Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021

GBD 2021 Low Back Pain Collaborators; Himal Kandel; Lalit Yadav

doi:10.1016/S2665-9913(23)00098-X

Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021

GBD 2021 Low Back Pain Collaborators, Himal Kandel, Lalit Yadav

Caring Futures Institute

Research output: Contribution to journal › Article › peer-review

449 Citations (Scopus)

29 Downloads (Pure)

Abstract

Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021.

Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates.

Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI.

Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change.

Funding: Bill and Melinda Gates Foundation.

Original language	English
Pages (from-to)	e316-e329
Number of pages	14
Journal	The Lancet Rheumatology
Volume	5
Issue number	6
DOIs	https://doi.org/10.1016/S2665-9913(23)00098-X
Publication status	Published - Jun 2023

Keywords

Lower back pain
Risk factors
Years lived with disability

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10.1016/S2665-9913(23)00098-XLicence: CC BY

Final published versionFinal published version, 913 KBLicence: CC BY

Cite this

@article{5a63c21f71714dc4b9d1127b93b227a7,

title = "Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021",

abstract = "Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding: Bill and Melinda Gates Foundation.",

keywords = "Lower back pain, Risk factors, Years lived with disability",

author = "{GBD 2021 Low Back Pain Collaborators} and Ferreira, {Manuela L} and {de Luca}, Katie and Haile, {Lydia M} and Steinmetz, {Jaimie D} and Culbreth, {Garland T} and Marita Cross and Kopec, {Jacek A} and Ferreira, {Paulo H} and Blyth, {Fiona M} and Rachelle Buchbinder and Jan Hartvigsen and Ai-Min Wu and Saeid Safiri and Woolf, {Anthony D} and Collins, {Gary S} and Ong, {Kanyin Liane} and Vollset, {Stein Emil} and Smith, {Amanda E} and Cruz, {Jessica A} and Fukutaki, {Kai Glenn} and Abate, {Semagn Mekonnen} and Mitra Abbasifard and Mohsen Abbasi-Kangevari and Zeinab Abbasi-Kangevari and Ahmed Abdelalim and Aidin Abedi and Hassan Abidi and Adnani, {Qorinah Estiningtyas Sakilah} and Ali Ahmadi and Akinyemi, {Rufus Olusola} and Alamer, {Abayneh Tadesse} and Alem, {Adugnaw Zeleke} and Yousef Alimohamadi and Alshehri, {Mansour Abdullah} and Alshehri, {Mohammed Mansour} and Hosam Alzahrani and Saeed Amini and Sohrab Amiri and Hubert Amu and Andrei, {Catalina Liliana} and Tudorel Andrei and Benny Antony and Jalal Arabloo and Judie Arulappan and Ashokan Arumugam and Tahira Ashraf and Athari, {Seyyed Shamsadin} and Nefsu Awoke and Sina Azadnajafabad and B{\"a}rnighausen, {Till Winfried} and Barrero, {Lope H} and Amadou Barrow and Akbar Barzegar and Bearne, {Lindsay M} and Bensenor, {Isabela M} and Berhie, {Alemshet Yirga} and Bhandari, {Bharti Bhandari} and Bhojaraja, {Vijayalakshmi S} and Ali Bijani and Bodicha, {Belay Boda Abule} and Bolla, {Srinivasa Rao} and Javier Brazo-Sayavera and Briggs, {Andrew M} and Chao Cao and Periklis Charalampous and Chattu, {Vijay Kumar} and Cicuttini, {Flavia M} and Benjamin Clarsen and Sarah Cuschieri and Omid Dadras and Xiaochen Dai and Lalit Dandona and Rakhi Dandona and Azizallah Dehghan and Demie, {Takele Gezahegn G} and Edgar Denova-Guti{\'e}rrez and Dewan, {Syed Masudur Rahman} and Dharmaratne, {Samath Dhamminda} and Dhimal, {Mandira Lamichhane} and Meghnath Dhimal and Daniel Diaz and Mojtaba Didehdar and Digesa, {Lankamo Ena} and Mengistie Diress and Do, {Hoa Thi} and Doan, {Linh Phuong} and Michael Ekholuenetale and Muhammed Elhadi and Sharareh Eskandarieh and Shahriar Faghani and Jawad Fares