy infants and toddlers: a prospective study from Irbid, Jordan. Pediatr Int. 2011;53(6):839-45. Epub 2011/04/22. doi: 10.1111/j.1442-200X.2011.03388.x. PubMed PMID: 21507148.
24. Abdul-Razzak KK, Almanasrah SO, Obeidat BA, Khasawneh AG. Vitamin D is a potential antidepressant in psychiatric outpatients. Int J Clin Pharmacol Ther. 2018;56(12):585-96. Epub 2018/10/20. doi: 10.5414/cp203309. PubMed PMID: 30336806.
25. Abdul-Razzak KK, Mayyas FA, Al-Farras MI. Vitamin D as potential antidepressant in outpatients with musculoskeletal pain. Int J Clin Pharmacol Ther. 2018;56(9):400-10. Epub 2018/08/07. doi: 10.5414/cp203252. PubMed PMID: 30079886.
26. Abdul-Razzak KK, Alshogran OY, Altawalbeh SM, Al-Ghalayini IF, Al-Ghazo MA, Alazab RS, et al. Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium. Neurourol Urodyn. 2019. Epub 2019/03/15. doi: 10.1002/nau.23975. PubMed PMID: 30869826.
27. Abdul-Razzak KK, Kofahi RM. Carpel tunnel syndrome: A link with vitamin D and calcium. Biomed Rep. 2020;13(3):15. Epub 2020/08/09. doi: 10.3892/br.2020.1322. PubMed PMID: 32765854; PubMed Central PMCID: Pmc7391289.
28. Alkhatatbeh MJ, Abdul-Razzak KK, Amara NA, Al-Jarrah M. Non-cardiac Chest Pain and Anxiety: A Possible Link to Vitamin D and Calcium. J Clin Psychol Med Settings. 2019;26(2):194-9. Epub 2018/08/29. doi: 10.1007/s10880-018-9579-2. PubMed PMID: 30151664.
29. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clinic proceedings. 2003;78(12):1463-70. Epub 2003/12/10. doi: 10.4065/78.12.1463. PubMed PMID: 14661675.
30. Sandoughi M, Zakeri Z, Mirhosainee Z, Mohammadi M, Shahbakhsh S. The effect of vitamin D on nonspecific low back pain. Int J Rheum Dis. 2015;18(8):854-8. Epub 2013/10/15. doi: 10.1111/1756-185x.12172. PubMed PMID: 24119149.
31. Straube S, Derry S, Straube C, Moore RA. Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev. 2015(5):CD007771. Epub 2015/05/07. doi: 10.1002/14651858.CD007771.pub3. PubMed PMID: 25946084.
32. Sindiani AM, Alkhatatbeh MJ, Abdul-Razzak KK. Hot Flashes in Adolescence and Young Adult Females: a Link to Vitamin D and Calcium. Med Arch. 2022;76(3):202-8. Epub 2022/10/07. doi: 10.5455/medarh.2022.76.202-208. PubMed PMID: 36200110; PubMed Central PMCID: PMC9478824.
33. Waltman NL, Ott CD, Twiss JJ, Gross GJ, Lindsey AM. Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. Cancer nursing. 2009;32(2):143-50. Epub 2009/01/07. doi: 10.1097/01. ncc.0000339262.44560.92. PubMed PMID: 19125120; PubMed Central PMCID: PMC2671887.
34. Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. Prevalence of musculoskeletal pain in association with serum 25-hydroxyvitamin D concentrations in patients with type 2 diabetes mellitus. Biomed Rep. 2018;8(6):571-7. Epub 2018/06/16. doi: 10.3892/br.2018.1093. PubMed PMID: 29904613; PubMed Central PMCID: PMC5996843.
35. Nadeem S, Munim TF, Hussain HF, Hussain DF. Determinants of Vitamin D deficiency in asymptomatic healthy young medical students. Pak J Med Sci. 2018;34(5):1248-52. Epub 2018/10/23. doi: 10.12669/pjms.345.15668. PubMed PMID: 30344585; PubMed Central PMCID: PMC6191788.
36. Mansoor S, Habib A, Ghani F, Fatmi Z, Badruddin S, Mansoor S, et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clin Biochem. 2010;43(18):1431-5. Epub 2010/09/30. doi: 10.1016/j. clinbiochem.2010.09.022. PubMed PMID: 20875809.
37. Castaldo M, Ge HY, Chiarotto A, Villafane JH, Arendt-Nielsen L. Myofascial trigger points in patients with whiplash-associated disorders and mechanical neck pain. Pain Med. 2014;15(5):842-9. Epub 2014/03/20. doi: 10.1111/pme.12429. PubMed PMID: 24641263.
38. Huang W, Shah S, Long Q, Crankshaw AK, Tangpricha V. Improvement of pain, sleep, and quality of life in chronic pain patients with vitamin D supplementation. Clin J Pain. 2013;29(4):341-7. Epub 2012/06/16. doi: 10.1097/AJP.0b013e318255655d. PubMed PMID: 22699141.
39. Le Goaziou MF, Bodier E, Souweine G, Moreau A, Perdrix C, Flori M, et al. [Musculoskeletal chronic pains and Vitamin D deficiency. Study before after in general practice]. Presse Med. 2013;42(4 Pt 1):e106-13. Epub 2013/01/22. doi: 10.1016/j. lpm.2012.09.021. PubMed PMID: 23332894.
40. National Health institute OoDs. Calcium dietary supplement fact sheet 2016 [updated November 17, 2016 cited 2016 Accessed June 14, 2016].
41. Manish Suneja HAM. Hypocalcaemia Clinical Presentation [updated Jul 26, 2016June 7th, 2017]. Available from: http:// emedicine.medscape.com/article/241893-clinical.
42. Abdul-Razzak KK, Obeidat BA, Al-Farras MI, Dauod AS. Vitamin D and PTH status among adolescent and young females with severe dysmenorrhea. J Pediatr Adolesc Gynecol. 2014;27(2):78-82. Epub 2014/01/11. doi: 10.1016/j.jpag.2013.07.005. PubMed PMID: 24405636.
43. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86(3):1212-21. Epub 2001/03/10. doi: 10.1210/jcem.86.3.7327. PubMed PMID: 11238511.
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Hand Numbness among Patients with Musculoskeletal Pain:A link to Neck Pain and Vitamin D deficiency—A Case-controlstudy. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-15. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3408
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How to Cite
1.
Hand Numbness among Patients with Musculoskeletal Pain:A link to Neck Pain and Vitamin D deficiency—A Case-controlstudy. Pharm Pract (Granada) [Internet]. 2026 Jun. 20 [cited 2026 Jun. 21];24(2):1-15. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3408