Hyperuricemia in Patients with Chronic Low Back Pain: Experience from a Single Institutional Neurosurgical OPD

Objective: To evaluate the frequency of hyperuricemia in patients with chronic low back pain. Methodology: A descriptive cross sectional study was conducted over a period of 4 months from August 2015 to November 2015 at the Neurosurgery Clinic, Liaquat National Hospital and Medical College, Karachi. A total of 104 patients were evaluated between the ages of 18 to 75 years with chronic low back pain. Data was collected by means of a structured Performa. X-rays and Magnetic Resonance Imaging (MRI) of lumbo-sacral spine were used to assess any findings in relation to low back pain. Serum uric levels were laboratory tested and recorded. A statistical association was established between hyperuricemia and chronic low back pain with respect to age, gender and related radiological findings. Results: Twenty six patients (25%) had elevated serum uric acid levels with no significant difference in genders. Patients in the age group of 26-60 years showed a higher frequency of hyperuricemia as compared to other age groups. There was a significant association of hyperuricemia with large joint pain of the lower limb as seen in 22 patients (85%). Other significant radiological findings were lumbar disc prolapse found in 19 out of 26 patients (73%), degenerative disc disease in 54% (n=14) and disc space narrowing in 96% (n=25) patients (P<0.05). Conclusion: Our study suggests existence of hyperuricemia in 1 out of every 4 patients with low back pain, irrespective of the patient’s gender, with higher . There is a variable association of occupation and preexisting co-morbidities of the patients with low back pain. Our study predicts a strong association of lumbar disc prolapse and joint space narrowing of the lumbar vertebrae with hyperuricemia. It raises a question that perhaps hyperuricemia augments the age related spondylolesthesis by mechanisms not understood so far.