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; Manuela L. Ferreira; Katie De Luca; Lydia M. Haile; Jaimie D. Steinmetz; Garland T. Culbreth; Marita Cross; Jacek A. Kopec; Paulo H. Ferreira; Fiona M. Blyth; Rachelle Buchbinder; Jan Hartvigsen; Ai Min Wu; Saeid Safiri; Anthony D. Woolf; Gary S. Collins; Kanyin Liane Ong; Stein Emil Vollset; Amanda E. Smith; Jessica A. Cruz; Kai Glenn Fukutaki; Semagn Mekonnen Abate; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Ahmed Abdelalim; Aidin Abedi; Hassan Abidi; Qorinah Estiningtyas Sakilah Adnani; Ali Ahmadi; Rufus Olusola Akinyemi; Abayneh Tadesse Alamer; Adugnaw Zeleke Alem; Yousef Alimohamadi; Mansour Abdullah Alshehri; Mohammed Mansour Alshehri; Hosam Alzahrani; Saeed Amini; Sohrab Amiri; Hubert Amu; Catalina Liliana Andrei; Tudorel Andrei; Benny Antony; Jalal Arabloo; Judie Arulappan; Ashokan Arumugam; Tahira Ashraf; Seyyed Shamsadin Athari; Subas Neupane; Rahman Shiri; Tommi Juhani Vasankari

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
, Manuela L. Ferreira^*
, Katie De Luca
, Lydia M. Haile
, Jaimie D. Steinmetz
, Garland T. Culbreth
, Marita Cross
, Jacek A. Kopec
, Paulo H. Ferreira
, Fiona M. Blyth
, Rachelle Buchbinder
, Jan Hartvigsen
, Ai Min Wu
, Saeid Safiri
, Anthony D. Woolf
, Gary S. Collins
, Kanyin Liane Ong
, Stein Emil Vollset
, Amanda E. Smith
, Jessica A. Cruz

Kai Glenn Fukutaki, Semagn Mekonnen Abate, Mitra Abbasifard, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Ahmed Abdelalim, Aidin Abedi, Hassan Abidi, Qorinah Estiningtyas Sakilah Adnani, Ali Ahmadi, Rufus Olusola Akinyemi, Abayneh Tadesse Alamer, Adugnaw Zeleke Alem, Yousef Alimohamadi, Mansour Abdullah Alshehri, Mohammed Mansour Alshehri, Hosam Alzahrani, Saeed Amini, Sohrab Amiri, Hubert Amu, Catalina Liliana Andrei, Tudorel Andrei, Benny Antony, Jalal Arabloo, Judie Arulappan, Ashokan Arumugam, Tahira Ashraf, Seyyed Shamsadin Athari, Subas Neupane, Rahman Shiri, Tommi Juhani Vasankari

^*Corresponding author for this work

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

1530 Citations (Scopus)

28 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
Publication type	A1 Journal article-refereed

Funding

T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. R Buchbinder is supported by an Australian National Health and Medical Research Council (NHMRC) Investigator Fellowship. M Cross acknowledges support from Global Alliance for Musculoskeletal Health. A Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. S M S Islam is funded by the National Health and Medical Research Council of Australia (NHMRC) and has received funding from the National Heart Foundation of Australia. H Kandel is a Kornhauser Research Fellow at The University of Sydney. J Khubchandani has received funding from TEVA Pharmaceuticals for Migraine related research. Y J Kim was supported by Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). T Lallukka is supported by the Academy of Finland (Grant #330527) and the Social Insurance Institution of Finland (grant 29/26/2020). L Monasta was supported by the Italian Ministry of Health, through a contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. P Pedersini was supported and funded by the Italian Ministry of Health - Ricerca Corrente 2021. S Sharma is supported by the International Association for the Study of Pain John J Monica Postdoctoral Fellowship. A Singh is supported by International Graduate Research Scholarship, University of Tasmania. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. R Buchbinder is supported by an Australian National Health and Medical Research Council (NHMRC) Investigator Fellowship. M Cross acknowledges support from Global Alliance for Musculoskeletal Health. A Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. S M S Islam is funded by the National Health and Medical Research Council of Australia (NHMRC) and has received funding from the National Heart Foundation of Australia. H Kandel is a Kornhauser Research Fellow at The University of Sydney. J Khubchandani has received funding from TEVA Pharmaceuticals for Migraine related research. Y J Kim was supported by Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). T Lallukka is supported by the Academy of Finland (Grant #330527) and the Social Insurance Institution of Finland (grant 29/26/2020). L Monasta was supported by the Italian Ministry of Health, through a contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. P Pedersini was supported and funded by the Italian Ministry of Health - Ricerca Corrente 2021. S Sharma is supported by the International Association for the Study of Pain John J Monica Postdoctoral Fellowship. A Singh is supported by International Graduate Research Scholarship, University of Tasmania. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.

