Background/Purpose: Low back pain (LBP) ranks as the fourth leading cause of disability in the United States, significantly impacting the quality of life and work productivity of those affected. Despite its considerable burden, there has been a lack of consistent and comparative estimates of LBP in the USA. This study is the first to estimate the prevalence of LBP over the last three decades, including the first two years of the COVID-19 pandemic, a period that presented significant challenges in managing non-COVID-19 diseases.

Methods: Using Global Burden of Disease tool 2021, we estimated prevalence, incidence, disability-adjusted life years (DALYs) due to LBP by age, sex, year and location across the USA from 1990-2021. Non-fatal heath outcome were estimated using DISMOD MR 2.1 a meta regression tool.

Results: The total prevalence count of low back pain in the United States increased from 32.2 million (95% Uncertainty Interval: 28.7-35.8) in 1990 to 45.1 million (42.1-47.8) in 2021. The highest total percentage change (TPC) in age-standardized prevalence rate (ASPR) was observed in Kentucky with a 2% increase, followed by Wyoming with 1%, while the remaining states saw decreases. The District of Columbia experienced the most significant decrease in incidence rate (ASIR), dropping by 17% from 1990 to 2021. Kentucky was the only state with an increase in Disability-Adjusted Life Years (DALYs) rate (ASDALR) by 1%, while other states saw decreases. In terms of age groups, the highest prevalence was observed in individuals aged 60-64 years with 4.4 million cases (3.5-5.2 million), followed by an incidence of 1.7 million (1.3-2.2 million) in 2021. The incidence among those under 20 years was 1.1 million, with those aged 20-54 years and 55+ years observing 8.5 million and 9 million cases respectively in 2021. Regarding gender, males showed a higher TPC in prevalence (43% vs. 37%), incidence (41% vs. 38%), and DALYs (40% vs. 35%) from 1990-2021.

Conclusion: DALYs due to LBP accounted for 3.9% of all cause of DALYs in 2021. The increasing prevalence and impact of low back pain underscores the need for enhanced public health strategies and identification of key factors contributing to its rise. The integration of e-health and m-health technologies offers promising avenues for improving management and treatment outcomes. These digital health tools can facilitate better patient engagement, real-time monitoring, and tailored interventions, potentially mitigating the burden of low back pain on a broader scale.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/statewide-burden-of-low-back-pain-in-the-united-states-and-its-trend-from-1990-2021-a-systematic-analysis-for-the-global-burden-of-disease-study-2022/