The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, University of Tasmania, Hobart, Tasmania, Australia, Monash University, Melbourne, Victoria, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China

Address correspondence to Changhai Ding, MD, Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. Email: [email protected].

Search for more papers by this author

Liudan Tu,

Liudan Tu

orcid.org/0000-0002-2628-6751

The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, and University of Tasmania, Hobart, Tasmania, Australia

Search for more papers by this author

Shuang Zheng,

Shuang Zheng

orcid.org/0000-0003-3552-1247

University of Tasmania, Hobart, Tasmania, Australia

Search for more papers by this author

Flavia Cicuttini,

Flavia Cicuttini

Monash University, Melbourne, Victoria, Australia

Search for more papers by this author

Xingzhong Jin,

Xingzhong Jin

orcid.org/0000-0003-4293-8665

University of Tasmania, Hobart, Tasmania, and the University of Sydney, New South Wales, Australia

Search for more papers by this author

Weiyu Han,

Weiyu Han

University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China

Search for more papers by this author

Zhaohua Zhu,

Zhaohua Zhu

orcid.org/0000-0003-3913-2564

University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China

Search for more papers by this author

Benny Antony,

Benny Antony

University of Tasmania, Hobart, Tasmania, Australia

Search for more papers by this author

Tania Winzenberg,

Tania Winzenberg

University of Tasmania, Hobart, Tasmania, Australia

Search for more papers by this author

Graeme Jones,

Graeme Jones

University of Tasmania, Hobart, Tasmania, Australia

Search for more papers by this author

Jieruo Gu,

Jieruo Gu

The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

Search for more papers by this author

Anita E. Wluka,

Anita E. Wluka

orcid.org/0000-0001-8024-9049

Monash University, Melbourne, Victoria, Australia

Search for more papers by this author

Changhai Ding,

Corresponding Author

Changhai Ding

[email protected]

Address correspondence to Changhai Ding, MD, Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. Email: [email protected].

Search for more papers by this author

First published: 05 July 2020

https://doi.org/10.1002/acr.24371

Citations: 13

ClinicalTrials.gov identifier: NCT01176344.

Supported by the Australian National Health and Medical Research Council (project code 605501). Drs. Winzenberg and Wluka are recipients of a National Health and Medical Research Council Career Development Fellowship. Dr. Jones is recipient of a National Health and Medical Research Council Practitioner Fellowship. Dr. Ding is recipient of an Australian Research Council Future Fellowship.

Drs. Tu and Zheng contributed equally to this work.

No potential conflicts of interest relevant to this article were reported.

Share a link

Email
Facebook
x
LinkedIn
Reddit
Wechat

Abstract

Objective

The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA).

Methods

A post hoc study was conducted from a randomized, double-blind, placebo-controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25-hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D₃ or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1–9 and 11) being documented as on “most/every day(s)” in the last month. A repeated-measures, mixed-effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders.

Results

A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (–0.03 versus 1.30; P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (–0.09 versus 2.19; P = 0.001).

Conclusion

Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.

