ascorbic-acid and Back-Pain

A 50-year-old man presented with a complaint of low-back pain and widespread joint pain for the previous 20 years. Conventional radiography revealed wide areas of calcification in the intervertebral discs and degenerative changes in the peripheral joints. A diagnosis of ochronosis was made by the observation of bluish-brown pigmentation in the nose and ears, dark urine colors following alkalization, and high levels of homogentisic acid in the urine. Ochronosis should be considered in the differential diagnosis of patients with chronic low-back pain regarding features of widespread calcification in the intervertebral discs at radiography and bluish-brown pigmentation in the nose and ears.

Topics: Alkaptonuria; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Ascorbic Acid; Back Pain; Calcinosis; Chronic Disease; Diagnosis, Differential; Diclofenac; Homogentisic Acid; Humans; Intervertebral Disc; Male; Middle Aged; Ochronosis; Radiography; Treatment Outcome; Vitamins

A nationwide cross-sectional study.. To measure the associations between cigarette smoking (defined as serum cotinine concentration >15 ng/mL) and the 3-month prevalence of spinal pain (neck pain, low back pain, low back pain with pain below knee, and self-reported diagnosis of arthritis/rheumatism) and related limitations, and to verify whether these associations are mediated by serum concentrations of vitamin C.. Cigarette smoking has been consistently associated with back pain, but this association has never been explained. Because vitamin C has recently been reported to be associated with spinal pain and related functional limitations, and the metabolism of vitamin C differs between smokers and nonsmokers, we hypothesized that the prevalence of spinal pain and related limitations might be greater among smokers because they are more susceptible to be in a state of hypovitaminosis C.. We conducted secondary analyses of National Health and Nutrition Examination Survey (NHANES) 2003 to 2004 data on 4438 individuals aged ≥20 years.. Serum concentrations of vitamin C and cotinine were strongly and inversely correlated (r = -0.35, P < 0.0001). Smoking was statistically associated with the prevalence of neck pain [adjusted odds ratio: aOR: 1.25; 95% confidence interval (95% CI): 1.06-1.47], low back pain (aOR: 1.20; 95% CI: 1.04-1.39), and low back pain with pain below knee (aOR: 1.58; 95% CI: 1.13-2.22) and related limitations, with a dose-response relationship (P < 0.05). However, the associations between smoking and spinal pain were not mediated by concentrations of vitamin C.. These results confirm the relationship between smoking and spinal pain, but they do not support a mediating effect of vitamin C on this relationship.. 2.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Back Pain; Cigarette Smoking; Cotinine; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Neck Pain; Nutrition Surveys; Prevalence

Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003-2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Ascorbic Acid; Back Pain; Cross-Sectional Studies; Female; Humans; Leisure Activities; Male; Middle Aged; Nutrition Surveys; Pain Measurement; Prevalence; Retrospective Studies; Surveys and Questionnaires; United States; Young Adult

Topics: Anesthesia, Intravenous; Anesthetics, Intravenous; Ascorbic Acid; Back Pain; Drug Combinations; Humans; Muscle, Skeletal; Pain, Postoperative; Pharyngitis; Placebos; Propofol; Thiopental

Topics: Adolescent; Adult; Ascorbic Acid; Back Pain; Bone Diseases; Child; Fractures, Bone; Humans; Muscular Diseases; Neoplasms; Osteogenesis Imperfecta; Pain

Topics: Aged; Aging; Arteriosclerosis; Ascorbic Acid; Ascorbic Acid Deficiency; Back Pain; Common Cold; Humans; Mental Disorders; Nutritional Requirements; Pituitary-Adrenal System; Renal Dialysis; Shock, Traumatic; Stress, Physiological; Structure-Activity Relationship; Surgical Procedures, Operative