Global trends in risk factors for low back pain. An analysis of the GBD study data from 1990 to 2021.

Abstract

Objectives: The increasing burden associated with low back pain (LBP) is a critical issue. This is a novel analysis of trends in risk factors for LBP aiming to identify risk factors that require further attention or consideration in global policies, to reduce the burden of LBP.

Methods: The Global Burden of Disease (GBD) study meta-data were used to describe the trends in three modifiable categories of risk factors that contribute to the burden associated with LBP. The trends in occupational/ergonomic, behavioural (smoking), and metabolic (high body mass index (BMI)) risk factors for LBP between 1990 and 2021 have been described with attention to global, high sociodemographic index (SDI) areas, and low SDI areas.

Results: The number of YLDs due to LBP increased globally, in high and low SDI areas between 1990 and 2021. The impact of smoking and occupational/ergonomic risk factors have decreased however, the impact of high BMI has increased markedly in the same time frame, with a particularly concerning impact in high SDI areas and on females.

Conclusions: The burden of LBP is increasing globally, with a significant proportion of the YLDs due to LBP attributed to three modifiable lifestyle factors - occupational/ergonomic, smoking, and high BMI. Of significant concern is the rapidly increasing impact of high BMI on YLDs due to LBP with the greatest impact seen among females in low and high SDI areas. The role of additional risk factors, e.g. physical inactivity, still needs to be determined in the context of the global burden of LBP.