“Pain is a complex issue. I can tell you from personal experience, my father was a terminally ill cancer patient. And I know that asking patients to stop taking medications for pain is not feasible. However, what we hoped to achieve by this work is twofold. One is highlighting the association between heavy narcotic use and poor outcomes in this patient population and second providing a foundation for future research in this matter.”
“For now, the most practical recommendations are to include opioid use as part of patient risk/outcome stratification and consider limiting or controlling opioid use in the preoperative period.”
Khaled Kebaish, M.D., professor of orthopedic surgery at the Johns Hopkins University School of Medicine, told OTW, “Patients who come into clinics reporting heavy narcotic use preoperatively, should be identified as higher risk patients who are likely to have higher long-term opioid use and disability when compared to non-heavy opioid users.”
Funding for this study was provided by DePuy Synthes Spine, K2M, Inc., NuVasive, Inc., Biomet and Orthofix International, N.V.
More Vitamin D = Better Muscle Strength, Athletic Performance
There is a new study from Stanford examining Vitamin D and its effect on sports performance. The research, “Effects of Vitamin D on Skeletal Muscle and Athletic Performance,” is published in the April 15, 2018 edition of the Journal of the American Academy of Orthopaedic Surgeons.
“Vitamin D deficiency commonly affects many people around the world,” said lead study author and orthopedic surgeon Geoffrey D. Abrams, M.D., in the April 16, 2018 news release. Dr. Abrams, who is with Stanford University, added, “With higher serum levels of vitamin D playing a role in muscle strength, injury prevention, and sports performance, it’s essential for individuals to take necessary steps to ensure they’re getting an adequate amount of vitamin D intake, whether through direct sunlight or other sources including fish, eggs, fortified dairy products, and dietary supplements. Studies also have shown that daily vitamin D supplements are proven to be more effective than weekly or monthly doses.”
“While vitamin D supplementation improves function and decreases fracture risk in people who are vitamin D deficient, it’s important for individuals to be aware of the safe dosage amount, which varies with age and the status of an individual’s current vitamin D level. We are not advocating for athletes to take additional vitamin D without first speaking with a doctor.”
Dr. Abrams told OTW, “This was a review study, but one of the only reviews done to date to focus on the role of vitamin D and its effect on sports performance. We are sports medicine physicians looking to give our athletes reduced injury risk as well as every possible competitive advantage. Vitamin D has the potential to accomplish both these goals.”
“Particular subsets of athletes (women’s basketball players) were particularly likely to have insufficient vitamin D levels. In addition, there is some suggestion that vitamin D therapy can improve muscle strength as well as some other metrics of physical performance.”
“Treatment should be individualized based on the recommendations of your physician, but there is evidence that some athletes may benefit from vitamin D supplementation. If supplementation is given, daily dosing seems to be most efficacious.”
