Global Burden, Temporal Trends, and Risk Factors of Low Back Pain Among People Aged 15–49 Years

BACKGROUND: Low back pain (LBP) remains a leading cause of disability worldwide. However, the disease burden among people aged 15-49 years has been insufficiently addressed. OBJECTIVE: The present study aimed to investigate the global burden, temporal trends, and attributable risk factors of low back pain among people aged 15-49 years. METHODS: Using data from the Global Burden of Disease (GBD) study 2021, we analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of LBP across 204 countries and territories. Age-standardized rates (ASRs) were calculated, and temporal trends from 1990 to 2021 were examined using joinpoint regression. RESULTS: According to GBD 2021 estimates, there are approximately 16,993,809 new cases of LBP that occurred worldwide, with South Asia bearing the highest case load. Although ASRs of incidence (AAPC: -0.16; 95% CI: -0.20, -0.12), ASRs of prevalence (AAPC: -0.17; 95% CI: -0.20, -0.14), and ASRs of DALYs (AAPC: -0.16; 95% CI: -0.18, -0.14) declined between 1990 and 2021, absolute case numbers and DALYs increased. Occupational ergonomic factors (28.4%, 95% CI: 26.3%-30.7%), tobacco smoking (11.4%, 95% CI: 7.6%-15.2%), and high body mass index (BMI) (10.9%, 95% CI: 1.1%-21.0%) were the major attributable risk factors. Women always bear a more severe disease burden than men, with the age-standardized incidence rate (ASIR) being 3788.64 vs. 2380.94 per 100,000; the age-standardized prevalence rate (ASPR) being 8822.52 vs. 5410.51 per 100,000; and the age-standardized DALY rates (ASDR) being 999.13 vs. 626.28 per 100,000 in women and men, respectively. When it comes to the socio-demographic index (SDI), ASIR and ASPR initially increased with rising SDI, reaching a peak in Australasia, with ASPR over 12,500 per 100,000 and ASIR over 5000 per 100,000, before subsequently decreasing with further SDI increments. CONCLUSIONS: Despite declining ASRs, the absolute global burden of LBP among individuals aged 15-49 continues to grow, particularly among women and in high-SDI regions. Targeted preventive strategies and control measures are urgently needed.