GLOBAL COMPARISON OF PREVALENCE AND YEARS LIVED WITH LOW BACK PAIN: 2019

D. Levine¹, F. Tudini¹, K. Johnson²

¹The University of Tennessee at Chattanooga, Physical Therapy, Chattanooga, United States, ²Johns Hopkins Medicine, Baltimore, United States

Background: The global need for physical therapy (PT) continues to increase as the population ages, and as the prevalence of chronic diseases and years lived with disabilities increases. In 2019, 2.4 billion people had conditions that would benefit from PT, which has increased by 63% from 1990 to 2019 (Cieza, 2020). The number of years of life lived with disability (YLDs) has also increased during that time with an estimated 310 million YLDs in 2019 (Cieza, 2020). Years lived with disability (YLD) is a metric reflecting the impact an illness has on the quality of life before it resolves or leads to death. Low Back Pain (LBP) is a common musculoskeletal symptom which occurs in all countries, all age groups, and affects almost everyone during their lifetime. Rehabilitation is a relatively cost-effective intervention that requires minimal resources and has been shown to be effective in improving functional outcomes in different health conditions in low-income and lower-middle-income countries (Dee, 2020), however, rehabilitation has not been prioritized in most countries and is still under-resourced (Stucki, 2018). There is moderate certainty evidence that exercise is a more effective treatment for chronic LBP compared to no treatment, usual care, or placebo comparisons to improve function and for pain outcomes (MD -15.2, 95% CI -18.3 to -12.2) (Hayden, 2021).

Purpose: The purpose of this paper is to examine prevalence and YLDs from LBP globally and to compare global data.

Methods: Using data reported from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we report on the prevalence and YLDs for LBP, and comparisons by the World Health Organizations (WHO) six global regions. These include the African region, region of the Americas, Southeast Asian region, European region, Eastern Mediterranean region, and Western Pacific region (https://www.who.int/#). Chi-square analysis was used to compare regions, genders, and age groups.

Results: Low back pain in 2019 was the leading musculoskeletal disorder requiring physical therapy (PT) services in 134 of 204 countries analyzed.Global prevalence of LBP was 6.97K/100K, and affects approximately 568 million people (95% CI 505–640) and accounts for 64.9 million (45–85) YLDs globally. Variations in LBP between regions were highest for the European region (8.85K/100K) and lowest for the Western Pacific region (5.55/100K), OR 1.65 (95% CI 1.6-1.7, p < 0.0001). The prevalence of LBP in females (8.6/100K) was significantly higher than males (6.1/100K) (OR 1.5 95% CI .95-2.3, p <0.001). Low back pain prevalence increased with each decade of life.

Conclusions: LBP was found to be the leading musculoskeletal disorder in 134 of 204 countries analyzed, with females, and aging being associated with increased rates.

Implications: There is a global need to increase PT services which will ultimately save money in individual countries. How to best manage this need may be country dependent but by working collaboratively on initiatives such as tele-health and screening tools to identify those most in need we can help to decrease this global burden.

Funding acknowledgements: No funding was received.

Keywords:
Lower back pain
Disability
Public Health

Topics:
Disability & rehabilitation
Musculoskeletal: spine
Globalisation: health systems, policies & strategies

Did this work require ethics approval? No

Reason: Data was obtained from the Institute for Heath Metrics and Evaluation. All data is reported in aggregate with no individual data reported.