Comparison of 1990-2021 trend of incidence, prevalence, and disability adjusted life year due to low back pain in China with worldwide: Based on the Global Burden of Disease study 2021 Data

Objectives: This study aimed to compare the temporal trends in age and gender burdens of low back pain (LBP) in China and the global from 1990 to 2021, including incidence, prevalence, and disability-adjusted life years (DALYs), and to predict the burden of LBP in China in the next 15 years. Methods: Using open data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analyzed the characteristics of LBP burden in China and globally, including changes in incidence, prevalence, and DALYs. The average annual percentage change (AAPC) and corresponding 95% confidence intervals (95% CI) were calculated using Joinpoint to reflect trends in LBP burden. The Autoregressive Integrated Moving Average (ARIMA) model was used to predict the future trend of LBP burden in China. Results: From 1990 to 2021, the age-standardized incidence rate (ASIR) of LBP in China decreased from 2,859.38/100,000 to 2,342.46/100,000, while globally, the ASIR decreased from 3,534.99/100,000 to 3,176.63/100,000. Similarly, the age-standardized prevalence rate (ASPR) in China declinedfrom 6,635.49/100,000 to 5,342.10/100,000, while the global ASPR declined from 8,391.58/100,000 to 7,463.13/100,000. The age-standardized DALY rate (ASDR) in China also fell, from 749.03/100,000 to 603.03/100,000, while globally, the ASDR decrease from 937.34/100,000 to 832.18/100,000. Over the next 15 years, China is projected to witness a gradual increase in ASIR and ASPR, along with a continued decline in ASDR. Conclusion: From 1990 to 2021,the burden of LBP in China have fluctuated and decreased, potentially indicating a close association with prior preventive strategies for LBP in China. However, ARIMA predictions suggest that China's ASIR and ASPR for LBP are expected to rise over the next 15 years. This calls for the development of targeted strategies that address the current social realities, particularly the aging population, to mitigate the growing burden of LBP.