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
Manuela L. Ferreira(The University of Sydney), Katie de Luca(The University of Sydney), Lydia M Haile(The University of Sydney), Jaimie D Steinmetz(The University of Sydney), Garland T Culbreth(The University of Sydney), Marita Cross(The University of Sydney), Jacek A Kopec(The University of Sydney), Paulo H. Ferreira(The University of Sydney), Fiona Blyth(The University of Sydney), Rachelle Buchbinder(The University of Sydney), Jan Hartvigsen(The University of Sydney), Aimin Wu(The University of Sydney), Saeid Safiri(The University of Sydney), Anthony D. Woolf(The University of Sydney), Gary S. Collins(The University of Sydney), Kanyin Liane Ong(The University of Sydney), Stein Emil Vollset(The University of Sydney), Amanda Smith(The University of Sydney), Jessica A Cruz(The University of Sydney), Kai Fukutaki(The University of Sydney), Semagn Mekonnen Abate(The University of Sydney), Mitra Abbasifard(The University of Sydney), Mohsen Abbasi‐Kangevari(The University of Sydney), Zeinab Abbasi-Kangevari(The University of Sydney), Ahmed Abdelalim(The University of Sydney), Aidin Abedi(The University of Sydney), Hassan Abidi(The University of Sydney), Qorinah Estiningtyas Sakilah Adnani(The University of Sydney), Ali Ahmadi(The University of Sydney), Rufus Akinyemi(The University of Sydney), Abayneh Tadesse Alamer, Adugnaw Zeleke Alem(The University of Sydney), Yousef Alimohamadi(The University of Sydney), Mansour Abdullah Alshehri(The University of Sydney), Mohammed M. Alshehri(The University of Sydney), Hosam Alzahrani(The University of Sydney), Saeed Amini(The University of Sydney), Sohrab Amiri(The University of Sydney), Hubert Amu(The University of Sydney), Cătălina Liliana Andrei(The University of Sydney), Tudorel Andrei(The University of Sydney), Benny Antony(The University of Sydney), Jalal Arabloo(The University of Sydney), Judie Arulappan(The University of Sydney), Ashokan Arumugam(The University of Sydney), Tahira Ashraf(The University of Sydney), Seyyed Shamsadin Athari(The University of Sydney), Nefsu Awoke(The University of Sydney), Sina Azadnajafabad(The University of Sydney), Till Bärnighausen(The University of Sydney), Lope H. Barrero(The University of Sydney), Amadou Barrow(The University of Sydney), Akbar Barzegar(The University of Sydney), Lindsay Bearne(The University of Sydney), Isabela M. Benseñor(The University of Sydney), Alemshet Yirga Berhie(The University of Sydney), Bharti Bhandari(The University of Sydney), Vijayalakshmi S Bhojaraja(The University of Sydney), Ali Bijani(The University of Sydney), Belay Boda Abule Bodicha(The University of Sydney), Srinivasa Rao Bolla(The University of Sydney), Javier Brazo‐Sayavera(The University of Sydney), Andrew M. Briggs(The University of Sydney), Chao Cao(The University of Sydney), Periklis Charalampous(The University of Sydney), Vijay Kumar Chattu(The University of Sydney), Flavia Cicuttini(The University of Sydney), Benjamin Clarsen(The University of Sydney), Sarah Cuschieri(The University of Sydney), Omid Dadras(The University of Sydney), Xiaochen Dai(The University of Sydney), Lalit Dandona(The University of Sydney), Rakhi Dandona(The University of Sydney), Azizallah Dehghan(The University of Sydney), Takele Gezahegn Demie(The University of Sydney), Edgar Denova‐Gutiérrez(The University of Sydney), Syed Masudur Rahman Dewan(The University of Sydney), Samath Dhamminda Dharmaratne(The University of Sydney), Mandira Lamichhane Dhimal(The University of Sydney), Meghnath Dhimal(The University of Sydney), Daniel Díaz(The University of Sydney), Mojtaba Didehdar(The University of Sydney), Lankamo Ena Digesa(The University of Sydney), Mengistie Diress(The University of Sydney), Hoa Do(The University of