591: Global Burden and Cross-country Inequalities in Low Back Pain (1990 to 2021) and Projections to 2050

Topic: Education, Societal Impact, and Others
Subtopic: Epidemiology

Background and Aims: Low back pain (LBP) significantly impacted quality of life and has become the leading cause of disability-adjusted life years (DALY) worldwide. This study aimed to evaluate the global burden and temporal trends of LBP from 1990 to 2021, while identifying the latest attributable risk factors.

Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 to assess the burden of LBP attributed to smoking, high body mass index (BMI), and occupational ergonomic factors across 204 countries and territories. Analyses were stratified by sex, age, geography, and socio-demographic index (SDI) regions. A Poisson regression model estimated annual percentage changes in DALY rate, while mixed-effects models projected LBP burden to 2050 using population forecasts.

Results: In 2021, the global age-standardized DALY rate for LBP was 832.18 per 100,000, with Central and Eastern Europe bearing the highest burdens. LBP attributed to smoking peaked at 60-64 years, high BMI peaked at 75-79 years, and occupational ergonomic factors peaked at 60-64 years in Sub-Saharan Africa. Males had higher burdens from smoking, while females experienced higher burdens from high BMI and occupational ergonomic factors. From 1990 to 2021, DALY for LBP showed a slight annual decline globally (-0.32%). Forecasts to 2050 indicate an overall decrease in LBP burden, though regional disparities will persist.

Conclusions: In conclusion, LBP burdens in 2021 varied by risk factor, peaking earlier for smoking, later for high BMI, and highest for occupational ergonomics. Global LBP burdens declined annually and are projected to decrease further by 2050, despite persistent regional disparities.

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Presenting Author: Yin Li
Submitting Author: Yin Li

Senior Author: Gaojian Tao

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Gaojian Tao: Doctor - Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University