The Global Burden of Low Back Pain: Estimates from the Global Burden of Disease 2010 study

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SOURCE:   Ann Rheum Dis. 2014 (Jun); 73 (6): 968–974

Prof Theo Vos, PhD, Abraham D Flaxman, PhD, Mohsen Naghavi, PhD, Prof Rafael Lozano, MD, Catherine Michaud, MD, Prof Majid Ezzati et. al.

School of Population Health,
Brisbane, QLD, Australia

OBJECTIVE:   To estimate the global burden of low back pain (LBP).

METHODS:   LBP was defined as pain in the area on the posterior aspect of the body from the lower margin of the twelfth ribs to the lower glutaeal folds with or without pain referred into one or both lower limbs that lasts for at least one day. Systematic reviews were performed of the prevalence, incidence, remission, duration, and mortality risk of LBP. Four levels of severity were identified for LBP with and without leg pain, each with their own disability weights. The disability weights were applied to prevalence values to derive the overall disability of LBP expressed as years lived with disability (YLDs). As there is no mortality from LBP, YLDs are the same as disability-adjusted life years (DALYs).

RESULTS:   Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, LBP ranked highest in terms of disability (YLDs), and sixth in terms of overall burden (DALYs). The global point prevalence of LBP was 9.4% (95% CI 9.0 to 9.8). DALYs increased from 58.2 million (M) (95% CI 39.9M to 78.1M) in 1990 to 83.0M (95% CI 56.6M to 111.9M) in 2010. Prevalence and burden increased with age.

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Years Lived with Disability (YLDs) for 1160 Sequelae of 289 Diseases and Injuries 1990-2010

CONCLUSIONS:   LBP causes more global disability than any other condition. With the ageing population, there is an urgent need for further research to better understand LBP across different settings.

KEYWORDS:   Epidemiology; Low Back Pain; Outcomes Research

From the FULL TEXT Article:


Low back pain (LBP) is well documented as an extremely common health problem [1–4]; it is the leading cause of activity limitation and work absence throughout much of the world, [5] and it causes an enormous economic burden on individuals, families, communities, industry and governments. [6–8] As part of the Global Burden of Disease 2010 Study (GBD 2010), [9] the global burden of musculoskeletal conditions was estimated using updated methods that address methodological limitations of previous GBD studies. [10–12] Burden was expressed in disability-adjusted life years (DALYs).

This paper details the methods and results for estimating the global burden of LBP for GBD 2010. It is one of a series of articles. The overall capstone GBD 2010 papers were published in the Lancet, [9, 13–16] and the papers that report the methods and results for the MSK conditions are published in Annals of Rheumatic Diseases. [17–25] One of these papers describes in detail the methods used for estimating the global burden of the MSK conditions [22] and should be read in conjunction with the current paper.

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