Serum uric acid levels in patients with chronic nonspecific musculoskeletal pain

Abstract

Background: Chronic nonspecific musculoskeletal pain (CNMP) represents a significant global health challenge affecting approximately 20-30% of the adult population. Despite its prevalence, the underlying pathophysiological mechanisms remain poorly understood. Recent evidence suggests potential roles for metabolic factors in pain generation and perpetuation. By contrasting cases with healthy controls and assessing related demographic and clinical factors, this study sought to determine the link between serum uric acid levels and CNMP. Methods: A case-control study was conducted with 30 patients diagnosed with CNMP (pain lasting ≥4 weeks without identifiable structural or inflammatory cause) and 30 age-matched healthy controls. Comprehensive demographic data, clinical characteristics, and lifestyle factors were assessed. Laboratory investigations included complete blood count, erythrocyte sedimentation rate, fasting blood sugar, renal function tests, rheumatoid factor, anti-streptolysin O titer, and serum uric acid levels. Statistical analysis was performed using appropriate tests, with p<0.05 considered significant. Results: The case and control groups showed similar age distribution, with most participants in the 21-40 years bracket (46.7% vs. 53.3%). All participants had normal BMI (18.5-24.9 kg/m2). Significantly, 60% of CNMP patients exhibited hyperuricemia (men >7 mg/dl, women >6 mg/dl) compared to none in the control group (p<0.001). Serum creatinine levels were higher in cases compared to controls (0.8±0.1 vs. 0.67±0. mg/dl, p<0.001) while remaining within normal clinical ranges. Most CNMP patients (83.3%) reported pain duration of 4 weeks, with 96.7% describing moderate intensity. Nearly all cases (96.7%) were negative for rheumatoid factor, and all were negative for anti-streptolysin O titer. No significant differences were observed in hematological parameters, dietary patterns, smoking, or alcohol consumption between groups. Conclusion: This study demonstrates a significant association between elevated serum uric acid levels and CNMP, with 60% of patients exhibiting hyperuricemia compared to none in the control group. This finding suggests that uric acid may play a role in the pathophysiology of CNMP through pro-inflammatory effects, oxidative stress induction, or microvascular dysfunction. Serum uric acid could serve as a potential biomarker and therapeutic target in CNMP, supporting a more integrated approach to chronic pain management that considers biochemical factors alongside biomechanical and psychosocial dimensions. Further research is warranted to establish causality and optimize therapeutic approaches targeting uric acid metabolism in CNMP patients.