Epidemiological trends and geographic disparities in low back pain burden based on the 2021 GBD study: A cross-sectional analysis

Low back pain (LBP) is a global health concern with varying incidence across regions. Recognizing these regional differences is essential for creating effective prevention and control strategies. This study examines the burden and trends of LBP globally using recent data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). We extracted GBD data on prevalence, incidence, and disability-adjusted life years (DALYs) for LBP from 1990 to 2021 via the Global Health Data Exchange (GHDx). Crude and age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs) were calculated globally, and by region, country, age, and sex. Decomposition, frontier, and cluster analyses were applied to identify influencing factors and trends. In 2021, there were 629 million (95% UI: 552-701 million) prevalent cases, 267 million (95% UI: 235-299 million) incident cases, and 70.16 million (95% UI: 65.76 to 83.22 million) DALYs due to LBP globally. From 1990 to 2021, ASRs of prevalence (EAPC = -0.32), incidence (EAPC = -0.29), and DALYs (EAPC = -0.32) declined. Central Europe and Hungary showed the highest burden, while Asia and China had the largest number of affected individuals. High Socio-demographic Index (SDI) regions exhibited the highest ASRs, whereas middle SDI regions had the lowest. Population growth and aging contributed to increasing case numbers, with burden peaking at ages 80-84 and being higher among females. Despite a slight decline in age-standardized rates, the global burden of LBP remains high, with marked regional and demographic disparities. Targeted health policies, particularly for elderly women in high-SDI regions, are essential to effectively reduce the burden of LBP worldwide.