Objective  To analyze the disease burden of low back pain in China from 1990 to 2021, and forecast the changing trend of the disease burden of low back pain in China from 2022 to 2050.

Methods  Data was collected from the Global Burden of Disease Study 2021 Database. The absolute counts and age-standardized rates of prevalence and disability-adjusted life years (DALYs) for low back pain in China were selected for analysis. Joinpoint 5.3.0 software was used to analyze the trend of low back pain disease burden and the annual average percentage change (AAPC), and a Bayesian age-period-cohort model was constructed to predict future trends. Finally, the contribution degree of population size, population age structure and the epidemiological trend to the burden of low back pain in China was discussed by decomposition analysis.

Results  Joinpoint regression analysis showed a decreasing trend in the age-standardized prevalence rate and age-standardized DALYs rate of low back pain in China from 1990 to 2021. The AAPC of them was -0.66% [95%CI (-0.71%, -0.61%)]. In 2021, the number of patients with low back pain in China was 100.094 [95% uncertain interval (UI) (87.128, 113.014)] million, with an age-standardized prevalence rate of 5 342/100 000 [95%UI (4 660/100 000, 5 976/ 100 000)]; the number of DALYs was 11.298 [95%UI (7.931, 15.328)] million, with an age-standardized DALYs rate of 603/100 000 [95%UI (428/100  000, 810/100  000)]. Women had higher quantitative indicators than men. The Bayesian age-period-cohort model predicted an increase in age-standardized prevalence and DALYs for both women and men in 2050. Compared to 2021, the age-standardized DALYs rates for women and men will increase by 9.5% and 2.9%, respectively, and the age-standardized prevalence rates for women and men will increase by 14.2% and 4.7%, respectively. The disease burden of low back pain will be more concentrated in people over 40 years old. The results of the decomposition analysis showed that the population size and the population age structure contributed the most to the changes of the disease burden of low back pain in China.

Conclusion  Despite the downward trend of the disease burden of low back pain in China, the challenges in the future are still severe. The popularization of disease prevention measures is crucial for controlling and reducing the disease burden of low back pain.

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