Global burden of low back pain from 1990 to 2021: a comprehensive analysis of risk factors and trends using the Global Burden of Disease Study 2021.

BACKGROUND

This study comprehensively assesses low back pain-related risk factors and the global burden from a multi-dimensional perspective, aiming to provide scientific evidence for disease prevention.

METHODS

Data from the Global Burden of Disease (GBD) database spanning from 1990 to 2021 were incorporated into this study. We conducted an analysis of baseline data, as well as gender and age subgroup data. Additionally, we introduced the Age-Period-Cohort (APC) and decomposition analysis models to clarify the independent effects of factors such as age, period, cohort, population growth, population aging and changes in epidemiological trends on the disease burden. The Estimated Annual Percentage Change (EAPC) was used to measure the temporal trends of health indicators. To enhance practical applicability, we constructed a model that integrates frontier analysis with health inequality assessment. Furthermore, the Autoregressive Integrated Moving Average (ARIMA) model was employed to forecast trends in LBP over the next 15 years.

RESULTS

In 2021, the global age-standardized prevalence of low back pain decreased by 11.06% compared to that in 1990. However, the number of affected individuals increased from 386.7 million to 628.8 million. Concurrently, the age-standardized Disability-Adjusted Life Years (DALYs) rate declined by 11.22% relative to 1990, while total DALYs rose from 43,386,225 to 70,156,962. The results derived from multiple models indicate that higher socio-demographic index levels, advancing age, female sex and occupational ergonomics-related factors may contribute to disparities in the burden of low back pain. Furthermore, this unequal health gap appears to be widening over time.

CONCLUSIONS

Disease burden of low back pain exhibit varying manifestations across different regions and temporal dimensions. Higher levels of the Socio-Demographic Index(SDI), increasing age, female gender and adverse occupational ergonomic factors may be important risk elements for the burden of low back pain. Meanwhile, certain changes in epidemiological trends may alleviate this burden to some extent. In the absence of effective intervention measures, the gaps in health inequality engendered by the aforementioned diverse factors are likely to expand continuously. In light of this, it is crucial to actively develop systematic, comprehensive and targeted health prevention strategies.