A question that our patients often ask is, “ My (Uncle, Cousin, Brother, Friend) got hurt and recovered in (days, weeks), and I still hurt months (or years) after I got hurt. Why don’t I get better like he (or she) did?”  The problem of persistent soft tissue pain is a sticky one. Pain that is localized to a shoulder or hip may be caused by arthritis or tendonitis, but generalized pain is different. When all the muscles seem to be sore, and the patient is also tired, the common diagnosis is fibromyalgia. However, there is increasing awareness in the medical and lay community that widespread muscle pain and fatigue may be caused by other medical conditions. One of these conditions, currently the object of a great deal of interest, is vitamin D deficiency. It has been found to be widespread and very common among those persons with musculoskeletal pain. It has been found to affect as many as 80% of persons with chronic musculoskeletal pain.
    Vitamin D deficiency leads to muscle wasting and weakness, in addition to osteoporosis. Persons with low vitamin D have muscle pain as well as bone or joint pain. Vitamin D deficiency has also been found to increase the likelihood of falling and fracturing bones. Replacement of vitamin D in vitamin D deficient persons has been shown to reduce muscle pain, increase strength and endurance, and to reduce falls in the elderly.
    Vitamin D is the “sunshine” vitamin. Exposure of the arms and the face to summer sunlight for as little as 15-20 minutes a day will supply all the vitamin D that is needed. However, when the sun is lower in the sky, as it is in the winter, or we are covered up or wear sunscreen, skin does not make vitamin D. As we age, our skin is  less able to make vitamin D. In winter we rely on vitamin D taken by mouth to provide us with this essential vitamin. Persons who are protected from sunlight also rely on oral vitamin D. Getting adequate vitamin D from the diet usually means taking a supplement. Again, as we age, we are less able to absorb vitamin D. Milk is supplemented but only to 100 units per eight ounces, well under the 800 to 1200 units that are needed every day. Some multivitamins have 400  units in each tablet. Persons with absorption problems may not be able to absorb vitamin D well, and need higher amounts to meet the daily needs of the body.
    The diagnosis of vitamin D deficiency is made by a simple blood test. Treatment is straight forward. It is accomplished by taking vitamin D supplements by mouth. For  persons with very low levels of vitamin D, prescription high-dose supplements are available.  Persons who have had calcium containing kidney stones must be treated carefully to avoid developing more kidney stones. Improvement is usually felt within two months.  This is a condition that is common, is easily treated, and should be considered in every person with widespread muscle pain.