Three Decades on the Burden of Low Back Pain in China, 1990-2019: Estimates From the Global Burden of Disease Study 2019

Abstract

Background: Low back pain (LBP) is an urgent public health concern with huge population base in China since 1990. We aimed to present the China’s burden of LBP through estimating prevalence and years lived with disability (YLDs) from 1990 to 2019. Methods: Data were obtained from systematic reviews of LBP in the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019. A Bayesian meta-regression tool was applied to estimate the prevalence of LBP. YLDs were calculated by multiplying the prevalence of LBP sequelae by their corresponding disability weights (DWs). China’s rank of LBP in the globe was determined, with the uncertainty intervals (UIs). Then analysis on the age-sex-province-specific prevalence and YLDs of 33 provinces/regions in China as well as their relationship with socio-demographic index (SDI) was performed. Findings: Over the three decades, China has had the lowest age-standardized prevalence and YLDs globally while still with the largest number of LBP (91·3 million) and YLDs (8·6 million), ranking as the leading cause of YLDs since 1990. The age-standardized prevalence was 7·25% (95% UI: 6·39-8·17%) in 1990 and decreased to 5·13% (95% UI: 4·55-5·79%) in 2019. The age-standardized YLDs rate was 579/100,000 (95% UI: 411-778) in 2019 with a decrease by 28·97% (95% UI: 26·95-30·82%). Both indicators increased with age, higher in females and varying across 33 provinces/regions for thirty years. The proportion of LBP prevalence and YLDs increased in population <50y since 1990 and both indicators correlated with SDI in 1990 and 2019 (P=0·002 and P=0·014, P=0·002 and P=0·014, respectively). Interpretation: Over the past three decades, China has the lowest age-standardized prevalence and YLDs while with the largest prevalent number. The prevalence and YLDs slightly decreased and was strongly correlated with developing level. There was still vast burden on LBP, particularly for children and postmenopausal women. Funding Statement: This research was supported by the China National Key Research and Development Program (grant number 2016YFC0105606). Declaration of Interests: We declare no competing interests.