Temporal trends of low back pain burden and joinpoint and age-period-cohort analysis in China from 1990 to 2021

BackgroundThe burden of low back pain (LBP) is increasing rapidly. This study aimed to analyze the temporal trends of the LBP burden in China from 1990 to 2021.MethodsData from the Global Burden of Disease (GBD) 2021 were used to examine the crude and age-standardized rates, along with their uncertainty interval (UI), for incidence, prevalence and disability adjusted life years (DALYs) per 100,000 for LBP, stratified by sex. The joinpoint regression model was applied to calculate the annual percent change (APC) and corresponding 95% confidence interval (CI) for the LBP burden. Additionally, an age-period-cohort analysis was conducted to assess the temporal trends in the LBP burden.ResultsIn 2021, LBP affected 100,093,745 individuals in China. The crude incidence, prevalence and DALYs rates were 3.05% (95% UI: 2.64-3.46%), 7.04% (95% UI: 6.12-7.94%) and 794.08 per 100,000 (95% UI: 557.48-1077.36), respectively. From 1990 to 2021, the age-standardized incidence, prevalence and DALYs rates declined annually by 0.71% (95% CI: 0.67-0.75%), 0.79% (95% CI: 0.75-0.83%), and 0.79% (95% CI: 0.75-0.84%), respectively. The LBP burden was higher in females than in males, with incidence rates rising with age. From the age of 45 onward, women exhibited significantly higher incidence rates than men. Over the past three decades, both period-specific and cohort-specific LBP incidence showed a downward trend.ConclusionLBP remains a substantial public health burden in China, with variations across sex, age, period and cohort. Targeted healthcare policies and resource allocation should be prioritized for high-risk populations, particularly older adults and females.