References

1Hiligsmann M, Cooper C, Arden N, Boers M, Branco JC, Luisa Brandi M, et al. Health economics in the field of osteoarthritis: an expert’s consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 2013; 43: 303–13.
10.1016/j.semarthrit.2013.07.003
PubMedWeb of Science®Google Scholar
2Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The population prevalence of foot and ankle pain in middle and old age: a systematic review. Pain 2011; 152: 2870–80.
10.1016/j.pain.2011.09.019
PubMedWeb of Science®Google Scholar
3Menz HB, Tiedemann A, Kwan MM, Plumb K, Lord SR. Foot pain in community-dwelling older people: an evaluation of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford) 2006; 45: 863–7.
10.1093/rheumatology/kel002
CASPubMedWeb of Science®Google Scholar
4Suri P, Morgenroth DC, Kwoh CK, Bean JF, Kalichman L, Hunter DJ. Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2010; 62: 1715–23.
10.1002/acr.20324
PubMedWeb of Science®Google Scholar
5Paterson KL, Hinman RS, Hunter DJ, Wrigley TV, Bennell KL. Impact of concurrent foot pain on health and functional status in people with knee osteoarthritis: data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2015; 67: 989–95.
10.1002/acr.22537
PubMedWeb of Science®Google Scholar
6Croft P, Jordan K, Jinks C. “Pain elsewhere” and the impact of knee pain in older people. Arthritis Rheum 2005; 52: 2350–4.
10.1002/art.21218
CASPubMedWeb of Science®Google Scholar
7Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study. J Foot Ankle Res 2008; 1: 2.
10.1186/1757-1146-1-2
PubMedWeb of Science®Google Scholar
8Bouillon R, Carmeliet G. Vitamin D insufficiency: definition, diagnosis and management. Best Pract Res Clin Endocrinol Metab 2018; 32: 669–84.
10.1016/j.beem.2018.09.014
CASPubMedWeb of Science®Google Scholar
9Malacova E, Cheang PR, Dunlop E, Sherriff J, Lucas RM, Daly RM, et al. Prevalence and predictors of vitamin D deficiency in a nationally-representative sample of adults participating in the 2011–2013 Australian Health Survey. Br J Nutr 2019: 1–24.
PubMedWeb of Science®Google Scholar
10Straube S, Andrew Moore R, Derry S, McQuay HJ. Vitamin D and chronic pain. Pain 2009; 141: 10–3.
10.1016/j.pain.2008.11.010
CASPubMedWeb of Science®Google Scholar
11Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry 2013; 202: 100–7.
10.1192/bjp.bp.111.106666
PubMedWeb of Science®Google Scholar
12Shipton EE, Shipton EA. Vitamin D deficiency and pain: clinical evidence of low levels of vitamin D and supplementation in chronic pain states. Pain Ther 2015; 4: 67–87.
10.1007/s40122-015-0036-8
PubMedWeb of Science®Google Scholar
13Gaikwad M, Vanlint S, Mittinity M, Moseley GL, Stocks N. Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis. Clin Rheumatol 2017; 36: 1201–8.
10.1007/s10067-016-3205-1
CASPubMedWeb of Science®Google Scholar
14Gao XR, Chen YS, Deng W. The effect of vitamin D supplementation on knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2017; 46: 14–20.
10.1016/j.ijsu.2017.08.010
PubMedWeb of Science®Google Scholar
15Hussain S, Singh A, Akhtar M, Najmi AK. Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials. Rheumatol Int 2017; 37: 1489–98.
10.1007/s00296-017-3719-0
CASPubMedWeb of Science®Google Scholar
16Jin X, Jones G, Cicuttini F, Wluka A, Zhu Z, Han W, et al. Effect of vitamin D supplementation on tibial cartilage volume and knee pain among patients with symptomatic knee osteoarthritis: a randomized clinical trial. JAMA 2016; 315: 1005–13.
10.1001/jama.2016.1961
CASPubMedWeb of Science®Google Scholar
17Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ. Development and validation of a questionnaire to assess disabling foot pain. Pain 2000; 85: 107–13.
10.1016/S0304-3959(99)00263-8
CASPubMedWeb of Science®Google Scholar
18Roddy E, Muller S, Thomas E. Defining disabling foot pain in older adults: further examination of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford) 2009; 48: 992–6.
10.1093/rheumatology/kep156
PubMedWeb of Science®Google Scholar
19Altman RD, Hochberg M, Murphy WA Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995; 3 Suppl A: 3–70.
