Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019

Abstract

Background: To comprehensively analyze the global level and trends of prevalence, incidence and years lived with disability (YLDs) for low back pain (LBP) from 1990 to 2019 by age, sex and sociodemographic index (SDI).

Methods: Publicly available modelled data and methods were obtained from the Global Burden of Diseases (GBD) study 2019, and used to evaluate the global burden of LBP through a systematic analysis.

Results: Globally, the age-standardized prevalence, incidence and YLDs rate of LBP were slightly decreased from 1990 to 2019, but the number of the prevalent cases, incident cases and YLDs had substantially increased, and LBP remains the leading cause of YLDs in 2019 worldwide. The number of prevalent cases was increased with age and peaked at the age of 45-54 years for both sexes, and the global prevalence rate was higher in females than in males and increased with age, peaking at the 80-84 age group in both sexes in 2019. Overall, a positive association between the age-standardized YLD rate and SDI was observed over the past thirty years. At the national revel, the United States, Denmark and Switzerland had the three highest levels of age-standardized prevalence, while Zambia, Zimbabwe and Canada showed the highest increase in the age-standardized prevalence during 1990-2019.

Conclusions: LBP is a major public health issue globally, and its burden remains high. Increasing population awareness about its risk factors and preventive measures for LBP are needed to reduce the future burden of this condition.

The translational potential of this article: Due to the high prevalence and heavy burden of LBP globally, it is important to update its epidemiological data. This systematic analysis provides researchers and healthcare policy makers with up-to-date, comprehensive and comparable information on global LBP burden, which is of clinical translational significance.

Keywords: Epidemiological science; Global burden; Low back pain.

Fig. 1

Age-standardized prevalence estimates of low back pain per 100,000 population by country in 2019 (generated from data available from http://ghdx.healthdata.org/gbd-results-tool).

Fig. 2

Age-standardized incidence estimates of low back pain per 100,000 population by country in 2019 (generated from data available from http://ghdx.healthdata.org/gbd-results-tool).

Fig. 3

Worldwide prevalent cases and prevalence estimates of low back pain per 100,000 population by age and sex in 2019; Dotted and dashed lines indicate 95 ​% upper and lower uncertainty intervals (95 ​% UI), respectively (generated from data available from http://ghdx.healthdata.org/gbd-results-tool).

Fig. 4

Age-standardized years lived with disability (YLD) rates for low back pain for 21 Global Burden of Disease (GBD) regions by sociodemographic index (SDI) between 1990 and 2019; Expected values based on the SDI and disease rates in all locations are shown as the black line. Thirty points are plotted for each GBD region and show observed age-standardized YLD rates from 1990 to 2019 for that region (generated from data available from http://ghdx.healthdata.org/gbd-results-tool).

Fig. 5

Age-standardized years lived with disability (YLD) rates of low back pain by 204 countries and territories and sociodemographic index (SDI) in 2019; Expected values are shown as the black line. Each point shows observed age-standardized YLD rate for specified country or territory in 2019 (generated from data available from http://ghdx.healthdata.org/gbd-results-tool).