The burden of low back pain in Brazil: estimates from the Global Burden of Disease 2017 Study

Deborah Carvalho Malta,Bruce B Duncan,Ewerton Cousin,Caroline Nespolo De David,Valéria Maria De Azeredo Passos,Lucas De Melo Castro Deligne,Rodolfo Souza Da Silva

doi:10.1186/s12963-020-00205-4

Abstract

BackgroundThe prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study. LBP has been the leading cause of non-fatal health loss for the last three decades. The objective of this study is to describe the current status and trends of the burden due to LBP in Brazil based on information drawn from the GBD 2017 study.MethodsWe estimated prevalence and years lived with disability (YLDs) for LBP by Brazilian federative units, sex, age group, and age-standardized between 1990 and 2017 and conducted a decomposition analysis of changes in age- and sex-specific YLD rates attributable to total population growth and population ageing for the purpose of understanding the drivers of changes in LBP YLDs rates in Brazil. Furthermore, we analyzed the changes in disability-adjusted life years (DALYs) rankings for this disease over the period.ResultsThe results show high prevalence and burden of LBP in Brazil. LBP prevalence increased 26.83% (95% UI 23.08 to 30.41) from 1990 to 2017. This MSK condition represents the most important cause of YLDs in Brazil, where the increase in burden is mainly related to increase in population size and ageing. The LBP age-standardized YLDs rate are similar among Brazilian federative units. LBP ranks in the top three causes of DALYs in Brazil, even though it does not contribute to mortality.ConclusionsFindings from this study show LBP to be the most important cause of YLDs and the 3rd leading cause of DALYs in Brazil. The Brazilian population is ageing, and the country has been experiencing a rapid epidemiological transition, which generates an increasing number of people who need chronic care. In this scenario, more attention should be paid to the burden of non-fatal health conditions.

Highlights

The prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study
Data from the Global Burden of Disease (GBD) study quantified the significant burden of MSK disorders, and its recent publications have shown that the prevalence and burden of MSK conditions are growing around the world [4,5,6]
GBD uses three main indicators to calculate disease burden—years of life lost due to premature mortality (YLLs), years lived with disability (YLDs), and the sum of Years of life lost (YLLs) with YLDs: disability-adjusted life years (DALYs) [24]

Summary

Introduction

The prevalence and burden of musculoskeletal (MSK) conditions are growing around the world, and low back pain (LBP) is the most significant of the five defined MSK disorders in the Global Burden of Disease (GBD) study. Data from the Global Burden of Disease (GBD) study quantified the significant burden of MSK disorders, and its recent publications have shown that the prevalence and burden of MSK conditions are growing around the world [4,5,6]. LBP is the most significant of these, ranking as the top cause of years lived with disability (YLDs) in GBD 2017 MSK disorders —especially in the high-income, highmiddle-income, and middle-income countries (as defined by the socio–demographic index)—and has been the leading cause of non-fatal health loss for the last three decades [6]. A recent series of publications reinforce warnings about the increasing magnitude of this problem [7,8,9,10]

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