Vitamin C and Back Pain: What’s the Link?

To analyze vitamin C level outcomes, researchers used the U.S. National Health and Nutrition Examination Survey database.

Low concentrations of vitamin C were significantly associated with a higher prevalence of spinal pain and related functional limitations among adults, a new cross-sectional study has found.

Vitamin C is essential for the activity of some enzymes that are necessary to maintain stable collagen helixes. To analyze vitamin C level outcomes, researchers used the U.S. National Health and Nutrition Examination Survey (NHANES) 2003—2004 database.

A total of 10,221 patients participated in NHANES 2003–2004; for the purpose of this study researchers only included individuals over ≥20 years who followed up later with a visit to a Mobile Examination Center (MEC), this left 4,742 as part of their study sample. 

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Individuals were categorized into five separate groups: Those with <11.9 μmol/l, 12–23.9 μmol/l, 24–52.9 μmol/l, 53–70 μmol/l, and >70 μmol/l serum vitamin C concentrations.

Outcomes were: pain that lasted a whole day or more in the past three months, in the neck, low back, or low back spreading below the knee. Arthritis/rheumatism existence was also measured, as well as fractures. Results were adjusted for vitamin C supplementation and analyzed with multiple logistic and linear regressions. The optimal vitamin C concentration level, 53–70 μmol/l was used as a gauge.

Results showed a significant link between serum vitamin C concentrations and all outcomes (except for limitations from fractures, bone or joint injuries, events unlikely to be related to vitamin C levels), with suboptimal levels associated with the prevalence of low back pain (LBP) (adjusted odds ratio [OR] 1.3), LBP with pain below knee (OR: 1.3), and neck pain (OR: 1.5) in the past 3 months. 

The authors acknowledged the limits of the study, consisting of the cross-sectional design which does not allow causal relationships and has limited measures of outcomes that are not specific. They assert that the association found in the study between back pain and vitamin C levels warrants further investigation into this area. The aim of further research should be to examine the possibility of utilizing vitamin C as a treatment for back pain patients.

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