and Ali Fatehizadeh and Getahun Fetensa and Irina Filip and Florian Fischer and Franklin, {Richard Charles} and Balasankar Ganesan and Gemeda, {Belete Negese Belete} and Getachew, {Motuma Erena} and Ahmad Ghashghaee and Gill, {Tiffany K} and Mahaveer Golechha and Pouya Goleij and Bhawna Gupta and Nima Hafezi-Nejad and Arvin Haj-Mirzaian and Hamal, {Pawan Kumar} and Asif Hanif and Harlianto, {Netanja I} and Hamidreza Hasani and Hay, {Simon I} and Hebert, {Jeffrey J} and Golnaz Heidari and Mohammad Heidari and Reza Heidari-Soureshjani and Hlongwa, {Mbuzeleni Mbuzeleni} and Mohammad-Salar Hosseini and Hsiao, {Alexander Kevin} and Ivo Iavicoli and Ibitoye, {Segun Emmanuel} and Ilic, {Irena M} and Ilic, {Milena D} and Islam, {Sheikh Mohammed Shariful} and Janodia, {Manthan Dilipkumar} and Jha, {Ravi Prakash} and Jindal, {Har Ashish} and Jonas, {Jost B} and Kabito, {Gebisa Guyasa} and Himal Kandel and Kaur, {Rimple Jeet} and Keshri, {Vikash Ranjan} and Khader, {Yousef Saleh} and Khan, {Ejaz Ahmad} and Khan, {Md Jobair} and Khan, {Moien A B} and Kashani, {Hamid Reza Khayat} and Jagdish Khubchandani and Kim, {Yun Jin} and Adnan Kisa and Jitka Klugarov{\'a} and Kolahi, {Ali Asghar} and Koohestani, {Hamid Reza} and Ai Koyanagi and Kumar, {G Anil} and Narinder Kumar and Tea Lallukka and Savita Lasrado and Wei-Chen Lee and Lee, {Yo Han} and Ata Mahmoodpoor and Malag{\'o}n-Rojas, {Jeadran N} and Malekpour, {Mohammad Reza} and Reza Malekzadeh and Narges Malih and Mehndiratta, {Man Mohan} and Nasab, {Entezar Mehrabi} and Menezes, {Ritesh G} and Mentis, {Alexios-Fotios A} and Mesregah, {Mohamed Kamal} and Miller, {Ted R} and Mohammad Mirza-Aghazadeh-Attari and Maryam Mobarakabadi and Yousef Mohammad and Esmaeil Mohammadi and Shafiu Mohammed and Mokdad, {Ali H} and Sara Momtazmanesh and Lorenzo Monasta and Moni, {Mohammad Ali} and Ebrahim Mostafavi and Murray, {Christopher J L} and Nair, {Tapas Sadasivan} and Javad Nazari and Nejadghaderi, {Seyed Aria} and Subas Neupane and Kandel, {Sandhya Neupane} and Nguyen, {Cuong Tat} and Ali Nowroozi and Hassan Okati-Aliabad and Emad Omer and Abderrahim Oulhaj and Owolabi, {Mayowa O} and Songhomitra Panda-Jonas and Anamika Pandey and Eun-Kee Park and Shrikant Pawar and Paolo Pedersini and Jeevan Pereira and Peres, {Mario F P} and Ionela-Roxana Petcu and Mohammadreza Pourahmadi and Amir Radfar and Shahram Rahimi-Dehgolan and Vafa Rahimi-Movaghar and Mosiur Rahman and Rahmani, {Amir Masoud} and Nazanin Rajai and Rao, {Chythra R} and Vahid Rashedi and Mohammad-Mahdi Rashidi and Ratan, {Zubair Ahmed} and Rawaf, {David Laith} and Salman Rawaf and Renzaho, {Andre M N} and Negar Rezaei and Zahed Rezaei and Leonardo Roever and {de Andrade Ruela}, Guilherme and Basema Saddik and Amirhossein Sahebkar and Sana Salehi and Francesco Sanmarchi and Sepanlou, {Sadaf G} and Saeed Shahabi and Shayan Shahrokhi and Elaheh Shaker and Shamsi, {Mohammad Bagher} and Mohammed Shannawaz and Saurab Sharma and Maryam Shaygan and Sheikhi, {Rahim Ali} and Shetty, {Jeevan K} and Rahman Shiri and Siddharudha Shivalli and Parnian Shobeiri and Sibhat, {Migbar Mekonnen} and Ambrish Singh and Singh, {Jasvinder A} and Helen Slater and Marco Solmi and Ranjani Somayaji and Ker-Kan Tan and Rekha Thapar and Tohidast, {Seyed Abolfazl} and Tahbaz, {Sahel Valadan} and Rohollah Valizadeh and Vasankari, {Tommi Juhani} and Narayanaswamy Venketasubramanian and Vasily Vlassov and Bay Vo and Yuan-Pang Wang and Taweewat Wiangkham and Lalit Yadav and Ali Yadollahpour and Jabbari, {Seyed Hossein Yahyazadeh} and Lin Yang and Fereshteh Yazdanpanah and Naohiro Yonemoto and Younis, {Mustafa Z} and Iman Zare",

