Vitamin D Supplementation and Chronic Musculoskeletal Pain Among Obese Patients

A Narrative Review

Abstract

Chronic musculoskeletal pain (CMP) is a complex clinical condition that is particularly prevalent among individuals with obesity. In addition to increased mechanical overload, its pathophysiology involves chronic low-grade systemic inflammation, adipose tissue dysfunction, metabolic abnormalities, and altered pain processing. Obesity is also associated with a higher risk of vitamin D deficiency.

The aim of this narrative review was to summarize current evidence on the relationship between vitamin D deficiency, vitamin D supplementation and chronic musculoskeletal pain in overweight and obese individuals. A comprehensive literature search was conducted using the PubMed/MEDLINE and Web of Science (WoS) databases. Original research articles, systematic reviews, meta-analyses, and relevant narrative review articles were included.

Current evidence suggests that vitamin D supplementation may reduce pain intensity, particularly in individuals with documented hypovitaminosis D, whereas findings in the general population remain inconsistent. Although only a limited number of studies have specifically investigated overweight and obese individuals, available randomized controlled trials suggest potential benefits of vitamin D supplementation on pain-related outcomes, especially when combined with physical activity. The underlying mechanisms are likely multifactorial and may involve vitamin D immunomodulatory and anti-inflammatory properties, improvements in musculoskeletal function and modulation of nociceptive pathways; however, these mechanisms remain incompletely understood. Current evidence does not support routine vitamin D supplementation as a sole treatment for chronic musculoskeletal pain. Nevertheless, identifying and correcting hypovitaminosis D may be a part of a multimodal treatment strategy for overweight and obese individuals.