Introduction A study was undertaken to test the hypothesis that musculoskeletal pain is associated with low vitamin D levels but the relationship is explained by physical inactivity and/or other putative confounding factors. METHODS: /st> Men aged 40-79 years completed a postal questionnaire including a pain assessment and attended a clinical assessment (lifestyle questionnaire, physical performance tests, 25-hydroxyvitamin D3 (25-(OH)D) levels from fasting blood sample). SUBJECTS: were classified according to 25-(OH)D levels as 'normal' (>/=15 ng/ml) or 'low' ( These findings have implications at a population level for the long-term health of individuals with musculoskeletal pain.