year = "2023",

month = jun,

doi = "10.1016/S2665-9913(23)00098-X",

language = "English",

volume = "5",

pages = "e316--e329",

journal = "The Lancet Rheumatology",

issn = "2665-9913",

publisher = "Elsevier Ltd.",

number = "6",

}

Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. / GBD 2021 Low Back Pain Collaborators; Kandel, Himal; Yadav, Lalit.
In: The Lancet Rheumatology, Vol. 5, No. 6, 06.2023, p. e316-e329.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050

T2 - A systematic analysis of the Global Burden of Disease Study 2021

AU - GBD 2021 Low Back Pain Collaborators

AU - Ferreira, Manuela L

AU - de Luca, Katie

AU - Haile, Lydia M

AU - Steinmetz, Jaimie D

AU - Culbreth, Garland T

AU - Cross, Marita

AU - Kopec, Jacek A

AU - Ferreira, Paulo H

AU - Blyth, Fiona M

AU - Buchbinder, Rachelle

AU - Hartvigsen, Jan

AU - Wu, Ai-Min

AU - Safiri, Saeid

AU - Woolf, Anthony D

AU - Collins, Gary S

AU - Ong, Kanyin Liane

AU - Vollset, Stein Emil

AU - Smith, Amanda E

AU - Cruz, Jessica A

AU - Fukutaki, Kai Glenn

AU - Abate, Semagn Mekonnen

AU - Abbasifard, Mitra

AU - Abbasi-Kangevari, Mohsen

AU - Abbasi-Kangevari, Zeinab

AU - Abdelalim, Ahmed

AU - Abedi, Aidin

AU - Abidi, Hassan

AU - Adnani, Qorinah Estiningtyas Sakilah

AU - Ahmadi, Ali

AU - Akinyemi, Rufus Olusola

AU - Alamer, Abayneh Tadesse

AU - Alem, Adugnaw Zeleke

AU - Alimohamadi, Yousef

AU - Alshehri, Mansour Abdullah

AU - Alshehri, Mohammed Mansour

AU - Alzahrani, Hosam

AU - Amini, Saeed

AU - Amiri, Sohrab

AU - Amu, Hubert

AU - Andrei, Catalina Liliana

AU - Andrei, Tudorel

AU - Antony, Benny

AU - Arabloo, Jalal

AU - Arulappan, Judie

AU - Arumugam, Ashokan

AU - Ashraf, Tahira

AU - Athari, Seyyed Shamsadin

AU - Awoke, Nefsu

AU - Azadnajafabad, Sina

AU - Bärnighausen, Till Winfried

AU - Barrero, Lope H

AU - Barrow, Amadou

AU - Barzegar, Akbar

AU - Bearne, Lindsay M

AU - Bensenor, Isabela M

AU - Berhie, Alemshet Yirga

AU - Bhandari, Bharti Bhandari

AU - Bhojaraja, Vijayalakshmi S

AU - Bijani, Ali

AU - Bodicha, Belay Boda Abule

AU - Bolla, Srinivasa Rao

AU - Brazo-Sayavera, Javier

AU - Briggs, Andrew M

AU - Cao, Chao

AU - Charalampous, Periklis

AU - Chattu, Vijay Kumar

AU - Cicuttini, Flavia M

AU - Clarsen, Benjamin

AU - Cuschieri, Sarah

AU - Dadras, Omid

AU - Dai, Xiaochen

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Dehghan, Azizallah

AU - Demie, Takele Gezahegn G

AU - Denova-Gutiérrez, Edgar

AU - Dewan, Syed Masudur Rahman

AU - Dharmaratne, Samath Dhamminda

