Social Sciences
Huaichun Yang, PhD
Attending Physician
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai, China (People's Republic)
Low back pain (LBP) is one of the musculoskeletal disorders with the highest global disability burden. This study aimed to explore its long-term trends and future patterns using the Global Burden of Disease Study 2021 (GBD2021) database, providing evidence for understanding LBP’s latest epidemiological characteristics and formulating health policies.
Design:
Based on 1990–2021 global and regional LBP data stratified by age and gender from GBD2021, indicators including incidence, prevalence, Disability-Adjusted Life Years (DALYs) rates, and their age-standardized counterparts (ASIR, ASPR, ASDR) were analyzed. A Stacking ensemble model (integrating multiple machine learning algorithms) predicted the LBP burden through 2035, with the SHAP method assessing contributions of age, gender, year, and population size.
Results:
In 2021, an estimated 267 million new cases and 629 million prevalent cases of LBP were reported globally. Corresponding DALYs increased significantly compared with 1990, predominantly driven by years lived with disability (YLDs). While ASIR, ASPR, and ASDR slightly declined (1990–2021), the absolute numbers of new cases, prevalent cases, and DALYs rose consistently. Model projections suggested a further 25% increase in absolute LBP burden by 2035 compared with 2021 levels. Females and middle-aged/elderly populations consistently bore a higher disease burden, while Central and Eastern Europe, along with certain medium-to-high Socio-Demographic Index (SDI) countries with large populations maintained persistently high levels of ASIR, ASPR, and ASDR over the long term. Age, year, and female gender are the primary positive contributing factors to the increase in the LBP burden.
Conclusion:
Amid global population growth and aging, absolute LBP burden will persistently rise by 2035 despite modestly falling age-standardized rates. Countries should prioritize high-risk populations and regions, develop stratified prevention and rehabilitation strategies, and optimize health resource allocation to mitigate future burden.