Sydney), Linh Phuong Doan(The University of Sydney), Michael Ekholuenetale(The University of Sydney), Muhammed Elhadi(The University of Sydney), Sharareh Eskandarieh(The University of Sydney), Shahriar Faghani(The University of Sydney), Jawad Fares(The University of Sydney), Ali Fatehizadeh(The University of Sydney), Getahun Fetensa(The University of Sydney), Irina Filip(The University of Sydney), Florian Fischer(The University of Sydney), Richard C. Franklin(The University of Sydney), Balasankar Ganesan(The University of Sydney), Belete Negese(The University of Sydney), Motuma Erena Getachew(The University of Sydney), Ahmad Ghashghaee(The University of Sydney), Tiffany K. Gill(The University of Sydney), Mahaveer Golechha(The University of Sydney), Pouya Goleij(The University of Sydney), Bhawna Gupta(The University of Sydney), Nima Hafezi‐Nejad(The University of Sydney), Arvin Haj‐Mirzaian(The University of Sydney), Pawan Kumar Hamal(The University of Sydney), Asif Hanif(The University of Sydney), Netanja I. Harlianto(The University of Sydney), Hamidreza Hasani(The University of Sydney), Simon I Hay(The University of Sydney), Jeffrey J. Hébert(The University of Sydney), Golnaz Heidari(The University of Sydney), Mohammad Heidari(The University of Sydney), Reza Heidari‐Soureshjani(The University of Sydney), Mbuzeleni Hlongwa(The University of Sydney), Mohammad‐Salar Hosseini(The University of Sydney), Alexander Kevin Hsiao(The University of Sydney), Ivo Iavicoli(The University of Sydney), Segun Emmanuel Ibitoye(The University of Sydney), Irena Ilić(The University of Sydney), Milena Ilić(The University of Sydney), Sheikh Mohammed Shariful Islam(The University of Sydney), Manthan D Janodia(The University of Sydney), Ravi Prakash Jha(The University of Sydney), Har Ashish Jindal(The University of Sydney), Jost B. Jonas(The University of Sydney), Gebisa Guyasa Kabito(The University of Sydney), Himal Kandel(The University of Sydney), Rimple Jeet Kaur(The University of Sydney), Vikash Ranjan Keshri(The University of Sydney), Yousef Khader(The University of Sydney), Ejaz Ahmad Khan(The University of Sydney), Mohammad Jobair Khan(The University of Sydney), Moien AB Khan(The University of Sydney), Hamid Reza Khayat Kashani(The University of Sydney), Jagdish Khubchandani(The University of Sydney), Yun Jin Kim(The University of Sydney), Adnan Kısa(The University of Sydney), Jitka Klugarová(The University of Sydney), Ali‐Asghar Kolahi(The University of Sydney), Hamid Reza Koohestani(The University of Sydney), Ai Koyanagi(The University of Sydney), G Anil Kumar(The University of Sydney), Narinder Kumar(The University of Sydney), Tea Lallukka(The University of Sydney), Savita Lasrado(The University of Sydney), Wei‐Chen Lee(The University of Sydney), Yo Han Lee(The University of Sydney), Ata Mahmoodpoor(The University of Sydney), Jeadran Malagón-Rojas(The University of Sydney), Mohammad‐Reza Malekpour(The University of Sydney), Reza Malekzadeh(The University of Sydney), Narges Malih(The University of Sydney), Man Mohan Mehndiratta(The University of Sydney), Entezar Mehrabi Nasab, Ritesh G. Menezes(The University of Sydney), Alexios‐Fotios A. Mentis(The University of Sydney), Mohamed Kamal Mesregah(The University of Sydney), Ted R. Miller(The University of Sydney), Mohammad Mirza‐Aghazadeh‐Attari(The University of Sydney), Maryam Mobarakabadi(The University of Sydney), Yousef Mohammad(The University of Sydney), Esmaeil Mohammadi(The University of Sydney), Shafiu Mohammed(The University of Sydney), Ali H. Mokdad(The University of Sydney), Sara Momtazmanesh(The University of Sydney), Lorenzo Monasta(The University of Sydney), Mohammad Ali Moni(The University of Sydney), Ebrahim Mostafavi(The University of Sydney), Christopher J L Murray(The