AU - Dhimal, Mandira Lamichhane

AU - Dhimal, Meghnath

AU - Diaz, Daniel

AU - Didehdar, Mojtaba

AU - Digesa, Lankamo Ena

AU - Diress, Mengistie

AU - Do, Hoa Thi

AU - Doan, Linh Phuong

AU - Ekholuenetale, Michael

AU - Elhadi, Muhammed

AU - Eskandarieh, Sharareh

AU - Faghani, Shahriar

AU - Fares, Jawad

AU - Fatehizadeh, Ali

AU - Fetensa, Getahun

AU - Filip, Irina

AU - Fischer, Florian

AU - Franklin, Richard Charles

AU - Ganesan, Balasankar

AU - Gemeda, Belete Negese Belete

AU - Getachew, Motuma Erena

AU - Ghashghaee, Ahmad

AU - Gill, Tiffany K

AU - Golechha, Mahaveer

AU - Goleij, Pouya

AU - Gupta, Bhawna

AU - Hafezi-Nejad, Nima

AU - Haj-Mirzaian, Arvin

AU - Hamal, Pawan Kumar

AU - Hanif, Asif

AU - Harlianto, Netanja I

AU - Hasani, Hamidreza

AU - Hay, Simon I

AU - Hebert, Jeffrey J

AU - Heidari, Golnaz

AU - Heidari, Mohammad

AU - Heidari-Soureshjani, Reza

AU - Hlongwa, Mbuzeleni Mbuzeleni

AU - Hosseini, Mohammad-Salar

AU - Hsiao, Alexander Kevin

AU - Iavicoli, Ivo

AU - Ibitoye, Segun Emmanuel

AU - Ilic, Irena M

AU - Ilic, Milena D

AU - Islam, Sheikh Mohammed Shariful

AU - Janodia, Manthan Dilipkumar

AU - Jha, Ravi Prakash

AU - Jindal, Har Ashish

AU - Jonas, Jost B

AU - Kabito, Gebisa Guyasa

AU - Kandel, Himal

AU - Kaur, Rimple Jeet

AU - Keshri, Vikash Ranjan

AU - Khader, Yousef Saleh

AU - Khan, Ejaz Ahmad

AU - Khan, Md Jobair

AU - Khan, Moien A B

AU - Kashani, Hamid Reza Khayat

AU - Khubchandani, Jagdish

AU - Kim, Yun Jin

AU - Kisa, Adnan

AU - Klugarová, Jitka

AU - Kolahi, Ali Asghar

AU - Koohestani, Hamid Reza

AU - Koyanagi, Ai

AU - Kumar, G Anil

AU - Kumar, Narinder

AU - Lallukka, Tea

AU - Lasrado, Savita

AU - Lee, Wei-Chen

AU - Lee, Yo Han

AU - Mahmoodpoor, Ata

AU - Malagón-Rojas, Jeadran N

AU - Malekpour, Mohammad Reza

AU - Malekzadeh, Reza

AU - Malih, Narges

AU - Mehndiratta, Man Mohan

AU - Nasab, Entezar Mehrabi

AU - Menezes, Ritesh G

AU - Mentis, Alexios-Fotios A

AU - Mesregah, Mohamed Kamal

AU - Miller, Ted R

AU - Mirza-Aghazadeh-Attari, Mohammad

AU - Mobarakabadi, Maryam

AU - Mohammad, Yousef

AU - Mohammadi, Esmaeil

AU - Mohammed, Shafiu

AU - Mokdad, Ali H

AU - Momtazmanesh, Sara

AU - Monasta, Lorenzo

AU - Moni, Mohammad Ali

AU - Mostafavi, Ebrahim

AU - Murray, Christopher J L

AU - Nair, Tapas Sadasivan

AU - Nazari, Javad

AU - Nejadghaderi, Seyed Aria

AU - Neupane, Subas

AU - Kandel, Sandhya Neupane

AU - Nguyen, Cuong Tat

AU - Nowroozi, Ali

AU - Okati-Aliabad, Hassan

AU - Omer, Emad

AU - Oulhaj, Abderrahim

AU - Owolabi, Mayowa O