Funders	Funder number
Department of Environmental Health Engineering of Isfahan University of Medical Sciences
Institute for Maternal and Child Health IRCCS Burlo Garofolo
TEVA Pharmaceuticals for Migraine
Xiamen University Malaysia	XMUMRF/2020-C6/ITCM/0004
Alexander von Humboldt-Stiftung
National Health and Medical Research Council
National Heart Foundation of Australia
University of Tasmania
University of Sydney
KELA	29/26/2020
Academy of Finland	330527
Bundesministerium für Bildung und Forschung
Ministero della Salute
International Zinc Association
Research Management Centre, International Islamic University Malaysia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Rheumatology
Immunology and Allergy
Immunology

Access to Document

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

1-s2.0-S266599132300098X-main-1Final published version, 934 KBLicence: CC BY

https://urn.fi/URN:NBN:fi:tuni-2023112410212Licence: CC BY

Cite this

GBD 2021 Low Back Pain Collaborators, Ferreira, M. L., De Luca, K., Haile, L. M., Steinmetz, J. D., Culbreth, G. T., Cross, M., Kopec, J. A., Ferreira, P. H., Blyth, F. M., Buchbinder, R., Hartvigsen, J., Wu, A. M., Safiri, S., Woolf, A. D., Collins, G. S., Ong, K. L., Vollset, S. E., Smith, A. E., ... Vasankari, T. J. (2023). 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. The Lancet Rheumatology, 5(6), e316-e329. https://doi.org/10.1016/S2665-9913(23)00098-X

@article{8a5126aff57c46e998776454402564fa,

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.",

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 Wu, \{Ai Min\} 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 Subas Neupane and Rahman Shiri and Vasankari, \{Tommi Juhani\}",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license",

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",

number = "6",

}

GBD 2021 Low Back Pain Collaborators, Ferreira, ML, De Luca, K, Haile, LM, Steinmetz, JD, Culbreth, GT, Cross, M, Kopec, JA, Ferreira, PH, Blyth, FM, Buchbinder, R, Hartvigsen, J, Wu, AM, Safiri, S, Woolf, AD, Collins, GS, Ong, KL, Vollset, SE, Smith, AE, Cruz, JA, Fukutaki, KG, Abate, SM, Abbasifard, M, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abdelalim, A, Abedi, A, Abidi, H, Adnani, QES, Ahmadi, A, Akinyemi, RO, Alamer, AT, Alem, AZ, Alimohamadi, Y, Alshehri, MA, Alshehri, MM, Alzahrani, H, Amini, S, Amiri, S, Amu, H, Andrei, CL, Andrei, T, Antony, B, Arabloo, J, Arulappan, J, Arumugam, A, Ashraf, T, Athari, SS, Neupane, S, Shiri, R & Vasankari, TJ 2023, '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', The Lancet Rheumatology, vol. 5, no. 6, pp. e316-e329. https://doi.org/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; Ferreira, Manuela L.; De Luca, Katie et al.
In: The Lancet Rheumatology, Vol. 5, No. 6, 06.2023, p. e316-e329.

Research output: Contribution to journal › Article › Scientific › 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 - Neupane, Subas

AU - Shiri, Rahman

AU - Vasankari, Tommi Juhani

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.

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 -

GBD 2021 Low Back Pain Collaborators, Ferreira ML, De Luca K, Haile LM, Steinmetz JD, Culbreth GT et al. 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. The Lancet Rheumatology. 2023 Jun;5(6):e316-e329. 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

Abstract

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UN SDGs

Publication forum classification

ASJC Scopus subject areas

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