PubMedWeb of Science®Google Scholar
20Zhu Z, Otahal P, Wang B, Jin X, Laslett LL, Wluka AE, et al. Cross-sectional and longitudinal associations between serum inflammatory cytokines and knee bone marrow lesions in patients with knee osteoarthritis. Osteoarthritis Cartilage 2017; 25: 499–505.
10.1016/j.joca.2016.10.024
CASPubMedWeb of Science®Google Scholar
21Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15: 1833–40.
CASPubMedWeb of Science®Google Scholar
22Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35: 1381–95.
10.1249/01.MSS.0000078924.61453.FB
PubMedWeb of Science®Google Scholar
23Paterson KL, Kasza J, Hunter DJ, Hinman RS, Menz HB, Peat G, et al. Longitudinal association between foot and ankle symptoms and worsening of symptomatic radiographic knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2017; 25: 1407–13.
10.1016/j.joca.2017.05.002
CASPubMedWeb of Science®Google Scholar
24Paterson KL, Kasza J, Hunter DJ, Hinman RS, Menz HB, Peat G, et al. The relationship between foot and ankle symptoms and risk of developing knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2017; 25: 639–46.
10.1016/j.joca.2016.12.003
CASPubMedWeb of Science®Google Scholar
25Wu Z, Malihi Z, Stewart AW, Lawes CM, Scragg R. Effect of vitamin D supplementation on pain: a systematic review and meta-analysis. Pain Physician 2016; 19: 415–27.
PubMedWeb of Science®Google Scholar
26Wu Z, Camargo CA Jr, Malihi Z, Bartley J, Waayer D, Lawes CM, et al. Monthly vitamin D supplementation, pain, and pattern of analgesic prescription: secondary analysis from the randomized, double-blind, placebo-controlled Vitamin D Assessment Study. Pain 2018; 159: 1074–82.
10.1097/j.pain.0000000000001189
CASPubMedWeb of Science®Google Scholar
27Hsiao MY, Hung CY, Chang KV, Han DS, Wang TG. Is serum hypovitaminosis D associated with chronic widespread pain including fibromyalgia? A meta-analysis of observational studies. Pain Physician 2015; 18: E877–87.
PubMedWeb of Science®Google Scholar
28Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 2003; 78: 1463–70.
10.4065/78.12.1463
PubMedWeb of Science®Google Scholar
29Hicks GE, Shardell M, Miller RR, Bandinelli S, Guralnik J, Cherubini A, et al. Associations between vitamin D status and pain in older adults: the Invecchiare in Chianti study. J Am Geriatr Soc 2008; 56: 785–91.
10.1111/j.1532-5415.2008.01644.x
PubMedWeb of Science®Google Scholar
30Krishnan AV, Feldman D. Mechanisms of the anti-cancer and anti-inflammatory actions of vitamin D. Annu Rev Pharmacol Toxicol 2011; 51: 311–36.
10.1146/annurev-pharmtox-010510-100611
CASPubMedWeb of Science®Google Scholar
31Kawasaki Y, Zhang L, Cheng JK, Ji RR. Cytokine mechanisms of central sensitization: distinct and overlapping role of interleukin-1β, interleukin-6, and tumor necrosis factor-α in regulating synaptic and neuronal activity in the superficial spinal cord. J Neurosci 2008; 28: 5189–94.
10.1523/JNEUROSCI.3338-07.2008
CASPubMedWeb of Science®Google Scholar
32Glover TL, Horgas AL, Fillingim RB, Goodin BR. Vitamin D status and pain sensitization in knee osteoarthritis: a critical review of the literature. Pain Manag 2015; 5: 447–53.
10.2217/pmt.15.43
PubMedWeb of Science®Google Scholar
33Cruz-Almeida Y, King CD, Goodin BR, Sibille KT, Glover TL, Riley JL, et al. Psychological profiles and pain characteristics of older adults with knee osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65: 1786–94.
10.1002/acr.22070
PubMedWeb of Science®Google Scholar
34Speed TJ, Richards JM, Finan PH, Smith MT. Sex moderates the effects of positive and negative affect on clinical pain in patients with knee osteoarthritis. Scand J Pain 2017; 16: 66–73.
10.1016/j.sjpain.2017.03.005
PubMedWeb of Science®Google Scholar

Citing Literature

Volume73, Issue6

June 2021

Pages 781-787

Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis

Abstract

Objective

Methods

Results

Conclusion

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis

Abstract

Objective

Methods

Results

Conclusion

References

Citing Literature

References

Related

Information