Papers of the Week

African Americans experience an increased burden of motor vehicle collision (MVC), post-MVC musculoskeletal pain (MSP) and Vitamin D insufficiency. In this prospective multicenter study, we tested the hypothesis that African Americans (n=133) presenting to the ED after MVC with low peritraumatic Vitamin D levels would have worse chronic MSP outcomes compared to individuals with sufficient Vitamin D. Vitamin D levels were assessed in the early aftermath of MVC via enzyme-linked immunosorbent assay, and pain severity was assessed via the 0-10 numeric rating scale at 6 weeks, 6 months and 1 year. In repeated-measures analysis, African American MVC survivors with vitamin D insufficiency experienced more severe chronic pain (β=1.18, p=0.031). In secondary analyses, we assessed for evidence that the effect of Vitamin D on post-MVC pain outcomes is mediated, at least in part, by the influence of Vitamin D on genetic variants in genes involved in immune system regulation (IL-10 and NLRP3). Genotyping was performed using a genome-wide microarray using collected DNA samples. Secondary analyses suggest that the effect of Vitamin D on post-MVC pain outcomes may be influenced by genetic variation in IL-10 and NLRP3. Further studies are needed to assess the impact of Vitamin D insufficiency on pain outcomes in African Americans experiencing MVC and other common trauma exposures, to assess factors affecting this relationship, and to assess the efficacy of administering Vitamin D in the immediate aftermath of MVC to prevent chronic pain. Such low-cost, non-opioid interventions are urgently needed to address chronic pain development following MVC.