University of Sydney), Tapas Sadasivan Nair(The University of Sydney), Javad Nazari(The University of Sydney), Seyed Aria Nejadghaderi(The University of Sydney), Subas Neupane(The University of Sydney), Sandhya Neupane Kandel(The University of Sydney), Cuong Tat Nguyen(The University of Sydney), Ali Nowroozi(The University of Sydney), Hassan Okati‐Aliabad(The University of Sydney), Emad Omer(The University of Sydney), Abderrahim Oulhaj(The University of Sydney), Mayowa Owolabi(The University of Sydney), Songhomitra Panda‐Jonas(The University of Sydney), Anamika Pandey(The University of Sydney), Eun‐Kee Park(The University of Sydney), Shrikant Pawar(The University of Sydney), Paolo Pedersini(The University of Sydney), Jeevan Pereira(The University of Sydney), Mário Fernando Prieto Peres(The University of Sydney), Ionela-Roxana Petcu(The University of Sydney), Mohammadreza Pourahmadi(The University of Sydney), Amir Radfar(The University of Sydney), Shahram Rahimi‐Dehgolan(The University of Sydney), Vafa Rahimi‐Movaghar(The University of Sydney), Mosiur Rahman(The University of Sydney), Amir Masoud Rahmani(The University of Sydney), Nazanin Rajai(The University of Sydney), Chythra R Rao(The University of Sydney), Vahid Rashedi(The University of Sydney), Mohammad‐Mahdi Rashidi(The University of Sydney), Zubair Ahmed Ratan(The University of Sydney), David Laith Rawaf(The University of Sydney), Salman Rawaf(The University of Sydney), André M. N. Renzaho(The University of Sydney), Negar Rezaei(The University of Sydney), Zahed Rezaei(The University of Sydney), Leonardo Roever(The University of Sydney), Guilherme de Andrade Ruela(The University of Sydney), Basema Saddik(The University of Sydney), Amirhossein Sahebkar(The University of Sydney), Sana Salehi(The University of Sydney), Francesco Sanmarchi(The University of Sydney), Sadaf G Sepanlou(The University of Sydney), Saeed Shahabi(The University of Sydney), Shayan Shahrokhi(The University of Sydney), Elaheh Shaker(The University of Sydney), MohammadBagher Shamsi(The University of Sydney), Mohammed Shannawaz(The University of Sydney), Saurab Sharma(The University of Sydney), Maryam Shaygan(The University of Sydney), Rahim Ali Sheikhi(The University of Sydney), Jeevan K. Shetty(The University of Sydney), Rahman Shiri(The University of Sydney), Siddharudha Shivalli(The University of Sydney), Parnian Shobeiri(The University of Sydney), Migbar Mekonnen Sibhat(The University of Sydney), Ambrish Singh(The University of Sydney), Jasvinder A. Singh(The University of Sydney), Helen Slater(The University of Sydney), Marco Solmi(The University of Sydney), Ranjani Somayaji(The University of Sydney), Ker‐Kan Tan(The University of Sydney), Rekha Thapar(The University of Sydney), Seyed Abolfazl Tohidast(The University of Sydney), Sahel Valadan Tahbaz(The University of Sydney), Rohollah Valizadeh(The University of Sydney), Tommi Vasankari(The University of Sydney), Narayanaswamy Venketasubramanian(The University of Sydney), Vasily Vlassov(The University of Sydney), Bay Vo(The University of Sydney), Yuan‐Pang Wang(The University of Sydney), Taweewat Wiangkham(The University of Sydney), Lalit Yadav(The University of Sydney), Ali Yadollahpour(The University of Sydney), Seyed Hossein Yahyazadeh Jabbari, Lin Yang(The University of Sydney), Fereshteh Yazdanpanah(The University of Sydney), Naohiro Yonemoto(The University of Sydney), Mustafa Z Younis(The University of Sydney), Iman Zare(The University of Sydney), Armin Zarrintan(The University of Sydney), Mohammad Zoladl(The University of Sydney), Theo Vos(The University of Sydney), Lyn March(The University of Sydney)
Cited by 1,450Open Access
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.
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