AU - Panda-Jonas, Songhomitra

AU - Pandey, Anamika

AU - Park, Eun-Kee

AU - Pawar, Shrikant

AU - Pedersini, Paolo

AU - Pereira, Jeevan

AU - Peres, Mario F P

AU - Petcu, Ionela-Roxana

AU - Pourahmadi, Mohammadreza

AU - Radfar, Amir

AU - Rahimi-Dehgolan, Shahram

AU - Rahimi-Movaghar, Vafa

AU - Rahman, Mosiur

AU - Rahmani, Amir Masoud

AU - Rajai, Nazanin

AU - Rao, Chythra R

AU - Rashedi, Vahid

AU - Rashidi, Mohammad-Mahdi

AU - Ratan, Zubair Ahmed

AU - Rawaf, David Laith

AU - Rawaf, Salman

AU - Renzaho, Andre M N

AU - Rezaei, Negar

AU - Rezaei, Zahed

AU - Roever, Leonardo

AU - de Andrade Ruela, Guilherme

AU - Saddik, Basema

AU - Sahebkar, Amirhossein

AU - Salehi, Sana

AU - Sanmarchi, Francesco

AU - Sepanlou, Sadaf G

AU - Shahabi, Saeed

AU - Shahrokhi, Shayan

AU - Shaker, Elaheh

AU - Shamsi, Mohammad Bagher

AU - Shannawaz, Mohammed

AU - Sharma, Saurab

AU - Shaygan, Maryam

AU - Sheikhi, Rahim Ali

AU - Shetty, Jeevan K

AU - Shiri, Rahman

AU - Shivalli, Siddharudha

AU - Shobeiri, Parnian

AU - Sibhat, Migbar Mekonnen

AU - Singh, Ambrish

AU - Singh, Jasvinder A

AU - Slater, Helen

AU - Solmi, Marco

AU - Somayaji, Ranjani

AU - Tan, Ker-Kan

AU - Thapar, Rekha

AU - Tohidast, Seyed Abolfazl

AU - Tahbaz, Sahel Valadan

AU - Valizadeh, Rohollah

AU - Vasankari, Tommi Juhani

AU - Venketasubramanian, Narayanaswamy

AU - Vlassov, Vasily

AU - Vo, Bay

AU - Wang, Yuan-Pang

AU - Wiangkham, Taweewat

AU - Yadav, Lalit

AU - Yadollahpour, Ali

AU - Jabbari, Seyed Hossein Yahyazadeh

AU - Yang, Lin

AU - Yazdanpanah, Fereshteh

AU - Yonemoto, Naohiro

AU - Younis, Mustafa Z

AU - Zare, Iman

PY - 2023/6

Y1 - 2023/6

N2 - Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding: Bill and Melinda Gates Foundation.

AB - Background: Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods: Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings: In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation: Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding: Bill and Melinda Gates Foundation.

KW - Lower back pain

KW - Risk factors

KW - Years lived with disability

UR - http://www.scopus.com/inward/record.url?scp=85160104010&partnerID=8YFLogxK

U2 - 10.1016/S2665-9913(23)00098-X

DO - 10.1016/S2665-9913(23)00098-X

M3 - Article

AN - SCOPUS:85160104010

SN - 2665-9913

VL - 5

SP - e316-e329

JO - The Lancet Rheumatology

JF - The Lancet Rheumatology

IS - 6

ER -

Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021

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